60-day dispensing will help patients

Transcript: AMA Queensland President, Dr Maria Boulton, ABC Gold Coast, Mornings with Sarah Cumming, Wednesday 26 April 2023

Subjects: 60-day dispensing

SARAH CUMMING:   When you go to the pharmacy, how much do you fork out for your medicines and how long does a packet last until you have to go back? Under a shakeup of the Pharmaceutical Benefits Scheme (PBS) in next month's federal budget, you'll be able to buy double the amount of medicine for the price, well, for a cheaper price, let's say. So if you've got a chronic illness like diabetes or heart disease, you can collect two months’ worth of medicine rather than one when you pick up your script. Dr Maria Boulton is President of the Australian Medical Association of Queensland.

DR MARIA BOULTON:   So the Federal Health Minister, Mark Butler, announced today some changes to the way that medications will be dispensed and prescribed, and these changes were recommended by an independent board called the Pharmaceutical Benefits Advisory Committee (PBAC) five years ago. And what they are is that some patients on some medications, they estimate about 325 medications, will now be able to get two months’ worth of those medications dispensed from a pharmacy rather than one month. Also, those same medications, patients will be able to receive a script that will last them 12 months rather than six months. These are for medications for chronic conditions and they are for people who have been very stable and very well-managed on those medications.

SARAH CUMMING:   And what do doctors think about these changes?

DR MARIA BOULTON:   We've always supported this change since 2018. We're seeing patients who present to us at the moment in a lot of distress because of the rise of cost of living pressures. Whatever helps patients to access healthcare easily, safely and cheaper makes good sense to us. At the end of the day, what this will mean is that some patients will save up to $180 worth of dispensing fees every year. But not only that, it's also every time you need to go to a pharmacy for example, you do have to pay for travel, et cetera. So we'll save on those costs as well. So we do support the recommendations from the government and the PBAC and we look forward to them being introduced in September.

SARAH CUMMING:    So, patients are still having to cover the cost of the actual medicine, the amount of medicine they get, but they won't have to pay the dispensing fee as often, and perhaps go to the GP as often, for referrals?

DR MARIA BOULTON:   Yes, correct. So they won't have to cover that second dispensing fee for the second month. And if the patient is stable under the medication and they don't need to see their GP for that particular medication, they won't need to see their GP until the 12 months, until the script runs out.

SARAH CUMMING:   Okay. And as you said, it's mostly for patients with chronic illnesses like diabetes and heart disease?

DR MARIA BOULTON:   Yeah, so I guess one commonly-used medication that people tend to be very stable on is cholesterol-lowering medication. That's one tablet a day. Once a patient is stable on a particular dose, provided that they have their blood pressure and their cholesterol and blood sugars checked regularly, they tend to stay on the same dose. Of course, if there are changes to the patient situation, then we'll review the dose, but that's one of the ones that we foresee would be in this list.

SARAH CUMMING:   We've spoken before about the pressure on GPs at the moment, and the increasing workload, do you think that this will go some way to alleviating that and making it a little easier for patients to get an appointment?

DR MARIA BOULTON:   I think so. I don't know that it'll help with the out-of-pocket fees that patients have to pay though. Our healthcare system is seeing a lot more visits. So that includes hospital, pharmacy, general practice. We're seeing a lot more people present than prior to COVID. And what we're seeing with the cost of living is that when you look at the Medicare rebates, which is what patients get rebated every time they access some of the health services including GP services, it has not kept up and has not been indexed by the federal government in the way that it should have. So that gap between what the rebate is and what the cost of providing those services is keeps getting bigger and bigger and bigger. And we do have a federal budget coming up, and we do urge and we've been advocating for that patient rebate to increase.

SARAH CUMMING:   The changes being announced today, the changes to the PBS, the Pharmacy Guild says that they may cause some supply shortages of certain medicines. What are your thoughts on that?

DR MARIA BOULTON:   At the moment, there are some supply shortages when it comes to antibiotics, but they are short-course medications, so it's not going to be affected by this, and normally there's another antibiotic that can be substituted for it. It is important that Australia does have adequate access to medications and we don't depend on the rest of the world.

But that's what we're seeing on the ground. It’s just those antibiotics, which are not the medications that will be included in this. This same change, in New Zealand, you can get three months’ worth of scripts dispensed, and they seem to be going all right. And the government is going to do a staged approach with this, so they can let the pharmacies ensure that they have their systems where they need to provide the medications that they need to.

But at the end of the day, when you look over a 12-month period for that patient, that patient will receive exactly the same amount of medication over those 12 months. So it's something that the pharmacies will have to make sure that they include in their processes, but it's going to be a staged approach, which hopefully will help them do that.

SARAH CUMMING:   Dr Maria Boulton, thanks so much for your time this morning.