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Scrapping medicines authority system should top Govt’s to-do list

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A new Government and a new Health Minister provide an opportunity to fix the long-standing red tape burden imposed by unnecessary regulation of PBS medicines.

AMA members regularly raise with us the impact this regulation has on their practice and their patients. The biggest impact is the requirement to call the Authority Freecall Service for an administrative officer to decide if the medical practitioner can have the necessary authority to prescribe a certain PBS medicine. In 2008-09, 6.4 million calls were made to the Authority Freecall Service, of which only 2.8 per cent did not result in an authority being provided.

Obtaining an authority diverts the medical practitioner from patient care. Based on information about Freecall waiting times provided to the AMA by the former Minister for Human Services, Senator Kim Carr, in November 2012, an estimated 25,000 patient consultations are lost every month while medical practitioners are waiting to obtain authorities to prescribe medicines.

The Coalition’s election policy document, Boosting Productivity and Reducing Regulation, states that “regulation should only be imposed where absolutely necessary and should not be the default position in dealing with public policy issues”. The Coalition has committed to a comprehensive review of legislation and regulations to repeal in its first term.

The AMA briefed the-then Shadow Health Minister Peter Dutton early this year about the PBS Authority Medicines policy and its negative impact on medical practitioners and their patients.

The AMA fully supports the objectives of the PBS to provide subsidised, cost-effective medicines to the Australian public. We understand that the Government needs to ensure taxpayers receive value for money, and that includes appropriate, quality prescribing by medical practitioners.

However, the AMA is still to see evidence that the PBS Authority Medicines policy is an effective or efficient way to achieve this.

Our view is that the authority system imposes an administrative burden on the vast majority of medical practitioners who do the right thing in order to potentially deter the few who may seek to prescribe outside the PBS requirements.

The Department of Human Services’ (DHS) compliance program already identifies individual medical practitioners with prescribing habits different to their peers, and audits prescribing of PBS medicines to patients who do not meet the PBS conditions.

The National Prescribing Service’s MedicineWise program is funded by the Government to improve the quality use of medicines. For example, it provides individual medical practitioners with information to compare their prescribing patterns with those of their peers, based on DHS data, and collects and analyses detailed information about how and why medicines are prescribed in medical practices, and whether prescribing aligns with recommended best practice. This information informs policy and clinical practice and shows the effectiveness of the PBS, particularly how new PBS medicines are used.

The DHS has other means than the authority system to track medicines prescribed and dispensed under the PBS, and allow detailed information on utilisation to be collected and analysed. This information can inform NPS activities and highlight risk areas to be audited by DHS.

The AMA urges the new Government to look at the PBS Authority Policy as one of its first deregulation projects. To assist, the AMA has provided a detailed submission (based on Therapeutics Committee advice) that proposes a staged approach to lifting the burden of the authority system.