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The Government’s recently passed health package, of which the Sixth
Community Pharmacy Agreement (6CPA) is a part, is estimated to achieve
PBS savings of $6.6 billion over the five years.
One of the measures incorporated
into the PBS Access and Sustainability
Package is the removal of some
low-cost, over-the-counter medicines
from the PBS. Consumers will instead
access these medicines from pharmacies
and supermarkets, at notionally cheaper
prices with the measure expected to
save $.5 billion over five years.
In April, the Pharmaceutical Benefits
Advisory Committee (PBAC)
recommened that ‘products with an
ex-manufacturer price below the PBS
Concessional co-payment should
be delisted from the PBS’ because
PBAC considered that ‘access to these
products would be unaffected by the
removal of PBS subsidy’.
There are reportedly 352 ‘candidate’
items of which 47 were on the list for
consideration by the PBAC in July.
PSA appreciates that the determination
of delisting criteria is being undertaken
with the best advice and transparent
processes. However we believe that
broader consultation of stakeholder
views should have been forthcoming.
‘Access’ is certainly not the only
consideration here and PSA has raised
concerns about the delisting measures
– by using paracetamol, an inexpensive
and widely available OTC pain medicine,
as an example.
Paracetamol – when prescribed on
the PBS for osteoarthritis – is frontline
therapy for 1.9 million Australians
suffering with this condition.
These consumers will reach the Safety
Net later and experience greater
out-of-pocket costs as paracetamol will
no longer contribute to reaching the
To access the dose required for regular
use in osteoarthritis from a supermarket,
consumers would need to purchase
multiple packets and take more tablets
Purely from a cost perspective these
consumers would appear to be worse
off, but of additional concern is that
supermarket purchases take the GP and
pharmacists out of the loop, fragment
treatment and affect the quality use of
medicines for many of these patients.
Paracetamol will no longer be recorded
in a patient’s dispensing history and
so pharmacists will no longer be able
to effectively monitor compliance,
check dosage or check for doubling up
of paracetamol containing products that
may have been inadvertently prescribed.
None of the above data, which would
normally have been recorded during the
process of dispensing, will be recorded
anywhere and doctors will not be able
by JOe DeMARTe, FPS, NATIONAL PReSIDeNT
» national president says
to liaise with pharmacists to in order to
access it if needed when reviewing a
Instead they will need to rely on the
patient’s own assessment of drug
usage and compliance, and we all
know that this is often an unreliable
Paracetamol was previously delisted
from the PBS 1986, and we do not
appear to have learned from this
previous delisting, when the decision
was reversed after only 12 months due
to unexpected problems arising from
PSA also has significant concerns
with the implementation date for any
resulting changes being scheduled for
1 January 2016.
These are mostly concession-card
holders and patients with chronic
conditions. A longer transition time
needs to be considered so that
people can organise their medical
appointments and have their medicine
needs reassessed and/or alternatives
considered. Making dose adjustments
or understanding changes to their
medication management plan may also
Community pharmacists know from
previous experience that significant
changes to PBS rules create a number
of problems for patients and carers:
confusion: (‘I never had to pay for these
medicines before’), inconvenience:
(the clinic is not open or the patient’s
own doctor not available) and distress
(‘I am away on holidays and need
A lead-up period of five months (at best)
is far from adequate.
Our preference, and one we will
continue to advocate for, is a
commencement date of 1 July 2016.
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