reform the Pharmacy Location Rules to remove barriers to community access and competition between pharmacies, and to ensure they continue to support equitable and affordable access to medicines for all Australians, in accord with the National Medicines Policy; establish a working group with the Pharmacy Guild of Australia or other representative of Approved Pharmacists with the aim of reforming the Pharmacy Location Rules to ensure that they remain responsive to the evolving needs of the community while also supporting innovation through competition between pharmacies; and ensure that any reform of the Pharmacy Location Rules is subject to a suitable transition period. Government Response The Government notes this recommendation. The Pharmacy Location Rules aim to ensure a well distributed geographical spread of pharmacies across Australia. The Pharmacy Location Rules may be amended from time to time to provide greater flexibility to respond to community need for access to PBS medicines. The express written agreement of the Guild and the Government, as signatories to the 6CPA, is required for any such amendment. As part of the 2017-18 Budget measure Improving Access to Medicines – support for community pharmacies, the Government committed to ensuring the ongoing legislative basis for Pharmacy Location Rules. Legislation to amend the relevant sections of the National Health Act 1953, to remove the sunset clause that would have seen the Pharmacy Location Rules expire at the end of the 6CPA (30 June 2020), was passed by Parliament on 13 February 2018. Recommendation 6-2: Pharmacy Location Rules — Concentration of Ownership For any group of two or more pharmacies with overlapping ownership: the Australian Competition and Consumer Commission is to determine if the overlapping ownership of those pharmacies results in a substantial lessening of competition in a market for the provision of pharmacy services, relative to independent ownership; and if so, the Australian Competition and Consumer Commission can require that one or more of the pharmacies in the group be divested. For avoidance of doubt, a group of pharmacies would be considered to have an overlapping ownership if any individual or set of individuals have ownership of at least 20 per cent of the equity in each of the community pharmacies in that group. Government Response The Government notes this recommendation.
In the long term, a single pharmacy regulator could be considered. As an interim measure, state and territory registering bodies should coordinate with the Australian Health Practitioner Regulation Agency to ensure that pharmacy regulations are being adequately monitored for best practice of pharmacy and the safety of the public. Government Response The Government notes this recommendation. The Government is supportive of initiatives to harmonise legislation and reduce regulatory burden for the sector and notes that jurisdictional differences create complexity for businesses as well as pharmacists and prescribers. Harmonisation of all state, territory and Commonwealth legislation pertaining to pharmacy, including harmonisation of jurisdictional responses to Commonwealth scheduling decisions, would be a complex process requiring the cooperation and agreement of all Australian governments. Consultation with key stakeholders including consumer, business and professional representative groups would also be important. Recommendation 6-6: Evaluation Mechanisms As early as practicable, the Australian Government should require the establishment of appropriate evaluation mechanisms for community pharmacy to ensure that policy and delivery requirements are met. Government Response The Government notes this recommendation. The 6CPA, made between the Government and the Guild, operates in the context of Australia’s National Medicines Policy and The National Strategy for Quality Use of Medicines. As part of the 2017-18 Budget measure Improving Access to Medicines – support for community pharmacies, the Government is providing $600 million to community pharmacy for new and expanded community pharmacy programs delivered under the 6CPA. Under this arrangement, the Australian Government Department of Health has worked with the Guild to redesign existing community pharmacy programs to provide better primary health care for Australians in key areas. These programs have also been redesigned to support the collection of additional information to allow assessment of their effectiveness. This information will inform the Government’s consideration of community pharmacy programs in connection with the negotiation of future CPAs. Recommendation 7-1: Community Service Obligation The Panel believes that the Community Service Obligation should revert to supply of all PBS medicines to any pharmacy within twenty-four hours and that this be considered a minimum standard to ensure that there can be no fragmentation of delivery arrangements across wholesalers or access for consumers through any community pharmacy.