A lack of bilateral agreement is causing stagnancy in PBS authorisation, with one prominent GP calling it "a waste of time".
The inefficiency of the PBS authority system is slowing down GPs and having a collatoral impact on patients, says the National Audit Office, backed by a prominent doctor.
The current system has faced nationwide criticism for its inefficiency for some time, with a recent audit by the ANAO making seven recommendations designed to streamline the system.
Newcastle GP Dr Max Mollenkopf told The Medical Republic reform was long overdue.
“The government wants to have the PBS go through a series of steps to provide purposeful friction points to stop what they would see as over-prescribing or an abuse of the system,” he said.
“What you find is speaking to an operator, they will override whatever problem is stopping you. So, on the digital system, when you come to a roadblock, you have no choice. I have no override. I have no way to get past it.”
“It’s still a handbrake. It’s still an unnecessary brake. It wastes huge amounts of time.
“It’s entirely unnecessary, and every time I have to get on the phone or two-factor authenticate my way through a series of screens to then somehow satisfy a random bureaucrat, a non-clinician, is a waste of time that I could be spending with patients.”
The reported inefficiency stems from the administration of the system, with it requiring repeated log-ins with various levels of authentication before actual usage.
This has caused stagnancy in the system with the ANAO reporting that PBS suppliers have uncertified claims totalling over 1.5 billion as of June 2024.
This has been caused by a lack of bilateral agreement from Services Australia end with Health Australia having agreed to answer authority requests within 30 seconds.
In contrast, Services Australia reported in its Annual Performance statement that the measured performance target for answering said calls was within 15 minutes.
Services Australia also reported that, for monthly quality checking of authority approvals, 0.5% of approvals are selected for investigation.
The agency’s telephone system recognises a completed call as when it has been transferred.
This means that a single phone call, from a caller’s perspective, may be counted as two or more phone calls for performance reviewing purposes, each measured at individual wait times.
The PBS measure does not account for this miscalculation.
The PBS system is designed to provide cheaper medication, with the authorisation system being used to regulate the process.
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While it is effective in that respect, many GPs have expressed frustrations with the system’s lengthy processes that many feel area hindering their productivity in patient care.
The RACGP’s Health of the Nation Report found that dissatisfaction with the amount of administration for GPs increased from 60% in 2023, to 70% in 2024.
This comes alongside the reporting of how 62% of GPs expressed how improved and streamlined administration services would benefit innovation.
The system previously ran entirely via phone before the introduction of a digital system to reduce user congestion and, in theory, shorten wait times.
Most GPs embraced the digital processing, with the phone system dropping in usage from 70% in 2022-3 to 54.5% with the digital usage still expected to rise.
However, this digital alternative has created further hinderance for some, with the rejection rate for digital applications being over double compared to phone applications (5.6% vs. 2.3%).
Outside of GPs, this administrative friction is having a collateral impact on patients, especially those with repeat prescriptions.
The ANAO reported that there was minimal communication with PBS prescribers regarding policy changes that would impact PBS authorisations.
