Dispelling the double-dispensing shortage myth

4 minute read

A new information kit on 60-day dispensing attempts to put drug shortage fears to bed once and for all.

Low medicine stock levels in community pharmacy caused by the introduction of 60-day dispensing are unlikely to inconvenience patients, the Department of Health says.

Under the incoming policy, which will begin a three-stage rollout from September, doctors will be able to write 60-day PBS-funded prescriptions for more than 300 common medicines.

Instead of being dispensed a month supply of medicine each time they hand in a script, patients will receive two months’ worth but pay the dispensing fee once.

The potential for this scheme to cause or exacerbate drug shortages has been spruiked by the pharmacy sector since it was announced.

At one point, the Pharmacy Guild of Australia even had a website with the URL medicineshortages.com.au. This address now redirects to saveyourlocalpharmacy.com.au, which focuses on the potential closure of community pharmacies given the reduced income from lower foot traffic.

The new site doesn’t mention medicine shortages in any of the copy or downloadable assets (posters, shelf wobblers, display screens) supplied by the Guild.

“They’ve pivoted on their lobbying focus,” RACGP president Dr Nicole Higgins told The Medical Republic.

While the Guild appears to have gone silent on the medicine shortages angle, the Department of Health still saw fit to put the rumours to rest in a new “communication kit”, released yesterday.

In a question-and-answer segment, the DoH reiterated that increased dispensing quantities would spread out the time period between repeat visits from customers, rather than add to the overall demand.

In the scenario where a patient presents with a 60-day script, but the pharmacy only has 30 days’ supply on hand – say, one box of medicine instead of two – pharmacists are directed to “exercise flexibility” by giving the patient the one remaining box and ordering in a second box from a wholesaler.

When this arrives, the patient returns and picks it up at no additional cost, because the script was considered “dispensed” at the first visit.

Crucially, the DoH said, wholesalers are required to deliver most medicines to any pharmacy within 24 hours, minimising any inconvenience to the patient.

If a prescribed medicine is completely unavailable, pharmacists are advised to follow the procedures that are already in place for this scenario: supplying a different brand name, contacting the prescriber directly or helping the patient access the medicine through another pathway.

From the beginning of this month, the department also pointed out, wholesalers are required to hold a minimum four- to six-month supply of medicine stock onshore in Australia to create a buffer against shortages.

At the end of the day, Dr Higgins said, it’s about what will be best for patients.

“We certainly support ensuring that rural and regional pharmacies, which don’t have that large retail footprint, are looked after,” she said.

“It’s in everybody’s best interest to have a thriving rural practice and thriving pharmacy in country areas.”

While Medicare rebates went up by 3.6% at the turn of the financial year, pharmacy payments received a 7% bump.

“Pharmacists are being indexed at CPI – they’ve done well,” Dr Higgins said.

“What I would say is that, as an Australian patient, the Medicare rebate is being indexed at almost half of that [rate].”

“The Medicare rebate [rise] is welcome, but we need to make sure that there’s consistency across healthcare and consistency for our patients.”

It’s also worth noting that while the Guild appear to have moved away from emphasising medicine shortages, the idea seems to have caught on in the public sphere.

While there’s no mention of shortages from the Guild on saveyourlocalpharmacy.com.au, the word “shortage” is mentioned 111 times in comments submitted by the public and displayed on the site.

The first tranche of medicines to be included in the scheme was announced in June, and includes drugs for cardiovascular disease, hypertension and high cholesterol.

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