Opposition ‘wobbling on 60-day dispensing’

The AMA fears the LNP will block the legislation, which Mark Butler is determined to deliver.

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The AMA has sought assurance from the federal opposition that 60-day dispensing will proceed, saying the opposition appeared to be “capitulating in the face of an irresponsible scare campaign”.

Federal Health Minister Mark Butler fronted a potentially hostile crowd at the Pharmaceutical Society of Australia conference in Sydney on Friday and doubled down on his double dispensing plan, renewing his commitment to pour every dollar saved back into community pharmacy. 

The move to 60-day dispensing was “undeniably good health policy”, he told the delegates. 

“It will help alleviate the cost-of-living pressures that many Australians are facing. It will help reduce pressure on our doctors, our emergency departments, and the wider health system. Importantly, it will mean fewer Australians have to make the choice between buying food, paying rent or buying medicine.” 

AMA president Professor Steve Robson has written to Opposition Leader Peter Dutton saying he feared the Coalition would try to block the government’s changes. This follows months of lobbying of cross-benchers by the Pharmacy Guild to thwart the legislation.

The pharmacy business lobby has been pushing back against the policy since it was announced just before the federal budget. What followed was outright war between the DoHAC and the Guild, including accusations of breached confidentiality protocols, an SMS-based scare campaign, and a Guild-driven “independent” review which came up with predictable results. 

Professor Robson wrote: “At a time when many people are struggling with cost-of-living pressures, the public positioning of the Coalition on 60-day dispensing suggests they are intent on having patients continue to absorb unnecessary financial pain with all the negative consequences this brings in terms of access to health care. 

“This policy was recommended by the independent Pharmaceutical Benefits Advisory Committee, an expert body. It has enormous benefits to the community and must be introduced.”

On Friday Mr Butler reiterated his determination to institute the policy from 1 September, come hell, high water, and pharmacist tears. 

“I know that change is difficult,” he said today. 

“But the international experience has shown that by working in partnership with Government and the pharmacy sector, 60-day prescriptions can be implemented without significant impact on the sector. 

“That’s why it is the norm in so many countries around the world, countries that we would normally compare ourselves to, like New Zealand, Canada, the UK and others.” 

Mr Butler detailed ways in which the pharmacy sector was already being helped, including a doubling of the budget for the Regional Pharmacy Maintenance Allowance, and changes to opioid dependency treatment which, he said, meant Australian would now be able to buy their medicine from PBS-approved pharmacies at PBS prices. 

“Others are on the way, like expanding the scope of pharmacists into residential aged care to work on site in a clinical role, improving medication management and safety,” he said. 

“And on 1 January 2024, we will further expand the National Immunisation Program to pharmacists, and have pharmacists finally paid the same rate that a doctor gets to administer a vaccine. 

“And we shouldn’t forget that on 1 July, we also delivered a major increase in government payments to every single pharmacy around the country. All community pharmacies are now paid 7% more for services like dispensing, handling, administration and infrastructure. 

“Indeed, the boost to pharmacy payments is nearly double the increase to Medicare rebates that took effect at the same time, even though that was the largest increase to Medicare rebates since Paul Keating was Prime Minister.” 

From 1 September, the federal government is committed to pouring $148.2 million over the next four years into regional, remote and rural pharmacies to help with the transition to 60-day dispensing. 

Pharmacies in regional, rural and remote Australia (Modified Monash areas 2 to 7) with average script volumes equalling dispensing income of under $1 million in the 12 months to 1 April 2023 will be eligible to receive a new Regional Pharmacy Transition Allowance. 

The new transition allowance will mean significant additional support over four years: 

• $52,030 in a regional centre or outer suburb (MM2); 
• $396,909 in a large rural town (MM3); 
• $344,697 in a medium rural town (MM4); 
• $338,477 in a small rural town (MM5); 

• $213,391 a remote community (MM6); and, 
• $198,263 a very remote community (MM7). 

That is in addition to the 1 July increase in the RPMA which will mean, over four years: 

• $24,000 in a large rural town (MM3); 
• $41,440 in a medium rural town (MM4); 

• $70,880 in a small rural town (MM5); 
• $100,320 in a remote community (MM6); and,  
• $129,760 in a very remote community (MM7). 

Also on the cards, said Mr Butler, was the launch of the National Scope of Practice Review “to explore other ways to enable and support pharmacists to play an even more central role in the healthcare of Australians”. 

“We want to make sure that regional and rural pharmacies are given the opportunity to seize these new growth opportunities, just like city pharmacies,” he said. 

“Dispensing medicines is complex and critical, but it is not the only reason that pharmacies and pharmacists are so highly valued. 

“This government is committed to providing more opportunities for pharmacists to play a more central role in the healthcare of Australians.” 

The review will inform the development of the Eighth Community Pharmacy Agreement. 

“There have been strong arguments put to the Government around bringing forward the negotiations for the 8CPA,” Mr Butler said. 

“We’re exploring that very closely and will have more to say on that soon. Whenever it starts, I look forward to the PSA’s involvement in the development of the 8CPA, as the steward of professional standards.” 

Mr Butler concluded by offering an olive branch to pharmacists – at least those represented by the PSA. 

“I hope my remarks today make it clear that this government is committed to the interests of both you – the nation’s pharmacists – and the Australian people,” he said. 

“Putting patients first, while helping pharmacists grow to be even more important players in the health and wellbeing of Australians, are not mutually exclusive. 

“Indeed, while our perspectives may differ from time to time, the objective remains the same – we want all Australians to be able to access quality care no matter where they live. 

“Our vision is for a health system that empowers coordinated and multidisciplinary teams of healthcare professionals. 

“We see you as an integral part of these teams. You – through the PSA – are really important partners on the government’s health and aged care reform journey.”