By Mikayla van Loon
Concerns have been realised since the introduction of the 60 day dispensing policy earlier this month, with a Lilydale pharmacy already seeing the downfalls of the new system.
Amcal Lilydale co-owner Frank Kazantzis said in just two weeks since the policy was brought into practice on Friday 1 September, pharmacists have been kept busy educating community members.
“We have been talking to people about 60 day scripts, there have been a lot of questions. It has mostly been people coming into the pharmacy expecting to or raising the question of ‘do I get two months now’,” he said.
“[They have been] thinking it was this automatic granting rather than understanding they had to go to the doctor, and the doctor had the discretion to prescribe them a 60 day script or a 30 day script. So there really wasn’t any understanding in the community about how it works.”
Despite these conversations giving the pharmacy a chance to explain what the 60 day dispensing policy means financially for them, the PBS and the supply chain, Frank said it has caused some frustration.
“It’s just been more of a workload of having to manage the expectations of people and have these conversations and explain these details over and over again,” he said.
“The government seemed to be quite happy to promote the benefit to patients but not actually explain to them what they needed to do.”
Although not yet seeing a large influx of 60 day scripts, Frank said he expects this to increase over the coming months having spoken with local doctors about prescribing habits.
“For most people, they will be asking doctors for a 60 day script and I think from most doctors, I don’t expect that much pushback,” he said.
“It’s really going to be patient driven. If people want it, then they’re going to get it.”
Sixty day scripts are only available to people with chronic conditions like asthma, diabetes, endometriosis and high cholesterol to make the affordability of ongoing medication needs cheaper.
Concerningly though, Frank said within pharmacy forum groups it has become clear doctors are prescribing scripts to patients who may be unstable in their medication usage.
“We’re seeing doctors write 60 day scripts for people who are starting a new medication or writing a 60 day script with minimum repeats, there might be one or two repeats rather than the full six months or 12 months worth and it’s kind of suggesting this person isn’t stable,” he said.
“These contradictory prescribing habits that we’re seeing don’t really go in the same ethos as what this was brought in for. [It] was for people who are stable, have been on the same medication for a while and don’t need to check in with the doctor for another 12 months.”
Frank said he hopes as this rolls out further, the government “notices that and puts some restrictions on how doctors can prescribe” so that habits across the country don’t lead to “medication misadventures”.
These changes should also be discussed as part of the community pharmacy agreement (CPA) that has been brought forward by more than a year.
Pharmacy Guild president Trent Twomey told AAP he hopes the negotiations with the federal government will ensure pharmacies are remunerated fairly for medicine dispensing and can continue to operate sustainably under the new scheme.
“We thank the prime minister and the health minister for hearing our concerns, and 60-day dispensing, along with other reforms, will now be dealt with in the normal way under a community pharmacy agreement,” he said.
The CPA is a five year agreement defining how much pharmacies will be reimbursed under the Pharmaceutical Benefits Scheme (PBS).
Having heard early talks, Frank said he is worried there won’t be more money put into the dispensing process but rather through other avenues, even though dispensing for most pharmacies is their primary income.
“That being the majority of our business it really needs to carry its own weight, we can’t be adding more revenue streams just for the sake of adding more work.”
Other key items Frank hopes are included in the CPA are uncapped medication checks and better remuneration for immunisations.
Leading into the March CPA deadline, Frank said he feels quite comfortable in knowing the Pharmacy Guild and other advisory bodies understand what is impacting pharmacies most.
“[The Guild is] going into the new agreement with a fairly good idea of what all pharmacists out there are hoping to achieve and they’ve got a pretty good radar as to what’s realistic, as well, and what works in government.
“So I’m quite confident in the guild and even the PSA and the other pharmacy groups with their ability to advocate for us.”
