A plan to allow millions of patients to buy 60 days’ worth of medicines for the price of a single prescription has reignited a longstanding turf war between doctors and pharmacists, amid warnings it could lead to supply shortages.
A flurry of online petitions and media releases has followed Federal Health Minister Mark Butler’s pre-budget announcement of plans to double the amount of medicine some people can collect with each script.
The policy will target millions of people with chronic illnesses and include 325 medicines on the PBS, with a staged start from September.
They include drugs used to treat type 2 diabetes like alogliptin and dapagliflozin, the antibiotic doxycycline for severe acne, beta blockers carvedilol and propranolol hydrochloride for heart issues and ezetimibe for high cholesterol.
About 100 medicines will be listed for double-dispensing from September, with a second tranche in March next year and the final tranche in September 2024.
Effectively it means that instead of paying, for example, $30 for one month’s worth of medicine, patients will pay the same amount for a two-month supply.
Doctors will still decide if safe
While it will still be up to doctors to decide if it is appropriate to provide a two months’ supply, the measure is expected to mean fewer visits to the GP because doctors will be able to prescribe 12 months’ supply at a time, rather than six months.
“Over the past five years, patients with chronic disease have literally shelled out hundreds of millions of dollars in co-payments that they didn’t need to shell out,” Mr Butler said.
“We are going to put an end to that.”
The Government estimates the scheme – which needs to be endorsed in the upcoming Federal Budget — will save at least six million Australians more than $1.6 billion over the next four years.
It has pledged to commit its savings from the new measure back into community pharmacy.
The Royal Australian College of GPs, the Australian Medical Association and the Australian College of Rural and Remote Medicine have been quick to back the move – arguing it will be more convenient as well as save money for millions of people with chronic, stable medical conditions.
The RACGP said having bigger pack sizes and longer scripts would not take away the need for regular review but would free up “low value care” appointments that were just for prescriptions.
Warning of med shortages
However, pharmacists have poured cold water on the news, with the Pharmacy Guild — which represents pharmacy owners — arguing that extended dispensing will create medicine shortages and even lead to job losses and businesses closing their doors.
While Mr Butler hosed down warnings of widespread medicine shortages, saying few of the medicines listed for double-dispensing were experiencing supply issues, pharmacists claim they are already having to choose which patients most need medications.
They argue that that if most patients came in wanting double their usual supply of medications, current shortages would quickly worsen.
Pharmacy Guild president Professor Trent Twomey said there were already 472 medications in Australia that were critically short in supply or completely unavailable.
“We’ve got more medicine outages in Australia than we’ve ever had in the history of the Pharmaceutical Benefits Scheme,” he said.
Pharmacists say the proposed changes could also leave regional patients without access to life-saving drugs, and the risk of medication hoarding, overdose and wastage would also increase.
Meanwhile, the Federal Government maintains that new minimum stockholding requirements will be in place from July, meaning that manufacturers of some PBS medicines will be required to hold a minimum four months’ worth of stock onshore in Australia.
This, it argues, will create buffers in the event of a supply disruption, preventing severe shortages.
Mixed reactions
Health consumer groups have largely welcomed the plan, with the Consumers Health Forum arguing that allowing people to buy two months’ worth of medicine for the price of a single prescription would help those struggling with living costs.
“This is a really good move which shows the government is listening to the voices of consumers,” CEO Dr Elizabeth Deveny said.
But the advocacy group Painaustralia was more circumspect, with its CEO Giulia Jones questioning whether the change would benefit consumers, and “the devil would be in the detail.”
“From the consumer’s perspective, those who rely on medicines, I hope this is not another toilet paper crisis (like in the pandemic), where some have plenty and others not enough,” she said.
“If we change from 30 to 60 days dispensing how will the government manage supply, and which consumers will get prioritised in this system?
“Which ones will turn up to the pharmacy and find stock is not available and how will that be managed?”