Pay rise for pharmacists as seventh CPA signed

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The Seventh Community Pharmacy Agreement has been signed, with commonwealth funding of the sector expected to reach just under $16 billion over the next five years

The Seventh Community Pharmacy Agreement has been signed, with commonwealth funding of the sector expected to reach just under $16 billion over the next five years.

Negotiated amid the pandemic, the deal was signed last night less than three weeks before the Sixth was due to expire, by Health Minister Greg Hunt and George Tambassis, national president of the Pharmacy Guild of Australia.

The Sixth CPA had been projected to cost $19 billion, but was now expected to fall about $2 billion short of that, according to the guild.

The powerful business lobby remains the sole negotiator on behalf of pharmacists, although for the first time the professional body, the Pharmaceutical Society of Australia, is a co-signatory on matters of ethics and standards.

The CPA is the instrument that sets out location and ownership rules for community pharmacies, which Professor Graeme Samuel, the former chair of the Australian Competition and Consumer Commission, has slammed as anti-competitive and the result of “straight political blackmail” by the guild.

This agreement does not appear to include two-pack prescriptions, a move firmly opposed by the guild, nor any reference to the optional $1 discount, which the guild wanted dumped.

Some key features of the new agreement are:

  • a 9% increase in dispensing fees
  • a Rural Pharmacy Maintenance Allowance
  • more funding for the Closing the Gap PBS co-payment measure for Aboriginal and Torres Strait Islander people
  • uncapped access to Dose Administration Aids (a pill packaging service) for Aboriginal and Torres Strait Islander people and a doubled cap for other patients
  • $1.2 billion for patient-focused professional pharmacy programs and services

Those programs include medication management programs funded under the 6CPA that were reviewed by the Medical Services Advisory Committee last year and found to show no evidence of clinical or economic benefit. They will be “largely unchanged” during this agreement.

The deal continues to remunerate pharmacists through the Community Service Obligation funding pool.

The parties to the agreement both “believe that there may be improved health outcomes for Australians if the arrangements for pharmacists administering vaccines are harmonised across Australia”.

The PSA’s national president Associate Professor Chris Freeman said the agreement supported the uptake of electronic prescribing “to enable safer and more efficient use and supply of medicines by pharmacists while supporting patient choice and ensuring their privacy is maintained”.

Pharmacists earn several fees per script, which have now been increased by varying proportions: a wholesale mark-up for ready-prepared medications (now ranging from 41c to $54.14 depending on the manufacturer price); an administration, handling and infrastructure (AHI) fee in three tiers ($4.28 to $95); a dispensing fee for ready-prepared medications ($7.74); a higher dispensing fee for medications prepared themselves (an extra $2.04); and a dangerous drug fee ($4.80).

The tier-1 AHI, dispensing and dangerous drug fees will now all be indexed.

Justifications for the increases include “the inherent uncertainty in forecasting prescription volumes due to factors such as patient and prescriber behaviour” and pharmacists’ fixed costs regardless of how much they dispense.

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