The remuneration that pharmacists receive for dispensing Pharmaceutical Benefits Scheme (PBS) medicines has been governed since 1990 by a series of agreements between the Australian Government and the Pharmacy Guild of Australia, who represent the majority of community pharmacy owners.The Sixth Community Pharmacy Agreement (CPA) is now in place and provides almost $19b to over 5000 community pharmacies for medical dispensing.
In November 2015 The Australian Department of Health commissioned a review panel to conduct an independent review of Pharmacy Remuneration
and Regulation to consider payments made to community pharmacies for pharmaceutical dispensing of PBS medicines and to look at the overall role of community pharmacy in the community.
The Pharmacy Review discussion paper, released in April 2016, proposed an incentive payment to encourage pharmacies to operate after hours to support those patients visiting GPs outside of business hours who may then expect to access prescribed medicines through pharmaceutical dispensing.
In its submission to the King Pharmacy Review, the Royal Australian College of General Practitioners (RACGP) has made a number of recommendations, one being that General Practitioner doctors should be given greater doctor dispensing rights.
The RACGP’s view is that many pharmacies already have extended business hours and that the additional incentive is unnecessary.
Concerns have been raised that pharmaceutical dispensing poses health risks to patients because of the ad-hoc nature of patients seeking treatment through pharmacies and the RACGP states that allowing greater doctor dispensing will improve continuity of care and promote a more cost-effective and coordinated health system.
There are also concerns about pharmacies expanding into services traditionally provided by GPs, such as vaccinations, because pharmacy settings do not provide the necessary environment for administering vaccinations.
The RACGP believes that many services being offered by pharmacists unnecessarily duplicate the role of GPs and that pharmacists, as a retail business model, can have health implications for patients through the sale of complementary or alternative medicine which may cause patients to devalue evidence-based medications or delay consultations with doctors.
The recommendations of the RACGP submission also calls for greater collaboration between pharmacies and GPs and that location and ownership rules be replaced by incentive-based methods of increasing patient access to PBS medicines.
Among the recommendations made by the Pharmacy Guild of Australia are that medical dispensing arrangements for urgent PBS medicine be expanded to include other medicines used to treat chronic health conditions and that a proportion of the savings from PBS reforms is reinvested into ensuring that the core clinical role of pharmaceutical dispensing remains viable.
The Review of Pharmacy Remuneration and Regulation is expected to be completed in March 2017. So we’ll certainly know more then.