The pharmacists of Australia turned faces of naked entitlement towards Parliament and their own client base, jeering and yelling on Monday 4 September 2023

 

Financial Review, 4 September 2023:

Hundreds of pharmacists were in Canberra for a protest on Monday morning, and many pharmacists attended question time in white uniforms, jeering as Prime Minister Anthony Albanese defended Labor’s consultation over the plan.

In an already rowdy question time, Speaker of the House of Representatives Milton Dick warned people in public galleries that they were present as observers, not participants, in parliamentary proceedings and should refrain from interjecting.

But hostilities escalated dramatically when members of the group loudly exited the chamber, with many yelling at MPs on the chamber floor below in a co-ordinated exit.

Some shouted “lies” and at least one pharmacist raised his middle fingers as he walked out. The sitting was disrupted for a few minutes…..

Pharmacists leaving House of Representatives visitor's gallery after disrupting Question Time and also allegedly abusing Parliament House staff. IMAGE: Canberra Times

MPs on the Opposition benches in the House of Representatives cat calling & encouraging pharmacists in the Visitor's Gallery during Question Time on 4 September 2023. It is believed that some of the pharmacists were signed in as visitors by one or more Liberal Party MPs. IMAGE: Daily Mail

Because the industry union, Pharmacy Guild of Australia, has run such a virulent campaign against the the federal government’s reduction of prescription medicine costs to eligible consumer/patients via the introduction of 60-day prescriptions for certain medicines and because Liberal & Nationals members of federal parliament are attempting to turn this issue into a political football, there may be a need to restate what the 60-day prescription scheme entails.

Australian Government, Dept. of Health and Aged Care, 4 September 2023:

60-day prescriptions of PBS medicines

Learn about the changes to Pharmaceutical Benefits Scheme (PBS) medicine prescriptions.

From 1 September 2023, nearly 100 common medicines listed on the Pharmaceutical Benefits Scheme (PBS) will have the option of a 60-day prescription. This means many patients can now receive twice the medication for the cost of a single prescription. To qualify, patients must be:

• living with an ongoing health condition

• assessed by their prescriber to be stable on their current medicine/medicines

• have discussed with their prescriber and obtained a new prescription for a 60-day quantity of medicine per dispensing.

The changes are happening in 3 stages over 12 months and will apply to more than 300 medicines once completed on 1 September 2024.

The changes follow advice from the independent Pharmaceutical Benefits Advisory Committee (PBAC), which recommended it was clinically safe and suitable to allow 60-day prescriptions for eligible patients.

The full list of PBS medicines recommended by PBAC as suitable for dispensing in increased quantities includes some medicines for ongoing health conditions, such as:

• asthma

• breast cancer

• cardiovascular disease

• chronic obstructive pulmonary disease (COPD)

• constipation

• chronic renal failure

• Crohn’s disease

• depression

• diabetes

• endometriosis

• endometrial cancer

• epilepsy

• glaucoma and dry eyes

• gout

• heart failure

• high cholesterol

• hormonal replacement and modulation therapy

• hypertension

• osteoporosis

• Parkinson’s disease

• ulcerative colitis.

The full list of medicines recommended by the PBAC for 60-day prescribing is available on the medicine list for increased dispensing quantities.

Prescribers have the option to prescribe these medicines for either 30 or 60-day prescriptions, according to their professional clinical judgement.

Benefits and cost savings

Patients with a 60-day prescription for a PBS medicine may save up to:

$180 a year, per medicine for Medicare card holders who do not have a concession card

$43.80 a year, per medicine for concession cardholders….

Stage one – available from 1 September 2023

The first stage of medicines available for 60-day prescriptions will support patients stable on their current treatment and living with ongoing health conditions including:

• cardiovascular disease

• Crohn’s disease

• gout

• heart failure

• high cholesterol

• hypertension

• osteoporosis

• ulcerative colitis.

Stage one includes nearly 100 medicines and represents roughly one third of all the medicines available for 60-day prescriptions.

See the list of stage one medicines. The Department is finalising the order of medicines available in stage 2 and 3.

Medicine supply

The move to 60-day prescriptions won’t cause medicine shortages as patients will still buy the same amount of medicine annually. While eligible patients are able to buy double the medication on a single prescription, demand for medicines will remain unchanged.

Of the more than 300 medicines PBAC recommended for 60-day prescriptions, the vast majority have no shortage of supply in Australia. The Department is monitoring the 60-day dispensing medicine list and has ensured that medicines were only included in stage one if they were not in shortage or at risk of shortage.

Medicine shortages can occur for different reasons, like:

• shortages of raw material

• transport issues

• factory quality control issues

• temporary factory closures

• natural disasters.

Most shortages are short-term, temporary disruptions and often only limit some brands, strengths or formulations.

The introduction of 60-day prescriptions in three stages over 12 months reduces pharmacy disruption and let’s supply chains adapt, as eligible patients will use existing prescriptions first.

Helping to ensure good medicine supply

Pharmaceutical companies must tell the Therapeutic Goods Administration (TGA) of expected medicine shortages. This means any medicine supply not likely to meet normal or projected consumer demand at any point during the next 6 months.

The Australian Government has made changes to the Medicines Supply Security Guarantee. From 1 July 2023, medicine manufacturers must have more onshore stockholdings for chosen brands. This will help make sure there is stock onshore, ready for pharmacy delivery to meet any temporary increase in demand.

Wholesalers must deliver to any pharmacy in 24 hours (excluding weekends or public holidays) if they are running low on medicine. This applies for most medicines.

Reinvestments into pharmacy services

The government commits to supporting a thriving community pharmacy sector.

All money saved by the government from reductions in fees paid to pharmacy for supplying medication to patients will be reinvested into community pharmacy.

This is to support the ongoing vital role of the pharmacy sector and give new opportunities for expanding pharmacists scope of practice.

Note: All yellow highlighting is mine.

Read the full advice at:

https://www.health.gov.au/our-work/60-day-prescriptions

The 60 day script for medication treating chronic stable medical conditions was first recommended in August 2018 - it finally arrives in September 2023

 

RACGP: 60-day dispensing a win for Aussie patients

Royal Australian College of GPs

The Royal Australian College of General Practitioners (RACGP) has warmly welcomed the federal Government’s decision to put patients first and make medicines cheaper and easier to access.

It comes following the Minister for Health and Aged Care Mark Butler’s announcement today doubling the amount of medicine a pharmacy can dispense to a patient to up to 60 days’ worth for more than 320 medicines on the Pharmaceutical Benefits Scheme. This effectively halves the dispensing fees for these medicines.

Currently, patients are limited to a 28- or 30-day supply, forcing them to take more trips to the pharmacy for medications for stable conditions. The changes, which will come into effect on 1 September, will save patients up to $180 a year on medications for chronic conditions including heart disease and hypertension.

RACGP President Dr Nicole Higgins said it was a momentous day.

“This is a win for patients,” she said.

“Cost of living pressures are placing tremendous strain on households across Australia, so there has never been a more important time to save patients money and time. Patients with a range of chronic conditions including heart disease will be able to save up to $180 a year and that will make a huge difference for so many households.

“This announcement shows the tide is finally turning. In 2018, the Pharmacy Benefits Advisory Committee recommended increasing the maximum dispensed quantities of common medications from one to two months’ supply. This change has been recommended because it is in the best interests of patients, and I am pleased that the Government has heeded the expert advice.”

Dr Higgins urged the nation’s leaders to remain steadfast.

“Beware of scare campaigns,” she said.

“A recent Westpac report found that pharmacies are reaping record profits, with the total consumer spending in pharmacies rising from $92.5 million in July 2019 to more than $123 million in January this year. Also, despite what you hear from the Pharmacy Guild, there is no evidence of a shortage of the medications that are included in today’s announcement. Some pharmacy owners may be concerned that they will lose retail sales; however, at the end of the day cheaper access to lifesaving medications must come before retail sales, it’s as simple as that.”

The RACGP President said that the was plenty more to be done.

“My aim is for today’s announcement to be just the beginning,” she said.

“Let’s go even further and extend the length of prescriptions for patients with stable chronic conditions. The RACGP also supports further investigation of the benefits to patients in changing the $1 discount rule. It effectively stops pharmacies from discounting medicines that cost more than the current co-payment of $30 by more than $1. When you consider that in New Zealand the patient contribution is as little as $5 for most items, you have to ask whether we can do better here.

“I’m also focussed on reforming the Pharmaceutical Benefits Scheme prescribing system to reduce administration time and free up GPs to do what they do best – care for patients. Right now, the system is too cumbersome and time-consuming. If it was streamlined, GPs would be able to spend more time with patients rather than admin work. As a GP myself in Mackay, that sounds like a winning combination to me.

“It’s also vital that the Government overhauls Australia’s anti-competitive pharmacy ownership and location laws, which inflate costs for patients. The rules appear to be focussed on protecting pharmacy owners rather than increasing patient access to cheaper medicines.

“Today is a great day for Australian patients. The tide is turning, and patient well-being is front and centre – right where it should be. Mark my words, this is just the beginning.”

A recent poll of more than 1,000 GPs who answered the question: “Do you think your patients would benefit from doubling dispensing times to 60 days?” found a staggering 85% said “yes”.

~ ENDS

List of medications possibly being considered for inclusion in 60 day script scheme can be found at:

https://m.pbs.gov.au/industry/listing/elements/pbac-meetings/pbac-outcomes/2022-12/Increased-Dispensing-Quantities-List-of-Medicines.pdf

 

BACKGROUND

AUGUST 2018 PBAC OUTCOMES – OTHER MATTERS, excerpt:

The PBAC considered a list of PBS medicines taken from the Pharmaceutical Benefits Schedule that are indicated for the treatment of chronic conditions. Based on an assessment of clinical safety and ongoing cost-effectiveness, the PBAC recommended that 143 medicines (348 PBS items) were acceptable for listing with increased maximum dispensed quantities (approximately 60 days or two months’ supply per dispensing). The list of medicines accepted by the PBAC as suitable for additional PBS items with increased dispensing quantities (Proposal 2) is available on the PBS website.

Remember in the 2022 federal election campaign Scott Morrison promising voters he would bring down the cost of prescription medicines? He lied. The 1 October 2022 price rise was already locked in with the pharmaceutical industry by September 2021

 

The price of certain prescription medicines will rise on 1 October 2022 and there appears to be some confusion surrounding the subject. After all Scott Morrison repeatedly promised that the maximum cost of prescription medicines would come down across the board by $10.

Now we find that all the while Morrison & Co had entered into an agreement which permanently raised the cost to non-concessional patients of what appears to be hundreds of generic medicines. 

Indeed Morrison appears to have had the terms of a new strategic agreement with the pharmaceutical industry, the 5 year Medicines Supply Security Guarantee, done and dusted in early September 2021 so he was well aware during the April-May 2022 election campaign that he was not be entirely honest with voters.

The new Labor Government Minister for Health and Aged Care Mark Butler does not appear to have created a media release on the subject so far out from implementation of the price hikes and, given that these price hikes are one of the former Coalition Government’s political time bombs left behind to cause maximum pain, former Coalition health minister Greg Hunt is not around to give any sort of explanation as to why costs are going to go through the roof for many general patients.

It is also rather suspicious that it was the Murdoch media who ran with this story on the last working day of the week.

Journalist Sue Dunlevy ran with at least three different versions of the story on Friday, perhaps proving that confusion was not confined to the general public.

SUE DUNLEVY in the Townsville Bulletin, 15 July 2022, p.17:

The price of nearly 1600 prescription medicines is set to rise on October 1 under a deal struck with the generic medicines industry to overcome drug shortages.

The nation’s biggest selling scripts including cholesterol-lowering statins, antibiotics, antidepressants, reflux treatments and diabetes drugs will increase by up to several dollars a script.

Pensioners and concession card holders will not be affected, however, and will continue to pay the set charge of $6.80 a script.

However, the Department of Health and Ageing said “the price increases may result in an increase to the maximum general patient charge for medicines that receive a price increase”.

And they will also come at substantial cost to taxpayers, who will pay generic companies sometimes five times as much for medicines as is paid now.

The rises are the result of a strategic agreement struck between the previous federal government and the generic medicines industry to overcome shortages of medicines.

The deal affects the top 10 most commonly prescribed medicines on the Pharmaceutical Benefits Scheme (PBS). These medicines are off patent and the ex-manufacturer price is currently below $4 a pack.

SUE DUNLEVY in the Herald Sun, 15 July 2022, p.4:

EXCLUSIVE The price of almost 900 prescription medicines will rise on October 1 under a deal struck with the generic medicines industry to prevent shortages.

The nation’s biggest-selling scripts such as statins, antibiotics, antidepressants, reflux treatments and diabetes drugs will increase in price by up to several dollars a script.

The price hike affects all of the 10 most-prescribed medicines on the Pharmaceutical Benefits Scheme.

Some of the medicines, such as the heart drug candesartan, cost just 43 cents a pack. That drug’s ex-manufacturer price will rise to $2.50 – an increase to pharmacists of 480 per cent.

Pensioners and concession card holders are unaffected.

However, the Department of Health and Ageing warned: “The price increases may result in an increase to the maximum general patient charge.” They will also come at substantial cost to taxpayers who will be paying generic companies up to five times as much for medicines as is paid now.

It is a result of a deal struck between the former Morrison government and the generic medicines industry.

A spokesman for Health Minister Mark Butler said: “This was an arrangement nherited from the former government”.

Pricing of medicines under the PBS is highly complex. As well as the ex-manufacturer charge, pharmacists can apply dispensing, administration and handling fees of up to $18.40.

Discount chains such as Chemist Warehouse limit these extra fees and for many of these scripts charge just $5.99. Because they order large quantities they get discounts on the ex-manufacturer prices.

But under the new agreement, these discounts are set to end for drugs priced under $4 – a change that would make it harder for discount pharmacies to maintain their low prices.

Chemist Warehouse director Mario Tascone said the company was not planning price rises at this point.

“Permanently and artificially raising the wholesale price of prescription medicines (which will flow directly to the bottom line of drug companies P & L) seems like an odd thing to do in times where the cost of living is already rising out of control,” Mr Tascone said.

“Previous stock shortages were the result of a once-in-a-lifetime pandemic. Not sure a significant and permanent raising of prices is necessary.” The Department of Health said on its website global medicine shortages were disrupting supply of medicines. Requiring companies to hold up to six months’ supply in Australia would help overcome this.

It said the price rises would help manufacturers of low-cost medicine pay for improvements in the supply chain.

Labor promised to cut the price of prescription medicines by $12.50 a script from 2023 but this applies only to medicines that cost more than $42.50 and will not affect drugs caught up in this new price.

SUE DUNLEVY in The Mercury, 15 July 2022, p.21:

EXCLUSIVE The price of nearly 900 prescription medicines is set to rise on October 1 under a deal struck with the generic medicines industry to overcome drug shortages.

The nation’s biggest selling prescriptions, including cholesterol lowering statins, antibiotics, antidepressants, reflux treatments and diabetes drugs will increase in price by up to several dollars per script.

Pensioners and concession card holders will not be affected by the price rises and will continue to pay the set charge of $6.80 per script.

However, the Department of Health and Ageing has warned: the rise might result in an increase to the maximum general patient charge.

And they will also come at substantial cost to consumers who will be paying generic companies up to five times as much for medicines as they do now.

The price rises will further fuel inflation which the Reserve Bank forecasts will peak at 7 per cent in December.

The price rises are the result of a strategic agreement struck between the previous Morrison government and the generic medicines industry to overcome shortages of medicines.

The deal affects all of the top 10 most commonly prescribed medicines on the medicines subsidy scheme the Pharmaceutical Benefits Scheme (PBS).

These medicines are off patent and the ex-manufacturer price is currently below $4 per pack. Some of the medicines, like blood pressure treatment and heart failure drug candesartan, cost just 43 cents per pack. That drug’s ex-manufacturer price will rise to $2.50.

The nation’s biggest selling treatment, anti-cholesterol drug atorvastatin, which costs $2.95 will jump to $3.45. Rosuvastatin will rise from $1.70 to $2.50.

Anti anxiety treatment sertraline will go from $1.57 to $2.50, while asthma treatment salbutamol will rise from $2.61 to $3.11. “This was an arrangement inherited from the former government,” a spokesman for Health Minister Mark Butler said. 

Most helpfully the federal Dept. of Health has an Excel file listing 1,597 prescription medicine pills, capsules, powders, granules, liquids, ointments, gels, creams, injections, suppositories etc., which are subject to the 1 October price increase - it can be downloaded from here and a two-page fact sheet is available here.