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

As It Happened In The Australian Senate On Thursday 10 August 2023: a case of the biter bit

 

Having left it to the last day both the Upper House and Lower House chambers were sitting in August, to spring what the Opposition obviously thought was a clever raid on Labor's legion holding the Senate, the Liberals smugly alerted the media to their intention to save pharmacists across Australia from a non-existent threat. Rather swiftly the plan began to go awry.

However Opposition forces rallied. 

As Business of the Senate a postponement notice was promptly lodged ie., Notice of Motion No. 1 (to disallow government dispensing reforms making medicines cheaper for six million Australians) in the name of Shadow Minister for Health Liberal Senator Anne Ruston and others, seeking postponement to 4 September 2023.

Then the wheels spectacularly fell off the Liberal Party chariot......

The Guardian, extracts from Live News, 10 August 2023:

15.59 AEST

What happened in the Senate today

This is for those who have asked me what was going on with all that procedure because it was a bit to keep track of.

Yesterday the Coalition gave notice it was going to move a disallowance motion to stop the 60-day dispensing changes coming in from 1 September.

It had to be moved today, because the parliament doesn’t resume until 4 September, after the changes came into effect.

At one point, the Coalition thought it had the numbers to make this happen, or at least could spook the government into thinking it had the numbers to make it happen, and force the government to delay the start date itself.

Along came the Greens who said, actually, no thank you to the disallowance motion, we have been chatting to the government and they are bringing negotiations on the next community pharmacy agreement forward by a year and that is what we wanted.

So that meant the Coalition needed to get all the remaining crossbenchers on board to beat the government on numbers.

The government needed the Greens to all show up in the chamber and one other crossbench MP. Cue late night chats and Mark Butler emerges this morning on the interview circuit saying “watch what happens in the Senate, but we have had VERY PRODUCTIVE chats with the crossbench”.

Very productive chats in that context is “we have the support we need, but can’t say so officially”.

The Coalition, realising it is about to lose, then tried to delay the disallowance motion, pushing it into the next sitting.

Labor, who wanted it dealt with once and for all, decided, actually no, we ARE going to have that disallowance motion today, senate what do you think? And all the senators who were voting with Labor on the motion agreed, meaning it the Coalition couldn’t delay it.

BUT (continued in next post):

Updated at 16.15 AEST

16.03 AEST

How Labor 'adopted' the disallowance motion – and defeated it

(Continued from previous post)

It is very difficult to move another senator’s disallowance motion and shadow health minister Anne Ruston wasn’t moving it (because the Coalition wanted it delayed). Labor tried to force it, but couldn’t because it wasn’t their motion.

So in a bunch of boring procedural motions, Labor managed to de-couple the motion from Anne Ruston’s name, making it an orphan.

The poor little orphaned disallowance motion was sent into the senate orphanage as as a delayed motion to wait out question time, when SURPRISE, it was adopted by Labor senator Louise Pratt.

Before it even had time to see its new bedroom, Labor called to suspend standing orders so it could call it on for a vote, where it was once again centre stage, despite Liberal senator Simon Birmingham objecting very loudly.

But this time all the procedural ducks were in a row, the motion was in Pratt’s name, so Labor had control and a vote was called.

And the disallowance motion was decided in the government’s favour – 33 votes to 28.

Which means that the two-for-one prescriptions slated to begin on 1 September will go ahead, the disallowance motion is defeated and this probably won’t be an issue again until six months time when the next tranche of medications join the list.

We hope that little motion gets to live out its dreams in the hansard now.

Updated at 16.20 AEST

16.34 AEST

Opposition to try to disallow 60-day medicine move again in September

Bridget McKenzie, the Nationals leader in the Senate, has said the opposition will launch a further attempt to disallow the government’s 60-day pharmacy dispensing changes when parliament returns in September.

On Thursday, the Senate voted down a Coalition push to tear up Labor’s changes.

McKenzie, speaking to the ABC, said the opposition had already moved to try to disallow it again.

We have lodged this afternoon another disallowance for this mechanism. This highlights for the government that we are very very serious, it is not good enough to say is not going to have a negative impact, the people’s healthcare delivery and particularly in the regions won’t be impacted when it actually will.

Updated at 16.41 AES

The 60-day script dispensing reform is due to commence on 1 September 2023 and the Senate Chamber does not sit again until 4 September 2023.

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.