Guild concerns over pharmacy review

The Pharmacy Guild of Australia says it is concerned that some options in the Interim Report of the Pharmacy Remuneration and Regulation Review, if ever implemented, could put at risk one of the most trusted, sustainable and best performing parts of Australia’s health system.

The Guild says that from the time of the review’s establishment under the former health minister, the organisation has stressed that the review should build on, rather than dismantle, “the best system of community pharmacy in the world”.

Options in the Interim Report lack an evidence base, the Guild says, and have done little to allay its concerns, which include that:

Requiring pharmacies to provide detailed regulatory accounts to the federal government has no legal basis and would be an unprecedented regulatory impost on 5,600 small businesses.

  • Calculating dispensing remuneration on the basis of an efficient cost per unit of production treats a vital patient health service delivered by highly trained health professionals like a utility company transmitting electricity, gas or telecoms.
  • Turning the medicines supply chain on its head by giving individual medicine companies responsibility for guaranteeing timely PBS access for patients would be a leap into the unknown – potentially adding significant transaction costs for community pharmacies.
  • Breaking up the Community Pharmacy Agreement into pieces would run contrary to a more integrated approach to primary care, while including the Consumers Health Forum (CHF) in future agreements makes no sense and was called for only by the CHF itself.
  • Generic medicine tendering with a capped number of generics would exacerbate medicine shortages and be a retrograde step for the pharmaceutical industry.

“While the review panel’s decision not to proceed with any recommendations to replace the location rules [in light of the Pharmacy Compact] is reassuring, the Interim Report still contains conceptual approaches to the location rules that would undermine Australia’s National Medicines Policy and encourage pharmacies to cluster in affluent suburbs at the expense of patient access in outer metropolitan and rural areas,” the Guild said.

Guild National President George Tambassis said: “Australia’s 5,600 community pharmacies, their 50,000 hard-working staff and millions of loyal patients need certainty and security about their ability to deliver and receive the highest quality healthcare. This review should be enhancing rather than threatening one of the most strongly supported parts of Australia’s health system.”

The Guild notes that Health Minister Greg Hunt committed in the recent Pharmacy Compact to work with the Guild to ensure that the government’s response to the review maintains the community-pharmacy model and ensures the future viability of community pharmacies.

The Guild also has noted and welcomes several options in the Interim Report that it says are worthy of further consideration – some of which reflect the Guild’s submission to the review. These include:

  • Abolition of the optional discount of up to $1 of the patient co-payment.
  • Electronic safety-net management.
  • Electronic prescriptions to be integrated with medicine records as the legal record.
  • Better management of medicine risks for patients on discharge from hospital.
  • Remuneration for the same services should be the same for all healthcare professionals.
  • Price caps to limit the cashflow impact of high-cost medicines

Mr Tambassis said: “The Guild will continue to represent the interests of community pharmacy constructively to the review ahead of its final report, in the hope that it sees the benefit of focusing on practical solutions that address real issues and add value to one of the best-functioning and most strongly supported parts of our health system.”