Only one in five eligible antihypertensive medications are being dispensed under the double dispensing system, says new data.
The uptake of 60-day dispensing has been far slower than expected, with only one in five antihypertensive medications dispensed under the new 60-day supply policy that’s been in place since late 2023.
Reasons for the slow uptake include reluctant pharmacists, default 30-day dispensing in prescribing software, confusion among GPs about which drugs are eligible and GPs who want to keep seeing their patients more regularly, researchers said.
The George Institute analysis of PBS dispensing data, published in the MJA this week, found that in April 2025 – 20 months after the policy was introduced – only 21% of blood pressure medications were dispensed as 60-day scripts.
Despite that slow update, the policy has saved patients around $65 million and saved the government $300,000 during that period, the researchers said.
“If uptake of 60-day dispensing increased to 50% of dispensing, estimated annual savings from antihypertensive medicines alone could rise to ~$165 million for patients and net ~$11.6 million for the government,” they wrote.
The federal government’s 60-day dispensing policy came into effect in September 2023 and is open to patients with stable, ongoing medical conditions. Anti-hypertensives were among the very first tranche of drugs made available for double dispensing.
The researchers also interviewed 20 GPs and four pharmacists in NSW, Victoria and Queensland between June and September 2024.
They found that eight GPs said they willingly offered 60-day prescriptions, six did so only if patients asked, and five said they “rarely or never” wrote 60-day scripts.
The researchers said there were two main barriers to more widespread 60-day prescribing: GPs were unsure which medications were eligible for 60-day prescriptions, and pharmacists discouraged longer prescriptions.
Half of the GPs reported that “some pharmacies discouraged 60-day prescriptions or could be ‘unhappy about it’”, the researchers said in the MJA.
“Pharmacists identified barriers including incorrect dispensing and shortage of medicines in pharmacy.
“One pharmacist expressed cost (lost income) as a potential barrier for pharmacy owners.
“Five GPs and two pharmacists expressed concerns that patients on 60-day prescription may not return for regular follow-up appointments.”
Lead researcher and post-doctoral research fellow at the George Institute, Dr Tian Wang, said that when the policy was first introduced, GPs reported difficulty keeping track of which medicines were eligible for the 60-day policy.
Dr Wang told TMR that the default setting for antihypertensives in prescribing software was still 30 days.
Clearer communication with GPs and patients would help overcome barriers to double dispensing, she said.
“We also found that some patients actively ask GPs to give them 60-day prescriptions, so patients address these barriers and enhance the uptake of this new policy.
“We would need to have clearer communication to patients about the financial benefits.
“Many patients in the community are not aware of this policy and that they can save money.”
Dr Wang said the research team published another study in the MJA that found patients preferred the new policy when presented with the potential savings.
“We would also need support for clinicians to address these barriers,” she said.
“Ideally if government can promote this new policy, we can get benchmarking and feedback on the prescribing rates and improve the prescribing software to 60 days so it’s easier for GP to use.
“If we could address the system-level barriers, the uptake is very likely to improve.”
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The researchers said one possible solution was working with software providers to make 60-day prescribing the default option for eligible medications.
“Some GPs found it cumbersome to prescribe 60-day medicines with their prescribing software,” they wrote in the MJA.
“To improve uptake, prescribing software should be updated to clearly indicate medicines eligible for 60-day dispensing and set these as the default where appropriate.”
Dr Wang said most patients were still on 30-day prescriptions because their GP had not yet made the switch.
“Updating prescribing software is one of the most straightforward changes that could make a real difference.”
Dr Wang noted that the PBS data was gathered before the federal government’s Additional Community Supply Support payment program to offset the financial impact on pharmacies.
She said the results of the study echoed a separate analysis by the Grattan Institute that found only 21% of all eligible prescriptions had 60-day prescribing in the first 14 months of the policy – less than half of the Department of Health, Disability and Ageing’s projected uptake of 45%.
That Grattan analysis also did not account for the 2024 policy to support pharmacists, Dr Wang said.
