8 NEWS
* Always mg
8 NEWS
16 JUNE 2023 ausdoc . com . au
Guild dispensed harsh figures
ANALYSIS Rachel Fieldhouse
SHORTLY before the federal budget in May , the president of the Pharmacy Guild of Australia stood before reporters on the verge of tears as he accused Mark Butler of “ not giving a shit ” about pharmacy owners on the verge of losing everything .
The source of his anger — for which he apologised — was the federal Minister for Health and Aged Care ’ s announcement that GPs would be able to issue scripts for 60-day dispensing .
The idea was to reduce prescription cost on patients with long-term stable conditions .
But guild president Professor Trent Twomey ’ s predictions of mass bankruptcies do have some basis if you read the impact analysis of the policy , published by the Department of Health .
It admits that lost revenue for the average pharmacy from PBS dispensing fees could be up to $ 160,000 for the average pharmacy in 2027 alone .
This represents 18 % of the total remuneration from PBS fees . There are some assumptions that the policy — which
Not all DPP4i ’ s are the same .
Dosing is different . 1-5
Professor Trent Twomey .
will apply to 325 common medications , including statins and antidepressants — will be implemented on a single date during the 2023 / 24 financial year . This would lead to maximum savings for the government and patients .
In reality , the rollout will be staged in three waves over a 12-month period from this September .
In this form , the department ’ s loss revenue
figures more or less max out at a $ 49,000 loss in the first year for a typical pharmacy .
The impact of the financial blow , according to the report , will be softened with ministerial promises to reinvest taxpayer savings to support expanding pharmacists ’ scope of practice and clinical services — including allowing pharmacists to administer vaccines under the National Immunisation Program . But there is a question . Much of the anguish expressed by Professor Twomey — who has already launched a national campaign against the dispensing policy — is partly based on the resulting drop in customer footfall as patients frequent pharmacies less often .
Footfall is revenue in the commercial world after all .
The report is silent on this issue — beyond saying it may decline .
But you can measure some of the impact simply by looking at the drop-off in the number of dispensed medicines : 38 million avoided dispensings in
The drop-off in dispensings equals 571 years of work .
For your adult patients with T2D ,
Choose simplicity . * 1
PBS Information : TRAJENTA ® : Authority Required ( STREAMLINED ). Type 2 Diabetes . Code 6346 – Add-on to metformin or SU . Code 6363 – Triple therapy ( with metformin and SU ). Code 6376 – Add-on to insulin . Code 7541 – Triple therapy , initial treatment ( with metformin + SGLT2i ). Code 7505 – Triple therapy , continuing treatment ( with metformin + SGLT2i ).
Boehringer Ingelheim Pty Limited , ABN 52 000 452 308 . 78 Waterloo Road , North Ryde , NSW 2113 Australia . Copyright © 2023 . BOEH1470 _ ADG _ A4SP4C . PC-AU-102880 . Prepared February 2023 .
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BEFORE PRESCRIBING , PLEASE REVIEW THE FULL PRODUCT INFORMATION AVAILABLE FROM BOEHRINGER INGELHEIM AT WWW . BOEHRINGER-INGELHEIM . COM . AU / PI
TRAJENTA ® ( linagliptin ) 5mg film-coated tablets . INDICATION : Trajenta is indicated in adult patients with type 2 diabetes mellitus to improve glycaemic control in conjunction with diet and exercise . Monotherapy when metformin and sulfonylureas are not tolerated , or are contraindicated . Add on to metformin , sulfonylureas or metformin plus sulfonylureas , or to insulin ( with or without metformin ). Add on to metformin plus SGLT2 inhibitors . CONTRAINDICATIONS : Hypersensitivity to linagliptin or to the excipients . PRECAUTIONS : Not for use in type 1 diabetes , diabetic ketoacidosis . Discontinue if pancreatitis or bullous pemphigoid is suspected . Risk of hypoglycaemia when used in combination with sulfonylureas and insulin ; arthralgia , pregnancy ; lactation ; children < 18 years . INTERACTIONS : Antagonised by strong P-gp or CYP3A4 inducers . Others , see full PI . ADVERSE REACTIONS : Very common : combination with metformin and a sulfonylurea and combination with insulin – hypoglycaemia ; Common : increase in uric acid , increase in lipase ; combination with metformin – arthralgia , back pain , headache ; combination with a sulfonylurea – nasopharyngitis , hypertriglyceridaemia , urinary tract infections ; combination with metformin and a sulfonylurea – cough . Others , see full PI . DOSAGE AND ADMINISTRATION : 5 mg once daily taken with or without food . No dose adjustment is necessary for the elderly , or patients with renal or hepatic impairment . Boehringer Ingelheim Pty Limited . ABN 52 000 452 308 . 78 Waterloo Road North Ryde NSW 2113 . March 2020 .
References : 1 . TRAJENTA ® Product Information . 2 . Onglyza ® Product Information . February 2019 . 3 . Nesina ® Product Information . September 2021 . 4 . Galvus ® Product Information . July 2022 . 5 . Januvia ® Approved Information . October 2021 . DPP4i , Dipeptidyl peptidase-4 inhibitors .
2023 / 24 , climbing to 68 million in 2026 / 27 .
The report attempts to offer the result of this as a comfort : workload .
Pharmacists , it says , can expect to save an estimated 4.5 minutes for each dispensing they avoid .
AusDoc ’ s quick calculation suggests it amounts to 571 years of work time in 2026 / 27 .
That is a lot of looking out of the shop window .
But the reports says pharmacists can keep busy .
“ This time may be spent on other patient-related healthcare activities , including public-funded health programs and services delivered in pharmacies .”
Of course , the analysis comes with the further caveat that the impact will vary based on the location and operating model of a given pharmacy .
The government is already considering proposals “ to mitigate the financial impact ” of its dispensing reforms — something that never happened with GP clinics and the big Medicare freeze .
According to the report , this includes new measures to fund more dose administration aids , medication management and reviews , opioid dependency treatment services and vaccination services above the current level of funding of the current Seventh Community Pharmacy Agreement .
That agreement is already worth $ 18 billion .