The scare campaign against 60-day medication dispensing was bad enough. Then, on Monday, aggrieved pharmacists descended on Parliament House, reportedly hurling abuse at people who work there.
As a reminder of where all the outrage is coming from, the federal government announced earlier this year that it would allow patients to collect a 60-day supply of some medicines when they visit the pharmacy instead of the previous model, which generally only allowed for 30-day supplies. Though the change will initially apply to around 100 drugs for chronic conditions such as high blood pressure and high cholesterol, the pushback from pharmacists has been intense.
Still, the attempt to convince people the sky would fall in if 60-day dispensing came in failed, and hopefully this week’s protests will too. Rather than having the desired effect of intimidating the government, these protests should stiffen its resolve in negotiations about how to pay for community pharmacies.
The change will allow millions of patients to save time and money by avoiding needless visits to the pharmacy amid a cost of living crisis, and with one in 20 Australians skipping prescribed medicines due to cost, the change is a health win too. GPs will also be freed up by not having to see as many patients simply seeking repeat prescriptions, which will likely reduce wait times for people who need appointments for more pressing medical issues.
The policy follows independent advice from the expert group that oversees the Pharmaceutical Benefits Scheme. It has strong support from medical groups. There are similar schemes in the US, Canada, and New Zealand. How often do we see a triple-win for patients, GPs, and taxpayers, supported by experts and international experience?
Yet none of this has stopped the Pharmacy Guild, which represents pharmacy owners, from spinning hyperbolic hysteria.
Few would have forgotten the guild’s president weeping during a press conference about the change or the claims that pharmacies would be forced to close, that Australia would be crippled by medicine shortages or the suggestion that children would be at greater risk of overdose.
These claims were never credible. With the change flagged months in advance and a phased roll-out, there was never going to be supply chain chaos. There are onerous requirements on manufacturers and wholesalers to maintain stockpiles and to supply community pharmacies on tight timelines.
The spectre of pharmacy closures was overblown too. The government committed to reinvesting savings made through the change back into community pharmacies, which includes new funding for vaccination services, subsidies for rural and regional pharmacies and increased services to support people with opioid addictions.
Yes, there will be less foot traffic and associated sales within the pharmacy, but that doesn’t pose an existential threat to their existence. And even if profits were to come under pressure, exaggerated claims and trying to block a big win for patients isn’t the appropriate answer.
The scare campaign lacked perspective. It ignored new revenue pharmacies made over recent years from selling rapid COVID tests and face masks. It doesn’t acknowledge that pharmacy vaccination has gone from unusual to normal, with almost half of COVID vaccinations late last year given in pharmacies, and the major expansion under way to deliver other vaccines.
Forecasts also suggest that the pharmacy industry’s revenue will keep growing because of our ageing population, growing rates of medicine use, new medicines, and new pharmacy services.
The doomsaying also overlooks the industry’s unique protections. Strict regulations control who can own pharmacies and where they are located, reducing competition and benefiting business owners.
Given all of this context, the guild wants to have their cake and eat it too, plus get another cake for later on.
Rates of chronic disease are rising, along with health spending, patient fees, and wait times for care. As people need more support, clinicians will need to work as a team and use all their skills. Shifting funding from dispensing to supporting a bigger role for pharmacists is part of the answer.
The reinvestment of 60-day dispensing savings is a great start. Negotiations over the next pharmacy funding agreement are an opportunity to go further. For example, regulation and funding could change so that pharmacists can play a role in prescribing for chronic conditions, when GPs and patients agree.
That is one way Australia could join other countries by making the most of a highly skilled, trusted workforce that’s available on a walk-in basis in almost every community. The huge contribution pharmacies made during the pandemic could be the start of a new chapter for the industry.
As services expand, red tape blocking pharmacy competition should be cut. Ownership and location rules, too, should be relaxed for pharmacies in high-density areas. Profits might come under pressure from competition, but the new taxpayer-funded revenue streams can make up for it. Like 60-day dispensing, that’s a fair bargain that will leave the community better off.
The guild has distanced itself from the protests in Canberra and has grudgingly stopped opposing the change to 60-day dispensing. But if it takes the same intransigent approach to negotiations over pharmacy funding, we’ll all be worse off.
It’s time for the Pharmacy Guild to put exaggerated claims behind them and focus on constructive proposals for a bigger, better role for pharmacies.
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