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Government ‘open’ to talks about role of pharmacy

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Health Minister Peter Dutton has flagged the Federal Government is “open to discussions” about the scope of services that pharmacists can provide.

With negotiations on the next Community Pharmacy Agreement (CPA) looming, Mr Dutton has reassured pharmacists the Government would block any move by retail giants Coles and Woolworths to move into dispensing and left open the possibility of expanding the scope of pharmacy practice.

“I don’t believe pharmacists want to be doctors, nor retailers,” the Minister told the Australian Pharmacy Professional Conference on 13 March. “[But] the time is right to commence a discussion about the future of pharmacy… so I am open to discussions about an agreement which pays for tangible services and interventions that will provide better patient outcomes.”

Mr Dutton made his remarks as pharmacists braced themselves for a another hit to their profit margins as a result of the latest round of drug price cuts that came into effect on 1 April (see Billions could be saved as drug prices fall).

The Minister admitted that the accelerated price disclosure regime established by the previous Government had added to the financial strain on pharmacies in recent times.

“It has been a tough period for a number of pharmacies over recent years,” the Minister said. “People have been caught with the pressures of high rents, rising wages and other input costs and uncertainty and, in some cases, unmanageable levels of debt as a result of the former Government’s CPA and accelerated price disclosure.”

In their search for more revenue, pharmacists have mounted a controversial and increasingly aggressive push to expand their range of practice to include administering vaccinations and possibly undertake routine health checks.

The Queensland Government is expected this month to authorise the expansion of a pilot program under which pharmacists give flu vaccinations to customers.
And NSW Health Minister Jillian Skinner has given in principle support for pharmacists “being included in immunisation service delivery models”, in a letter to the Pharmaceutical Society of Australia seen by the Australian Financial Review.

But the AMA and other medical groups have voiced strong objections to the move, which they warn could put the health of patients at risk because pharmacists were not trained to provide such treatment.

Late last month the nurse practitioner Revive Clinic Group took out an advertisement in a Queensland newspaper in which it claimed pharmacists were not legally approved to administer vaccinations anywhere in Australia.

Group Managing Director Louise Stewart told Medical Observer the Queensland pilot project, which has expanded to include almost 60 pharmacies, was potentially misleading because patients taking part were not told that the service was a trial.

But the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia have hit back, condemning Revive’s statement as “false and misleading”.
Pharmacy Guild President George Tambassis said pharmacists taking part in the Queensland trial had been authorised to administer vaccinations, and the Northern Territory had introduced similar legislation.

National President of the Pharmaceutical Society Grant Kardachi said pharmacists were undertaking additional training in administering injections.
While he was careful not to explicitly endorse such an expansion in pharmacy practice, neither did Mr Dutton voice objections.

“Pharmacists should receive a fair and proper return on their capital investment, and financiers should know that is a key objective of the Government,” the Minister said.

Mr Dutton made his comments just days after his Government’s surprise decision to axe the Pharmaceutical Benefits Pricing Authority, which made recommendations on the prices of medicines on the PBS.

In a surreptitious move, a statement was published early last month announcing that the PBPA would cease operations from 1 April as part of a “new streamlined process to reduce the time taken to list medicines on the Pharmaceutical Benefits Scheme and improve access to medicines”.

While the final decision on medicine prices remains with the Health Minister, the Government said the change – which blindsided the pharmaceutical industry – would cut at least four weeks off the time needed to list medicines on the PBS.

“At the same time, sponsors will benefit from having additional time, to the end of week five after the meeting of the PBAC, in which to finalise pricing submissions following a positive PBAC recommendation,” it said, adding that there would be no change to current arrangements for sponsors seeking price increases for currently subsidised medicines.

Adrian Rollins

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