NACCHO #HealthElection16 : ­Co-­payment policy for the Pharmaceutical Benefits Scheme, and Aboriginal health

Pharmacy

“Labor’s pledge to scrap a ­proposed fee for subsidised medi­cines has been countered by government claims that patients could miss out on lifesaving new drugs without the measure, worth almost $1 billion.

Arguing that a new charge for prescription medicines would ­adversely affect millions of people, Bill Shorten promised yesterday to reverse the “co-­payment by stealth” announced in the 2014 budget but blocked by the Senate.”

From todays Australian

The PSA Federal Budget Submission 2016-2017 titled “The role of pharmacists in Australian health reform–Improving health outcomes through cost effective primary care” highlights the opportunities for pharmacists to work in Aboriginal Health Services.

The activities that could be provided by pharmacists shadow the proposed roles of pharmacists providing services in general practice.

At a recent meeting with NACCHO, PSA and pharmacists who work in Aboriginal Health the following services were identified as being able to be delivered across Australia by pharmacists.”

In the budget submission PSA recommends “that the Government consider an adaptation of the PGPIP to enable AHSs across Australia to improve medication adherence and reduce the progression of chronic disease, by utilising clinical pharmacists in the AHS service-mix.

This would allow AHSs to access up to $125,000 per year to employ a pharmacist where required, in keeping with the general practice proposal.

The use of culturally responsive clinical pharmacists could improve medication adherence and reduce the progression of chronic disease.”

SEE Press coverage below

Refer to Labor and Industry press releases from NACCHO Election files

Contact Colin Cowell at NACCHO for copies of #HealthElection16 press releases nacchonews@naccho.org.au

40. Pharmacy Guild Welcomes Labor PBS annoucement May 22

42. King Shorten LABOR WILL END MALCOLM TURNBULL’S MEDICINES PRICE HIKE (FED)

46. Pharmaceutical Society of Aust PSA Responds to Labors PBS Policy

“Sick people should not be deterred from going to the doctor because of the price of seeing the GP or the cost of medicine,” the Opposition Leader said of the government’s plan to lift the cost of subsidised prescriptions by $5 for general patients and 80c for concessional patients.

“We do not believe the case has been made out to increase the price of prescription drugs.”

Malcolm Turnbull said the government stood by the ­co-­payment policy for the Pharmaceutical Benefits Scheme, arguing that the Coalition’s management of the health budget had allowed new lifesaving medicines to be subsidised, unlike the previous Labor government that deferred several listings because of cost pressures.

“Because we have been able to manage the health budget well, we have been able to bring onto the pharmaceutical benefits schedule $3bn worth of new medi­cines,” the Prime Minister said, citing listings of melanoma and breast cancer drugs and the addition of a diabetes treatment as examples.

The Australian Medical Assoc­iation and consumer health groups welcomed Labor’s announcemen­t it would scrap the PBS increase, saying if the ­government pushed ahead with it, low-income earners would be discouraged from getting medicine they needed.

“It is welcome news for ­patients that they (Labor) are not going to go ahead with the PBS increases, because we know that for many people these costs all add up for their healthcare,” AMA president Brian Owler said.

Announcing $7 million for new cancer trials, Health Minister Sussan Ley sought to turn around Labor’s pledge on the PBS payment to question Mr Shorten on his plan for new drug listings.

“The Coalition has had to, and will continue to, make tough decis­ions when it comes to the list­ings of medicines,” she said.

“I see no plan (from Labor) for listing medicines at all. “I see increased spending, poorly targeted. I do not see any of the reforms necessary to do what the Coal­ition has been able to do in the medicines listing space.”

Ms Ley said the government’s policy was to approve all drugs recommended by the PBAC “without fear or favour”, with cabinet considering drugs that were expected to cost more than $20m a year to list.

“We are talking about breakthrough cures here. There is no time to wait. There is no way of saying the budget cannot afford it. We know we will list it and the Labor Party will not.”

Labor’s health spokeswoman Catherine King said Labor would continue the policy and principle of requiring recommendations from the Pharmaceutical Benefits Advisory Committee to go to cabinet for approval.

“The government lifted the amount that would go to cabinet and we would keep that,” she said.

On average, drug listings costing $12bn are assessed each year by the PBAC. About $1bn worth are recommended for adoption.

There are many opportunities for pharmacists to help improve the health and wellbeing of Aboriginal and Torres Strait Islander Australians, but it’s a complex area to work in, writes Karalyn Huxhagen

The PSA Federal Budget Submission 2016-2017 titled “The role of pharmacists in Australian health reform–Improving health outcomes through cost effective primary care” highlights the opportunities for pharmacists to work in Aboriginal Health Services.

The activities that could be provided by pharmacists shadow the proposed roles of pharmacists providing services in general practice.

At a recent meeting with NACCHO, PSA and pharmacists who work in Aboriginal Health the following services were identified as being able to be delivered across Australia by pharmacists.

Areas of collaboration and opportunity include:

  • medication management services;
  • quality Use of Medicine services for consumers and health workers;
  • health promotion;
  • disease prevention programs;
  • chronic disease management programs;
  • culturally appropriate education and competency development programs for pharmacists and health workers; and
  • improvement in equitable and timely access to medication services.

This work would assist in:

  • improving adherence;
  • reducing medication misadventure;
  • tailoring medication regimes;
  • providing tools to assist consumers and carers;
  • Identifying areas that require research and data analysis; and
  • Improving the health literacy of the patient, carers and Aboriginal community elders.

The employment of a clinical pharmacist in an AHS may also assist in research and drug utilisation activities.

Programs provided by organisations such as National Prescribing Service could be initiated in the health service under the project management portfolio of the of the clinical practice pharmacist. Issues identified when prescribing, dispensing and administering medication to Aboriginal people require more intense research to be undertaken.

The response to medications by this cohort can differ significantly to other ethnic groups. In my own work in aged care facilities I often encounter major issues with metabolism, distribution and elimination of medications due to advanced kidney diseases and differences in skin penetration kinetics.

For example the use of ‘patch’ therapy e.g. Durogesic, Norspan, Transiderm Nitro, smoking cessation patches is complicated by the hot and humid weather encountered in Aboriginal communities.

The application of large pieces of strapping tape or electrical PVC tape to keep the patch attached to the body can alter the kinetics of the medication. It is very difficult to keep the patches attached.

In the regional and rural areas where I perform medication management services I am often faced with the situation of:

  • limited access to GPs;
  • limited access to allied health professionals;
  • lack of resources to adequately support the health needs of the patient;
  • long distances to travel;
  • poor health literacy; and
  • low income families.

The care of these patients often falls to the community care centre or the domiciliary nursing service as the doctor is only available for short periods of time. Often these communities are without a regular GP.

The employment of a clinical practice pharmacist in the Aboriginal Health Service could provide a significant partner in improving patient health outcomes. The reduction in costs to the Medicare and health system could be measured in areas such as compliance and adherence: improved wound care, chronic disease management and general parameters such as blood pressure and glucose control.

In the budget submission PSA recommends “that the Government consider an adaptation of the PGPIP to enable AHSs across Australia to improve medication adherence and reduce the progression of chronic disease, by utilising clinical pharmacists in the AHS service-mix. This would allow AHSs to access up to $125,000 per year to employ a pharmacist where required, in keeping with the general practice proposal.

The use of culturally responsive clinical pharmacists could improve medication adherence and reduce the progression of chronic disease.”

Areas such as Home Medicine Review, Medscheck and medication adherence programs such as dosage administration aids require different formats when they are being utilised in health programs for Aboriginal people.

There will need to be opportunity within program rules to adapt programs to suit the requirements and needs of the patient cohort. The use of a pharmacist within an AHS who can work with the various members of the health service to develop programs and initiatives to improve the primary health outcomes of the community is paramount to improving the longevity of the patients who use the AHS.

I recommend this document to all Australian pharmacists as it is a blueprint for where the practice of pharmacy could be implemented to gain improvement in patient outcomes while delivering more efficient and cost effective health care.

Karalyn Huxhagen is a community pharmacist and was 2010 Pharmaceutical Society of Australia Pharmacist of the Year. She has been named winner of the 2015 PSA Award for Quality Use of Medicines in Pain Management and is group facilitator of the Mackay Pain Support Group

NNEWS

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