By Mikayla van Loon
With changes to the way some medicines will be dispensed across the country, a Lilydale pharmacy is concerned with the impact that will have on its services.
Amcal Lilydale owners Megan and Frank Kazantzis said come 1 September as the 60-day dispensing policy begins to roll out, they will seriously have to consider cutting staff and current services to cater for the loss of income.
“We’re all for affordable medications for patients, but it should be for everyone, not just for people who are taking this thing and in this way,” Megan said.
“And it shouldn’t be out of our pocket because it’s really great to say they can have two boxes, but the reality is before, we were paid for those two boxes, and now we’re still just being paid for one of them and giving the second one away out of our pocket.”
The 60-day dispensing policy introduced by the Federal Government aims to reduce the cost of medications for patients with chronic conditions, including asthma, diabetes, endometriosis and high cholesterol.
“The Government is delivering cheaper medicines through 60 day dispensing for more than six million Australians,” a spokesperson for health minister Mark Butler said.
Having owned and run the Amcal pharmacy since 2018, Megan said despite being part of a franchised company, she and her husband Frank are essentially small business owners.
“Having to have our revenue halved is devastating because that’s how we pay our bills,” she said.
“We’ve done the numbers for our business and it’s almost $200,000 a year. So it’s massive, it’s more than the business makes.
“So what that means, in reality, we employ about 15 people here, we’d be looking to lay off at least three people and obviously that’s devastating, because most of our team have young families.”
One of those staff members will most likely be a pharmacist, meaning only one pharmacist will be working in the dispensary per day, limiting the pharmacy’s ability to provide other services like vaccines, glucose testing and blood pressure testing.
The Federal Government does intend, from 1 July, to pay pharmacies seven per cent more for dispensing PBS medicines but Frank said this was already expected.
“That’s a CPI increase that was already inbuilt into the current Community Pharmacy Agreement, it’s just indexation,” he said.
“It’s not new money. It was actually an increase we were expecting because the cost of goods and everything has gone up.”
The Australian health department’s calculations however, indicate that with the new policy and the funding of other programs the average metropolitan pharmacy will earn more than $41,000 extra per year.
“Every single dollar saved by the Government will go back into pharmacy services, so pharmacists can continue to play an even more central role in the healthcare of Australians,” the spokesperson said.
Some of those programs include expanding the National Immunisation Program to pharmacies which will pay $19 for a vaccine to the pharmacy administering it, as well as the broadening of the PBS Opioid Dependence Treatment program for treatments in community pharmacies.
But despite these programs benefiting the community, Megan said it’s not new money and in fact they will again be at a loss for the vaccines.
“They pay us for giving vaccines, which is great, we don’t want people to have to pay for vaccines. It’s great if the government pays,” she said.
“But at the moment we do charge people so it doesn’t offset the money in any way because at the moment, our customer pays us $24 to get a flu vaccine.”
Pharmacy Guild of Australia Victorian Branch President Anthony Tassone said an independent report estimated a $4.5 billion cut to the industry would impact patients and their ability to get medicine, advice and services from their local pharmacy.
The report, conducted by renowned economist Henry Ergas AO with Tulipwood Advisory and the Relational Insights Data Lab at Griffith University, found that up to 20,000 jobs will be lost, 665 pharmacies will close and a further 900 will be at risk of closing due to significant financial pressure as a result of the 60-day dispensing policy.
“The Federal Government needs to work with our sector to ensure patients and community pharmacies will be no worse off under their 60 day dispense policy otherwise jobs, pharmacies and vital health services that older and vulnerable patients rely on are all at risk,” Anthony said.
The 60 day dispensing policy came from a recommendation of the Pharmaceutical Benefits Advisory Committee (PBAC) to make critical medicines cheaper for Australians.
“Every year, nearly a million Australians are forced to delay or go without a medicine that their doctor has told them is necessary for their health,” Minister Butler’s spokesperson said.
While the government has acknowledged that dispensing forms a large part of the work pharmacies do, the spokesperson said there are other elements to their services.
“Dispensing medicines is complex and critical, but it’s not the only reason Australian pharmacies are so highly valued,” they said.
Megan and Frank said it was insulting to have the government downplay the value of dispensing medications, as it is their “bread and butter” as trained pharmacists.
“We live in an area we’re passionate about and provide accessible health care to the community and the way they paint us out is really upsetting,” she said.
“We’re actually trying to deliver a health service. So even though there are other things that get sold in the pharmacy, our primary focus and our primary income is from our health service and our dispensing,” Frank said.
While Frank and Megan are aware that dispensing cannot sustain their business, Frank said over a 20 year period pharmacists have experienced an immense amount of cuts and changes to the way they operate.
“You do pivot and you do change but that’s been going on and on and on. There’s been changes with PBS funding, PBS price disclosure, we’ve been getting less and less money for medication that we dispense,” he said.
“So this is the brick that broke the camel’s back, it’s been the last thing out of a long line of cuts and we just can’t sustain it anymore.
“They could have created this policy to not impact the pharmacy industry as much and still have the same benefit and it wouldn’t have really cost the government that much more so it’s really disappointing because they could have really made an impactful policy change.”
