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Dire 60-day script predictions fail to materialise
As well as saving patients money, more pharmacies have opened than have closed since the policy first came into effect in September 2023.
Millions of scripts have been dispensed under the new 60-day dispensing arrangements.
Of all the recent health policy reforms in Australia, the move to 60-day dispensing has been one of the most fraught.
On paper, it seemed a simple proposal to benefit patients, supported by numerous health advocacy groups, including the RACGP and Consumers Health Forum, among others.
Backed by a Pharmaceutical Benefits Advisory Council (PBAC) recommendation in 2018, it suggested doubling the amount of certain medications – for treating chronic, stable conditions – that a pharmacy could dispense at one time.
According to the PBAC, the move from 30 to 60-day dispensing ‘would allow clinicians to exercise greater choice and provide patients both financial and convenience benefits’, reducing the time people had to travel for medications and cutting their dispensing fee costs.
However, the reality when the Federal Government announced the policy in April 2023 proved more complex.
There were warnings of more hoarding; the spectre of increased shortages was raised, as was the potential financial impact on pharmacies around the country.
A report commissioned by the Pharmacy Guild of Australia suggested as many as 665 pharmacies could close if the policy were introduced, with 900 more put under financial stress.
Published in June 2023, the analysis also warned of the potential loss of up to 20,818 pharmacy workers over four years – more than a quarter of the estimated workforce.
Perhaps most memorably, after the policy was announced the Pharmacy Guild’s President Professor Trent Twomey broke down at a press conference, saying the Federal Health and Aged Care Minister Mark Butler did not seem ‘to give a shit’ about its potential commercial impact.
At one stage, it even seemed possible the plan could be stalled by the Senate.
Now fully in effect, the policy has seen increased dispensing time for almost 300 PBS medicines treating stable, ongoing conditions ranging from asthma to breast cancer, with the final tranche coming online last September.
So, what has the impact really been?
In short, the predicted pharmacy closures have not transpired.
In figures confirmed to newsGP by Minister Butler’s office, there were 165 new pharmacy applications from the introduction of 60-day dispensing in September 2023 until the end of November last year.
Of those, 87 were approved, while 22 pharmacy approvals were cancelled, leaving a net gain of 65 pharmacies. Applications for relocating and changes of ownership were not included.
Minister Butler said the Government’s ‘hard-fought reforms’ had delivered cheaper medicines to millions of Australians.
‘We know it’s not just good for patients’ hip pocket, it’s also good for their health,’ he told newsGP.
‘Despite claims that pharmacies would close because of 60-day prescriptions, the opposite has happened.
‘More pharmacies have opened and they’re delivering more services.’
RACGP President Dr Michael Wright said he welcomed confirmation of the benefits of 60-day dispensing for patients.
‘We strongly supported the Government’s introduction of 60-day dispensing – it was clearly going to be a win for patients, particularly for people with chronic health conditions and facing cost-of-living pressures,’ he told newsGP.
‘With more than a year since the policy first came into effect, it is great to see the significant benefits it has brought to some of the most vulnerable people in our community without any obvious drawbacks.’
However, a spokesperson for the Pharmacy Guild said negotiations of the 8th Community Pharmacy Agreement (8CPA) were brought forward to mitigate the impact of 60-day prescriptions – a move they said provided important context for the modelled closures and job losses.
‘[The 8CPA], negotiated between the Pharmacy Guild and the Commonwealth Government, ensured the sustainability of the community pharmacy network and preserved community pharmacy as the most accessible primary health care destination,’ they told newsGP.
‘The 8CPA’s $3 billion investment in cheaper medicines and the community pharmacies that deliver them means Australia’s more than 6000 community pharmacies remain viable, open and able to deliver for patients.’
The 8CPA came into effect in July last year, and will run until June 2029.
The spokesperson also drew attention to the Pharmacy Guild’s support for Government cuts to PBS co-payments for non-concession card holders.
‘More affordable medicines have already saved Australian patients more than $346 million: three times the savings delivered by 60-day dispensing,’ they said.
In the meantime, Dr Wright said increased dispensing times had brought wider benefits for general practice.
‘As well as saving patients time and money, needing fewer trips to pick up medicine and repeat scripts, it has also freed up GP consultations where they are needed most, another positive impact for the health of our communities,’ he said.
According to the Federal Government, around 10 million scripts had been delivered under the new 60-day dispensing arrangements by the end of July last year.
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