Doubling the number of medicines a person can collect with each prescription from one to two months’ supply could save patients up to $180 a year and reduce the government’s payments to pharmacists for dispensing scripts, while freeing up doctors’ time in a stressed health system.
As the federal government is forced to find hundreds of millions of dollars for health spending in the May budget, the Royal Australian College of GPs (RACGP) will push for reforms to prescription rules it says will also ease cost of living pressures for patients now paying $41 on average to see a doctor.
They also want 12-months’ supply in a single script, instead of six, to save people a trip to the doctor each year.
Prominent independent MP Dr Monique Ryan, the consumer health lobby and the Australian Medical Association are backing the push for the government to change dispensing rules and follow a 2018 recommendation from the Pharmaceutical Benefits Advisory Committee, which said 60 days’ supply and 12-month scripts should be available for 143 medicines used to treat chronic conditions.
But Health Minister Mark Butler, who opened the door to the reform in question time this month when he said the government was looking at all options to improve healthcare, will face resistance from pharmacists who would lose income under the scheme. They have vowed to oppose it, saying the current system strikes the right balance between convenience and safety.
RACGP president Dr Nicole Higgins said the government spent $1.67 billion on pharmacy dispensing fees in 2021-22 and the change, which would halve the fees paid each year for the 143 commonly prescribed medicines, could deliver significant savings to a stretched budget.
“There are simple reforms the government can and should make that will save patients’ money and time, as well as freeing up GPs so we can see more patients, and reducing the overall healthcare budget,” she said.
“These reforms are an easy way to help those most in need, including people who are older and those with chronic conditions [such as heart disease] who often need multiple medicines.”
Butler told the pharmacy sector’s annual conference on the weekend he needed to find “hundreds of millions of dollars” in the health budget to fund programs that were a mainstay of the health system – including My Health Record, public dental services and after-hours GP services – but had not been accounted for in forward estimates by the previous government.
However, he would not respond to questions about whether the government would change dispensing rules to do so. “We’re in the pre-budget period, increasingly things become highly fevered and speculative,” he said when asked at the conference.
“Any number of ideas [that] have been speculated about in the upcoming budget … will become clear in May.”
Ryan said the reform was an immediate opportunity in the May budget for the government to cut red tape, improve access to medicines and make Medicare more efficient and cost-effective.
“The cost of medicines is exacerbated by the increasing out-of-pocket cost of GP visits. Time spent away from work for those visits and for trips to the pharmacist impacts productivity,” she said.
“The 21-year-old on the pill, the 70-year-old with longstanding scripts for high cholesterol, hypertension, diabetes and gout, the 55-year-old perimenopausal woman on [hormone replacement therapy] – all could see their doctor when they needed to, for the right reasons, rather than being forced to go back for routine scripts at inopportune times.”
The Australian Medical Association has estimated patients’ savings would be up to $180 a year on selected medicines.
President Steve Robson wrote to Butler earlier this year urging him to adopt the reform, which pharmacies have strongly opposed and had been shelved by the previous government.
“We think that there is an opportunity for your government to show leadership and move forward with this independent recommendation. It is a safe, practical change that will make a difference to patients. The profession will support you in moving forward to implement the proposal,” he wrote.
But a spokesman for the Pharmacy Guild, which has long opposed the reform, said it continued to do so.
“The current system of generally providing one month’s supply of a medicine strikes a practical balance between patient convenience and minimising the availability of medicines in a patient’s home, and hence the community,” he said.
“When a patient returns to their community pharmacy for a repeat supply of a prescription medicine, pharmacists have the opportunity to access patient compliance with the prescribed medicine, and can intervene if confusion or adverse reactions to medicines are identified.”
The pharmacy sector is pushing for pharmacists to play a greater role in the health system, and several state governments are trialling expanding their prescription powers for items such as the contraceptive pill and antibiotics for urinary tract infections.
Butler has flagged he wants all health professionals – including pharmacists, nurses and allied health workers – to work to a greater capacity as part of the Medicare reforms. However, doctors’ groups have resisted giving pharmacists greater powers to prescribe.
Chief executive of the Consumers Health Forum, Elizabeth Deveny, said the issue of pharmacists prescribing had “become a debate about health professionals protecting their patches rather than what is best for consumers” and required nuance.
However, she said doubling the dispensing rule from 30 to 60 days was a “simple measure that could help consumers access medicines more quickly without the need to visit a GP”.
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