60-day prescription change impacting locally: Bendigo pharmacies

In September, the federal government introduced changes to the Pharmaceutical Benefits Scheme (PBS) to enable doctors to prescribe 60 days worth of medication for a range of long-term medicines on the PBS that were previously only available for 30 days at a time. For some patients the change effectively halved the drugs' prices and reduced GP visits.

Pharmacists around the country are angry and worried about the change, which they claim are already leading to indirect cost increases for many patient

Strathdale Pharmacy proprietor Gary Leung told the Advertiser he estimated he would lose $300,000 a year due to the reduction in prescription numbers.

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While the government had established allowances to offset the policy's impact on pharmacies, it wasn't yet clear whether he would qualify and how much was involved, he said.

Mr Leung felt disappointed and "to a certain extent angry" that the policy change "wasn't even talked about before they put it in place".

"We are one of the interested parties, and there should be consultation," he said.

Like businesses across "the community pharmacy industry", he had been forced to look at costs.

"A lot of services that used to be free of charge are incurring a charge now, unfortunately."

These included medicine delivery, multi-medication "Webster pack" packaging and signing statutory declarations, with weekly delivery, which was previously free, now $5 and pill box packaging rising from $4 to $5.

Other local pharmacies were introducing charges for blood pressure checks and diabetes tests.

This was because the $7.30 dispensing charge per prescription (for concession card holders) paid to pharmacists by the government was "cross-subsidising" these services, Mr Leung said.

"We have been trying our very best to help the local community but at the end of the day we are a small business and this is affecting the number of people that I can employ," he said.

Kirrilee Miller, from Emily Roberts Amcal Pharmacy, said while on the face of it the new policy was "a great idea", there were a lot of concerns about it.

"In all honesty, [the effects are] so unknown," the Kennington pharmacist said, noting that the full range of subsidised medications won't be fully phased in until May or June next year.

"Pharmacy authorities are estimating a business of our size will do 20 per cent less scripts," she said.

That would mean a drop of up to 1500 scripts on the current 5000 to 7000 a month, at a minimum cost of $10,220.

"We are concerned," said Ms Miller, whose employer had also implemented a charge for previously free services such as delivery.

The impact on pharmacies in small country communities was even greater than in large towns and cities like Bendigo, she said, with some of them confronting the possibility of closing.

It was also a disincentive to young people entering the industry.

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She had friends in "one-or-two-pharmacy towns", where there was talk about people losing interest in entering the industry.

Ms Miller's other concerns included patient and doctor confusion, loss of pharmacists' capacity to check in on their patients, and signficant stock shortages.

White Hills Pharmacy owner Sanjay Jhaveri echoed these concerns.

"It's only two months down the track and the impacts are already being felt," he said.

He was also worried about the policy's potentially serious impacts on nursing homes.

Mr Jhaveri's business had recently taken over looking after the medication of 10 people at a Bendigo facility after its previous pharmacist suddenly left as a result of the change, he said.

Servicing nursing homes was very labour intensive because it involved a lot of variations of medication, Mr Jhaveri said.

"Currently we do that free of charge."

However, Australian Patients Association CEO David Clarke told the Advertiser 60-day dispensing was "good for patients".

"We respect pharmacies and we respect the role they play in the community and we don't want to see them closed down," he said.

However, it was "common sense" that people not be forced to pick up long-term drugs they used every day once a month.

In his own case, he welcomed the chance to get two months supply at a time of the blood pressure medication he had been taking for six years.

In any case, "the bottom line is the government is at the table with the Pharmacy Guild now talking about offsetting the financial impact, and we think that's important for pharmacies" he said.

Meanwhile, trials currently underway in Queensland exploring pharmacists prescribing medications suggested a promising new direction.

"The real future for pharmacies is in extending their scope of practice," Mr Clarke said.

Mr Jhaveri said he would be interested in pursuing prescribing in the future but described it as a potential "add-on" to a pharmacy's business.

"Heating, lighting, power, paying staff, keeping the pharmacy going - the huge bulk of that comes from the dispensing fee," he said.

However, the White Hills pharmacist was "a hopeful person", he said, and was optimistic that the government would "find a way around the issues".

"The nicest thing", he said, was that a lot of his pharmacy's customers, after hearing about the situation, said they would tell their doctors they wanted to stick with 30-day scripts.

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