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Home medicines services capped as spending blows out


Patient access to services aimed at improving medication use is to be rationed following concerns of a cost blowout.

The Federal Health Department and the Pharmacy Guild of Australia have agreed to cap services provided through the Home Medicines Review (HMR) and other medication programs amid fears funding for the service would run out before the current Community Pharmacy Agreement expires in mid-2015.

Under the changes, which came into effect on 1 March, a referral for a HMR will expire after three months, and there will be strict cap on the number of HMRs and MedsCheck/Diabetes MedsCheck services GPs, pharmacists and other health professionals can commission.

For HMRs, there will be a limit of 20 a month for each service providers, and for MedsCheck/Diabetes MedsCheck services there will be a combined limit of 10 services per month for each s90 pharmacy.

The Pharmacy Guild said “these changes have been agreed between the Guild and the Department of Health in the interests of patients, community pharmacy, the pharmacy profession and taxpayers”.

Guild National President George Tambassis said the changes would ensure the continued viability of these services.

“The new capping arrangements for some medication programs are necessary to ensure that the programs stay within budget and do not compromise the range of other important programs and services funded through the Fifth [Community Pharmacy] Agreement,” he said.

But the Society of Hospital Pharmacists of Australia has voiced alarm about the changes, claiming they had the potential to put patients at risk.

The Society said it had “grave concerns” that the HMR cap and changes to access to Residential Medication Management Reviews (RMMR) would compromise patient safety.

President Professor Michael Dooley warned the wellbeing of aged care facility residents, in particular, could be threatened.

“This group of patients is at high risk of medication misadventure, particularly when they become frail and their health deteriorates,” Professor Dooley said. “A limit of on RMMR service every two years is entirely inadequate for this high risk group.”

He questioned the policy priorities that appeared to underpin the changes.

“The focus should always be the patient, and their health and wellbeing,” Professor Dooley said. “These changes appear to be focused on meeting budgetary targets rather than being a strategy to ensure that those consumers who most need medicines management reviews receive those services.”

But Mr Tambassis said “all of these changes are about making the best use of available funds to deliver the best possible services to patients who most need them”.

Adrian Rollins