By Suzanne Greenwood, Executive Director
The delegation of community pharmacists to Canberra recently was a watershed moment for the profession and one which had a major impact on the country’s politicians and policy-makers.
The delegation saw some 80 community pharmacists and industry representatives from all States and Territories meet in Canberra to explain to their elected politicians the impacts that the introduction of 60-day dispensing will have on their patients, their livelihoods and their communities.
In total, some 100 meetings were held and delegation members impressed upon politicians during their talks that while the introduction of 60-day dispensing at face value seems well intentioned, the unintended consequences would be huge, and the government can certainly not argue that they are unforeseen as every Australian Federal politician has had the opportunity to speak with community pharmacists from their electorates.
I spent much of the week at Parliament House with members of the delegation and it was heartening to see how passionate and committed they were in getting their important message across.
Wearing their white coats, these pharmacists certainly made their presence felt. And during Question Time, when rows and rows of the public gallery was filled with these pharmacists, the visual impact was immense. Parliament House was left in no doubt that these pharmacists were there because they knew the policy wasn’t viable.
Interestingly, many delegates told me that despite a lot of publicity about 60-day dispensing, the people they met with hadn’t really grasped the concept, nor indeed the negative impacts and risks, of such a policy.
It took the face-to-face meetings to really hammer home that 60-day dispensing would mean reduced opening hours for pharmacies and an end to many pharmacies being open after normal business hours, or at weekends. It would force patients to seek alternative advice at hospitals and emergency departments, adding further pressure to an already critically stretched health system.
It would also result in charging for, or reducing the availability of, services like blood pressure monitoring, weighing babies, free home deliveries of medicines, and free health advice when GP surgeries are closed. It would also reduce services to elderly patients, making an already at-risk cohort even more vulnerable.
Many also were not fully aware that the 60-day proposal was first raised in 2018 when the Pharmaceutical Benefits Advisory Committee announced it had “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 were acceptable for listing with increased maximum dispensed quantities (approximately 60 days or two months’ supply per dispensing).” And they didn’t know that quietly that list of medicines had, without consultation with community pharmacists, been raised to 325. Interestingly, at the recent two days of questioning at Senate Estimates, it was revealed that this significant increase that more than doubled the list of medicines was made after only three working days to consider the request – this contrasts starkly to the usual four months for most single-product PBAC submissions. You know what they say, “haste makes mistakes”.
While the recommendation in 2018 had its supporters, it was rejected more than once including on the grounds that it could result in stockpiling, would potentially result in medicine shortages (which already were a growing problem) and also medicine safety fears.
Delegates also pointed out that any introduction for 60-day dispensing midway through the Seventh Community Pharmacy Agreement effectively negated much of the financial basis of that agreement which had been developed and signed on a basis of 30-day dispensing.
Politicians who met delegates were also concerned at the negative impacts that would be felt by constituents in their electorates and many accepted invitations to spend time in a pharmacy to better understand how a pharmacy operates and the extent of services provided by community pharmacies.
Pharmacy representatives reported that many of the politicians met during the two days were very responsive to the concerns of the sector.
All in all I would say this was grass-roots advocacy at its best. It was respectful, but forceful, and had the desired effect of reinforcing that while some people may benefit from the policy, it would ultimately hurt all patients.
I want to thank all the community pharmacist who gave up their time to come to Canberra for a few days to represent their profession and their patients. I also want to thank the pharmacy sector representatives who included representatives from the Pharmaceutical Society of Australia, PDL, the National Australian Pharmacy Students’ Association, WebsterCare, MedAdvisor and Australian Healthcare Providers Advisory Solutions.
