of all Community Service Obligation distributors and the broader pharmacy supply SUPPORTING ACCESS TO HIGH-COST THROUGH COMMUNITY PHARMACY The supply of complex and high-cost medicines does not sit well within existing supply chain and pharmacy remuneration arrangements. Supplying these medicines is of significant concern for a number of pharmacies in supporting access to medicines within the community. RECOMMENDATION 7-3: SUPPORTING ACCESS TO HIGH-COST MEDICINES The Australian Government should investigate alternative payment arrangements for the supply of high-cost PBS medicines from community pharmacy to support their continued availability within the community. A cap should be placed on the amount that a community pharmacy contributes to the cost of any PBS medicine, in the range of $700 to $1000, to allow consumers to access high cost PBS medicines from the pharmacy of their choice. SUPPORTING ACCESS TO HIGHLY SPECIALISED DRUGS THROUGH COMMUNITY PHARMACY The distinction between highly specialised and other PBS medicines causes administrative inefficiencies for community pharmacy and may compromise patient access to these medicines within the community. RECOMMENDATION 7-4: SUPPORTING ACCESS TO HIGHLY SPECIALISED DRUGS The Highly Specialised Drugs Program under section 100 of the National Health Act 1953 (Cth) should be reformed to remove the distinction between section 100 (Community Access) and other medicines listed under section 100 Highly Specialised Drugs arrangements. This should include, for example, harmonising access and fees regardless of where the medicine is dispensed. LIMITING THE PBS LISTING OF GENERIC MEDICINES A more targeted approach to listing PBS medicines can improve supply efficiency and reduce costs to the Australian community. RECOMMENDATION 7-5: TIGHTENING THE LISTING OF GENERIC MEDICINE When an ‘originator’ (or ‘branded’) medicine comes off patent then the Australian Government should hold a tender for the PBS listing of generic versions of the medicine. The Australian Government should limit the number of generic versions of a particular medicine to be listed to a relatively small number that is still sufficient to allow for patient choice (e.g. generics and the original brand of the medicine). The chosen generics should be those best able to meet the distribution and other conditions, including the security of supply, required by the Australian Government at the least cost to the PBS. 8: Finding Recommendation COMMUNITY PHARMACY trial
In relation to the PBS Safety Net, the Australian Government should: require the PBS Safety Net to be managed electronically for consumers. This functionality should be automatic from the consumer’s perspective; investigate whether the PBS Safety Net scheme can be adjusted to spread consumer costs over a twelve-month period; provide sufficient transparency in the way a consumer’s progress towards the PBS Safety Net is collated, including information on any gaps in how it is calculated; and investigate and implement an appropriate system which allows payments for opiate dependence treatments to count towards the PBS Safety Net. 2.4 CONSUMER INFORMATION ON SERVICES Some consumers are unaware of the range of services available from community pharmacies. Utilising technology to improve consumer awareness could increase overall access. The diversity of pharmacy businesses is strongly valued by consumers; however, this diversity brings with it a complexity which, for some sections of the community, acts as a barrier to access. The Panel is therefore keen to ensure that all consumers can access an acceptable minimum set of information about the location, opening hours and health services offered by individual pharmacies. ATLAS Most consumers appear to have a low awareness of the 6CPA funded programs available from community pharmacies, such as the availability of Home Medicines Reviews (HMRs), and the pharmacy’s responsibilities this program. Similarly, some community pharmacies have tailored their services to help meet the diverse cultural, linguistic and demographic needs of their local communities, whereas other pharmacies in the same region have not. The Panel believes that providing a consumer with this information is of the utmost importance in facilitating consumer access to the most appropriate community pharmacy for an individual’s own needs. The need to improve awareness of specialist programs and services was in the Discussion Paper: “Although programs are in place for the delivery of certain specialist services, not all community pharmacies participate in these programs and in many instances do not promote the services. It was noted to the Panel that consumers accessing these specialist services are hesitant to openly ask about these services owing to privacy concerns and stigma associated with their condition. Consumer groups suggested that public education and awareness of these specialist services could be improved through an online website or digital application that listed all community pharmacies that delivered specialist services. It was also noted that discreet symbols could be displayed at the front of pharmacy premises to denote participation in specialist programs.”
Community Pharmacy Programs (CPPs) Has the meaning given in clause 6 of the Sixth Community Pharmacy Agreement. Community Service Obligation (CSO) Arises when a government specifically requires a public enterprise to carry out activities relating to outputs or inputs which it would not elect to do on a commercial basis. Under these arrangements, payments are provided directly to eligible wholesalers (known as CSO Distributors) who supply the full range of PBS medicines to any pharmacy, usually within twenty-four hours, and that meet compliance requirements and service standards. CSOD Community Service Obligation Distributors Complementary medicine Also known as ‘traditional’ or ‘alternative’ medicines. Complementary medicines include vitamin, mineral, herbal, aromatherapy and homeopathic products. They may be either listed or registered, depending on their ingredients and the claims made. Consumers Health Forum of Australia (CHF) Represents the interests of Australian healthcare consumers at a national level. Determination The determination in force from time to time under subsection 98B(1)(a) of the Act. Dose Administration Aids (DAA) A tamper-evident, adherence device developed to assist medication management for a consumer by having medicines divided into individual and arranged according to the dose schedule. It can be either a pack (one single type of medicine per compartment) or a multi-dose pack (different types of medicines per compartment). DVA Department of Veterans’ Affairs Efficient Funding of Chemotherapy (EFC) Refers to PBS medications that are distributed alternative arrangements provided for under section 100 of the Act. FDA Food and Drugs Association GMP Good Manufacturing Practice
Discount Forum location Registrations by affiliation Consumer Pharmacist Wholesaler Organisations Total Adelaide 5 62 3 9 79 Brisbane 6 91 8 23 128 Canberra 3 42 2 30 77 2 26 0 1 29 Springs 1 5 0 2 8 Broken Hill 4 11 0 0 15 Cairns 5 10 1 1 17 Darwin 4 15 2 0 21 Hobart 4 22 1 0 27 Launceston 0 22 2 1 25 Melbourne 8 73 12 23 116 5 102 1 14 122 Sydney 2 88 3 23 116 Wagga Wagga 0 18 0 2 20 Broome 0 4 0 0 4 Webcast 1 33 0 23 57 Total 50 624 35 152 861 C: Bilateral Meetings—August 2016 to September 2016 Bilateral consultations were held with the following individuals and organisations: Pharmacy 777 Group NAB Health Winnunga Nimmityjah Aboriginal Health Service Cape York Pharmacy Slade Health Broome Regional Aboriginal Medical Service Western Australian Department of Health Fred IT Group The Pharmacy Guild Torres Strait Island Pharmacy Guildlink NT Department of Health SA Health Australian Healthcare Associates (AHA) Murrumbidgee PHN Dose Aid Ventura Health Danila Dilba Health Service Australian Pharmaceutical Council Victorian Government Department of Health and Human Services Chemist Warehouse Sigma Drug Stores and Chemist King Professional Pharmacists Australia Pharmacy Guild NT Nunyara Aboriginal Health Service Tasmanian Government Department of Health and Services Jim Cominos Pharmaceutical Defence Limited (PDL) Kimberley Pharmacy Services, Broome and Fitzroy Valley Central Australian Aboriginal Congress Pika Wiya Health Service Corporation The Pharmacy Board of Australia The Salvation Army QLD Health Kimberley Aboriginal Medical Service Nganampa Health Council Departmental officers NSW Health Professor Andrew Wilson Consumers Health Forum of Australia Western NSW PHN Southern Cross Care, Broken Hill