Sixty-day dispensing uptake lagging

Staying up to date of which medicines qualify, software inconsistencies, and resistance from pharmacists have been identified as key factors contributing to low uptake of the Federal Government’s 60-day dispensing policy.
 
That is according to a recently published evaluation gauging GP and pharmacist perspectives, with a focus on antihypertensive medicines, and estimating cost savings compared with 30-day dispensing.
 
The authors analysed Pharmaceutical Benefits Scheme (PBS) dispensing claims from when the 60-day dispensing measure came into effect on 1 September 2023 until 30 April 2025.
 
They also interviewed 20 GPs and four pharmacists across four months in 2024 – finding eight GPs ‘proactively’ offered 60-day prescriptions, six did so if patients asked, and five ‘rarely or never’ prescribed them.
 
GPs identified two main barriers: keeping track of which medicines qualified for 60-day prescriptions, and reports that some pharmacies discouraged or could be ‘unhappy’ about the model.
 
To help address this, the authors say updating prescribing software to ‘clearly show’ which medicines are eligible for 60-day dispensing and setting these as the default where appropriate would help.
 
A separate study released last year revealed similar findings, that complexity over medication eligibility, software barriers, and patient views contributed to slow uptake.
 
The RACGP strongly advocated for the policy to help save time and costs for patients accessing medication.
 
Now, more than two years on, RACGP President Dr Michael Wright believes there are many reasons for the slow uptake and echoes the authors in calling for software updates.
 
‘Even with this relatively slow uptake, we are seeing major benefits to patients,’ he told newsGP.
 
‘There is still a lack of awareness of which medications are applicable, but also the extra step within practice software of having to manually switch from 30 to 60 days will undoubtedly be a barrier.
 
‘Automating that or having a default option for 60-day scripts for applicable stable patients would make that easier for GPs.
 
‘I also heard stories where pharmacists were rejecting the 60-day scripts initially, but as they are now being compensated within the 8th Community Pharmacy Agreement [8CPA], I expect that is now less of a barrier.’
 
The Pharmacy Guild of Australia strongly opposed the reform, raising concerns that more pharmacies would be forced to close their doors with less patients coming in to fill scripts – but those predictions have since been overturned, with the 8CPA ‘ensuring sustainability of the community pharmacy network’.
 
Pharmacists interviewed for the latest evaluation reported incorrect dispensing and shortage of medicines in pharmacy as barriers to uptake, with lost income also cited as a potential barrier for pharmacy owners.
 
Five GPs and two pharmacists expressed concerns that patients on 60-day prescriptions may not return for regular follow-up appointments. Some confusion about PBS safety net rules was also reported.
 
There are currently more than 300 medications listed on the PBS for 60-day dispensing.  
 
Antihypertensives were one of the first tranches of drugs made available when the policy was introduced, and the latest evaluation shows 60-day antihypertensive prescription volume increased from 75,500 to 877,700 over 20 months, accounting for 21.2% of all antihypertensive dispensing by 30 April 2025.
 
This represents a patient saving of around $65 million, following an estimated $1.2 billion spent on hypertension management in primary care in 2021–22. Pharmacy fees accounted for 51% of the cost, with patients covering 82% of pharmacy out-of-pocket costs.
 
The authors estimate that increasing uptake of 60-day dispensing to 50% could generate annual savings of $165 million for patients and a further $11 million for the Federal Government.
 
They added that the financial benefits should be ‘clearly communicated to patients’, and the policy further promoted among doctors and pharmacists.
 
Dr Wright agrees.
 
‘The college has been very supportive of the Government’s proposals to roll out 60-day prescribing as a way to reduce costs for patients and reduce unnecessary pharmacy visits,’ he said.
 
‘I would encourage GPs to make the switch for your patients where you can.’
 
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60-day dispensing antihypertensive medicines GP prescribing medications PBS Pharmaceutical Benefits Scheme pharmacists