6th Annual Future of the Pharmaceutical Benefits Scheme

Friday 1st May 2009, Sydney

Realising the impact of the PBS reforms on consumer demand for medicines and consumer choice

Rollo Manning PhC GradDipPR MPRIA

THE INFRASTRUCTURE AROUND WHICH PHARMACY

SERVICES ARE DELIVERED TO THE AUSTRALIAN

CONSUMER NEEDS EXAMINATION WITH A VIEW TO

OVERHAUL 10 years in pharmaceutical industry (Glaxo) in sales, marketing

and public relations

15 years in public relations in Canberra (six years with Pharmacy Guild)

Eight years with own pharmacy business in Queanbeyan

12 years in the Northern Territory in practice, policy and consulting in Aboriginal health

Compounding Ready preparedIT based systems ?

Assumptions to be tested1. If half the pharmacies closed (PhARIA One) they would not be

be missed

2. The Government cannot continue to pay large sums to pharmacists with no accountability

3. All consumers are not the same

4. Pharmacy schools cannot continue to pour out highly qualified graduates for a job in a retail shop

5. The TOTAL spend on PBS medicines must be known for efficient and effective policy planning

6. There should be no more five year “Community Pharmacy Agreements” until a review is done of the current supply infrastructure

7. An agency should be established – Pharmcare- to pay pharmacists a fee that is commensurate for the service provided

If half the pharmacies closed (PhARIA One) they would not be missed

3,800 in PhARIA One

57% owned by one owner

$1.4 billion spread across too many

No economies of scale viz 1988 review

The tradition continues while the horizons change

The Government cannot continue to pay large sums to pharmacists with no accountability

Cost $ 3.00

15% mark up 0.45

Dispensing fee $ 5.99

Generic Incentive fee $ 1.50

Additional fee $ 3.62 PRF recording fee $1.03

TOTAL $15.59

Same for all

The consumer should be advised of this fee - 4CPA Clause 21.3

The consumer should be

offered this facility

OK for supermarket in pharmacy 0k

Same for Gove, Toorak or Pitt Street

Fourth Community Pharmacy Agreement

Are we talking medicines as part of a primary health care system or items of commerce

PBS is part of the NHS

Supply is not the only function

Clinical interventions also part of the mix

All consumers are not the same

Information, education and communication

Traditional dispensary

Supermarket style pharmacy

ATM style machine

Telepharmacy

Dispensing from doctor’s surgery

Internet pharmacy

Fees paid depending on level of

service given

University Pharmacy Schools cannot continue to pour out highly qualified graduates for a job in

a retail shop

Who is driving who?

Academics are right

Marketplace is wrong

Unlock the body of knowledge

• “By effectively standing still at the

beginning of the decade (1990), the current

restrictions arguably have not served the

community well. “

• They reflect, and to an extent have

locked in, the pharmacy and health care

outlook of the early 1990s, rather than

looking ahead to needs of the decade

ahead.”

National Competition Policy Review of Pharmacy Final Report

The TOTAL spend on PBS medicines must beknown for efficient and effective policy

planningWho pays for PBS/RPBSAIHW 2008 Australia's Health

13%

15%

72%

PBS/RPBS

Patient Copay

Under Copay

PBS/RPBS$,000 6046 72%

Patient Copay 1240 15%

Under Copay 1072 13%

8358

Who benefits when the co-payment increases?

There should be no more five year “Community Pharmacy Agreements” until a review is done

of the current supply infrastructure

AFR 4Jan 2009

The leaders are calling for change

The National President of the

Pharmaceutical Society of

Australia (PSA), Warwick

Plunkett recently wrote that:

“Pharmacy’s operational

structure needs an overhaul if

it is to become an active

participant in the Government’s

preventative health strategy”.

Aust Journal of Pharmacy December 2008

Today's pharmacy bulletin board

An agency should be established – Pharmcare- to pay pharmacists a fee that is commensurate for the service provided

• Pharmacists want to be remunerated for new

clinical services

• Needs strategic approach as to how this can

happen

• Must define areas of activity, cost them and

• Put forward a schedule of fees

• Redistribute the $1.4 billion to areas needed by

consumers to maximise QUM

SummaryMust review the structure of PBS supply to the public

Must define and establish new models of practice

Make the service meet the need

Get rid of “one size fits all”

Support a review of the infrastructure

Be part of a forum to direct the 5th Agreement

Stop talking and just do it - Cf Canberra 1978

Thank you for your attention.

FURTHER INQUIRIES OR COMMENTS:

Rollo Manning

RWM Consultancy

PO Box 98

Parap NT 0804

Email: rollom@iinet.net.au