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‘It’s a no-brainer’: Prominent backing grows for extended dispensing


Anastasia Tsirtsakis


10/03/2023 3:44:06 PM

In Parliament this week Dr Monique Ryan asked the Health Minister to put in place the 2018 PBAC recommendation for 60-day limits.
 

Pharmacist dispensing
GPs say doubling dispensing limits is a simple cost-saving measure and easy to implement.

With the May Federal Budget just months away, and healthcare reform on the table, GPs say that there is a clear way to save costs when it comes to medication – but it has been sidelined.

That is extending the dispensing rule from a 30-day supply to 60.
 
Doctors say that doubling the limit to allow for a two-month supply through the PBS could provide a significant cost saving of almost $200 per script each year and that it would help to alleviate cost-of-living pressures for the most vulnerable.
 
The initiative was placed firmly back in focus this week by independent MP and paediatric neurologist, Dr Monique Ryan.
 
During Question Time this week, on 6 March, the member for Kooyong brought Federal Health and Aged Care Minister Mark Butler’s attention back to a recommendation made in 2018 by the Pharmaceutical Benefits Advisory Committee (PBAC), calling for the Government to allow prescribing of two months’ supply for 143 medications. 
 
‘This would save dispensing fees of up to $180 a year per prescription medicine and take pressure off GPs,’ Dr Ryan said.
 
‘Will you commit to decreasing healthcare costs by making this change to the PBAC?’
 
While Minister Butler did not confirm or deny such a move, saying that the Government is in no ‘position to make any particular announcements’, he did acknowledge the cost-of-living pressures many Australians are facing and said they are taking these matters ‘very seriously’.
 
‘The member for Kooyong is right: the PBAC has made other suggestions about ways in which that cost-of-living pressure and also the convenience of patients can be improved – in which pressures can be alleviated, including the number of times they need to go to GPs, get scripts or go to the pharmacist to have their medicines topped up,’ he said.
 
‘We’re looking at all of the options available to Government to make access to health care better and easier for patients, and to make the cost of health care, including the cost of medicines, even cheaper.’
 
According to the Australian Bureau of Statistics, the proportion of people who delayed or did not get prescription medication when needed due to cost increased to 5.6% in 2021–22 – up from 4.4% in 2020–21.
 
Those most likely to delay or go without their prescription included women, people aged 15–24 years, those living in areas of most socio-economic disadvantage and those with a long-term health condition.
 
For a number of years, the RACGP has been advocating for Government to make a move on extending the dispensing rule.
 
Dr Michael Wright, Chair of RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), told newsGP that in the face of rising living costs, allowing patients to have greater access to their regular medications clearly makes sense.
 
‘It seems like a sensible idea in making it easier for patients to access the medications they need and also reducing the administrative burden for patients and for prescribers,’ he said.
 
‘It means less trips to the pharmacy, less trips to the GP and if it is for long-term medications, any reduction in those potentially unnecessary visits will free us all up to do other work, which we know we need to do.’
 
Dr Wright said by reducing red tape, the change would also help to save money within Australia’s health budget, which he says ‘could be better spent elsewhere’ – and also take the pressure off overrun GPs.
 
‘Given these cost-of-living pressures, we have to look at every way that we can introduce savings to reduce pressure on patients,’ he said.
 
‘So, this is good for patients, but it’s also good for the system by saving us money. It will save costs both to patients, but also to the health system.
 
‘And we know GPs are overworked, so creating one less task for us, as well as saving money for patients, seems like a bit of a no brainer.’
 
While extending the dispensing rule has support from the PBAC, the RACGP and others within the health sector, the proposed idea has faced strong opposition from the Pharmacy Guild of Australia, with Dr Cathryn Hester, member of the REC–FHSR, previously telling newsGP that the lobby group has ‘commercial reasons’ to reject the recommendation.
 
‘These changes will cause a reduction in dispensing fees and less foot traffic through retail pharmacies and pharmacy owners are worried that this will reduce their record-high profits,’ she said.
 
‘This is very disappointing, that profits of pharmacists have been prioritised over patient health, and it is clearly time for this to be redressed.’
 
Extended dispensing is a proposed reform that has previously been omitted – an outcome that has disappointed both GPs and patient groups – but Minister Butler appears to be keeping the Government’s options open this time.
 
Speaking to the House of Representatives this week following Dr Ryan’s question, he went on to highlight the initiative to save people $12.50 per general scripts, which was introduced on 1 January.
 
While the Minister said it has ‘made a real difference’, he noted the potential for further measures.
 
‘There is much more that we can do, and we’re examining all of those options very closely,’ he said.
 
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Dr Khalaf Adib Haddadin   11/03/2023 7:27:39 AM

Let’s see what the pharmacy guild has to say about this suggestion.
They are going to resist this with all their might .


Dr Sally Dunbar   11/03/2023 8:07:37 AM

For non-concessional patients a lot of common medications are no more expensive on a private script. Larger quantities can be prescribed, avoiding monthly trips to the pharmacy.


Dr Winston Smith   11/03/2023 10:23:54 AM

The 60 day supply rule is eminently sensible. This will save patients a lot of money and they can recoup the time lost visiting the chemist and use it for a more productive activity. Of course, the pharmacy shop keepers will be furious at the lost opportunity for selling the dross that fills their shops.
I don’t think this rule should apply to all medications (eg. Those with a low therapeutic index, abuse potential or diversion risk).


Dr Christine Colson   11/03/2023 4:24:12 PM

This is but one of a myriad ways we can make healthcare more efficient. Yesterday I left the surgery about 7 pm - there's still work left over but I was overstretched. I 'reflected' on the day's work and decided that if all patients had to put their hands in their pockets, (even for as little as $5 and I don't care if it doesn't go to me), I reckoned about a half a dozen patients would have had second thoughts about coming. Successive governments haven’t had the balls to do this – happens over the ditch, why not here?