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Mixed reaction to
The report from an Australian
Government review into anticoagulation
therapies released in December has
received a mixed reaction.
While it was welcomed by PSA and the
Consumer Health Forum (CHF), Medicines
Australia (MA) labelled it as 'bureaucracy
PSA National President, Grant Kardachi,
said PSA particularly welcomed the
report's recommendations for shared
care and collaboration between
health professionals in managing
anticoagulation therapy in patients
with atrial fibrillation which affects
approximately 300,000 Australians.
'Atrial fibrillation is a significant
contributor to the incidence of
strokes that are associated with high
morbidity and mortality. As a result the
consequent cost to the health system
is high and these costs are expected to
increase with the ageing population.
The report makes a number of very
positive recommendations which when
implemented will better utilise the skills
and services of pharmacists,' he said.
CHF CEO Carol
'recognising that the
to date on safety and
has not given the
PBAC certainty that listing these drugs
is the right choice for the safety of
'This is despite a 2011 recommendation
to Government to subsidise Pradaxa
through the PBS, which may now be
She said the report raised significant
questions about the safety and cost-
effectiveness of dabigatran and other
new anticoagulant medications.
'These need to be clarified prior to the
listing of these medications on the
Pharmaceutical Benefits Scheme (PBS),
and the final decision needs to strike a
balance between safety concerns and
targeted access to these medications for
consumers who will benefit from them,"
Ms Bennett said.
MA Chief Executive
Dr Brendan Shaw
said: 'This is
mad and it is
who are paying
'The Government's expert committee
reviewed Pradaxa almost two years ago.
The Government then ordered a review
of that decision. Now it's demanding a
review of that review. This has been a
two-year bureaucratic merry-go-round
that has got to stop.
'Essentially we're having a review of
a review of a review. It raises serious
questions about bringing new medicines
on to the PBS. If this is a prototype for
listing new medicines on the PBS, it's a
debacle. It undermines confidence in the
PBS listing process.
'This medicine was recommended for
PBS listing more than 650 days ago
and patients still don't have access to
it. That shouldn't be acceptable to the
Australian public,' he said.
Securing cold chain in a crisis
The Australian summer can throw up many
difficulties for managing the transportation
and storage of temperature-sensitive
medicines (cold chain).
Some of the challenges faced by
pharmacies include power outages
resulting from summer storms,
bushfires and other natural disasters.
Having a plan in place to deal with cold
chain breaches is an important part of any
pharmacy business plan and to provide
guidance in this important area the
Australian Pharmaceutical Formulary and
Handbook (APF22) has for the first time
included a detailed section on cold chain
Using APF22 guidance, pharmacists are
advised to review their written procedures
for dealing with cold chain breaches and
It contains a list of information that may be
required by manufacturers to determine
the most appropriate action to take.
The cold chain information is just one
feature of APF22 providing practical, current
and evidence-based information which
can be used in daily practice to quickly find
information and guidance on many areas of
pharmacy theory and practice, including:
• identifying drug-related issues
• making clinical judgments
• counselling consumers on the safe and
effective use of their medicines
• preparing extemporaneous products or
modified oral formulations
In addition to the cold chain management
information, APF22 contains many
new sections, including palliative care,
opioid conversion and dose calculations
The content of APF22 incorporates theory
and best practice, developed and rigorously
reviewed by a range of expert contributors
and an editorial board chaired by Emeritus
Professor Lloyd Sansom.
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