People living in regional, rural and remote areas of Australia may well have heard reports about services in their local pharmacies having to be cut, or even the possibility that their pharmacies may be forced to close, as a result of the impending introduction of 60-day dispensing.

Unfortunately, these possibilities are all too real.

The attraction at face value of 60-day dispensing is that it promises to offer two months’ supply of a range of medicines available under the Pharmaceutical Benefits Scheme for the price of one month’s supply. At a time when cost of living pressure are high on everyone’s agenda, this looks to be too good to be true – and it is.

The 60-day proposal was first raised in 2018 when the Pharmaceutical Benefits Advisory Committee announced it had “considered a list of PBS medicines taken from the Pharmaceutical Benefits Schedule that are indicated for the treatment of chronic conditions. Based on an assessment of clinical safety and ongoing cost-effectiveness, the PBAC recommended that 143 medicines were acceptable for listing with increased maximum dispensed quantities (approximately 60 days or two months’ supply per dispensing).” 

While the recommendation had its supporters, it was rejected more than once on the grounds that it could result in stockpiling, would potentially result in medicine shortages (which already were a growing problem) and also medicine safety fears.

But this year, with cost-of-living pressures mounting, the community pharmacy sector, represented by the Pharmacy Guild of Australia,  and the Government resumed talks about the proposal and how best such a scheme might be implemented if necessary without leaving any patient or pharmacy worse off.

It was therefore a complete surprise when it was discovered that the Government had secretly been working on an increased number of medicines – eventually arriving at 325 – since December, an increase which could push some pharmacies to the wall.

There are lots of issues we need to look at here and perhaps foremost is that our health system is seriously stretched, so quite clearly now is not the time to risk our medicine supply or force the closure of local community pharmacies.

If it goes ahead as planned, some patients will get double the medicine they need while others will miss out simply because the supply of medicines can’t keep up with demand. Already there are more than 400 medicines listed on the Government’s own website as being in short supply, with another 70 or so listed as anticipated to soon be in short supply. That’s not a situation any patient should have to face, and it’s one local community pharmacies are fighting to avoid.

Another reality of the scheme is that it will have a major impact on the income of community pharmacies and this is turn will affect what services pharmacies can provide, what staff they can employ, and what hours they can be open.

Over time we have become accustomed to pharmacies being open extended hours and often at weekends – and often when no other health professional is available. But that comes at a cost to the pharmacy and with its income slashed, it has to look at ways to remain viable, and reducing the hours that it is open is one option. This will not only negatively affect the communities where these pharmacies are located, it will increase pressure on hospitals and emergency departments as patients have nowhere else to turn to for advice and help.

Having your medicine dispensed every month as occurs now ensures you have a regular engagement with a health professional and can discuss any concerns or problems. It also lets the pharmacy staff ensure that you are ok and that you are not having any medication issues. This is important as a recent report revealed that 250,000 Australians are hospitalised each year, with another 400,000 presenting to emergency departments, as a result of medication errors, inappropriate use, misadventure and interactions. Halving the number of times a patient visits the pharmacy to have their prescriptions dispensed will inevitably increase problems.

Your community pharmacy is fighting this proposal because it cannot guarantee that no patient, or pharmacy, will be worse off. Your pharmacy has long been a health and community hub and it wants to stay that way.