You may have heard that the cost of hundreds of medicines will effectively be halved for millions of Australians with chronic illness, under a major shake-up of the Pharmaceutical Benefits Scheme.
Those people will soon be able to buy 60 days’ worth of medicine for the price of a single prescription.
The move has reignited a longstanding turf war between pharmacists and doctors, with pharmacies warning the change could lead to supply shortages and force them to close their doors.
But what does it mean for you? And are you one of the millions of Australians who stand to benefit?
Here are the details.
What medicines are on the list?
The list comes from the government’s independent advisory body, the Pharmaceutical Benefits Advisory Committee (PBAC).
Back in 2018, it recommended patients should be able to increase their script refill from one month’s supply to two for more than 140 medications, however, that wasn’t adopted by the then-Coalition government.
In December last year, the PBAC expanded its recommendation to include more than 320 medicines – and the government’s decision this week is based on that updated advice.
Sixty days’ worth of medicine to cost single prescription
The cost of hundreds of medicines will be halved for millions of Australians with chronic illness, who will be able to buy 60 days’ worth of medicine for the price of a single prescription from September.
It means that if your medication is on this list, you will ultimately be able to get two months’ supply of medicine, rather than one, when you go to the pharmacist. But you’ll still only pay the cost of one script.
So, for example, instead of paying $30 for one month’s worth of medicine, you’ll now be paying $30 for a two-month supply. Over the course of a year, for one of these medications, you will now be paying $180 instead of $360.
The listed medicines include several drugs used to treat type 2 diabetes such as alogliptin and dapagliflozin, the antibiotic doxycycline for severe acne, beta blockers carvedilol and propranolol hydrochloride for heart issues and ezetimibe for high cholesterol.
Here’s a link to the full list so you can see if your medication is included.
It’s worth noting that the decision to write a script that allows for two months of medicine to be dispensed will still ultimately need to be made by your doctor.
Who will this help?
The changes benefit people with a range of chronic conditions such as type 2 diabetes, depression, reflux, ulcerative colitis, heart failure, high cholesterol, asthma and rheumatoid arthritis.
As well as paying less for their medicines, people will also save money by having to go to their doctor less frequently.
Doctors can now prescribe 12 months’ supply of these medications at a time, rather than six months.
The Royal Australasian College of Physicians (RACP) and the Australian Medical Association (AMA) have been pushing for this change, and argue it will reduce pressure on overworked GPs while easing cost of living pressures for many Australians struggling to afford essential medicines.
To put the changes in context, there were 906 different medicines (across more than 5000 brand names) listed on the PBS as of June 2021.
The cost and script refills of any medication not on this list – or not on the PBS – isn’t changing at this stage.
How soon can I access this?
The federal government is implementing this change in stages.
The first starts from 1 September this year.
The next tranche starts from 1 March next year, with the final stage to roll out from 1 September, 2024.
Each stage will involve about 100 medicines, with details as to how they will be divvied up expected to be made available this week.
Choosing between food and medicine
Sally Parkes lives with chronic migraines and arthritis, and as cost-of-living rises bite she has struggled to stay on top of the ongoing cost of medications.
Will this cause supply issues?
It depends on who you ask.
The Pharmacy Guild is adamant this decision will put further pressure on a supply chain already under pressure, saying there are already hundreds of medications in Australia in short supply or unavailable.
They have also raised concerns about people hoarding medication and even overdosing.
But health minister Mark Butler has dismissed that argument as a “scare campaign”, saying only seven of the 325 medicines at play are experiencing supply shortages.
“This will not impact the supply and demand of these 300 medicines over a period of time,” he said.
“We have deliberately decided to phase in these arrangements over the course of this year and next year so pharmacists are able to change their itinerary arrangements.
“I caution people against taking advice from the pharmacy lobby group about supply arrangements that are monitored very closely by our medicines authorities.”
Medicines Australia says it will be consulting closely with the government to ensure it can prevent any supply issues over the coming months.
Why are pharmacists so upset?
Aside from concerns about supply shortages, pharmacists are also worried they’ll have less opportunity to ask important questions about your healthcare.
There’s also another issue: money.
At the moment, pharmacists receive dispensing fees from the Commonwealth each time medication is sold, and under these changes, they’ll be distributing medicine less often, so therefore will make less money.
Pharmacists push back on dispensing change
Pharmacists say proposed changes to the way medicines are dispensed could leave regional patients without access to life-saving drugs.
They also stand to lose foot traffic as those people affected won’t need to go to their pharmacist as often, and will therefore be more likely to grab things such as paracetamol or throat lozenges elsewhere.
Some pharmacists say that reduced income will mean they might need to sack staff, cut back on services or reduce opening hours.
These suggestions have been dismissed by the RACP, which has accused the guild of “fearmongering” at a time when it has “recorded the biggest profits in pharmacy”.
The health minister concedes the change will save $1.2 billion in dispensing fees over the next four years, but says that will be “entirely” reinvested back into community pharmacies.
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It’s a great idea, but not many boffins have done their homework…
My GP renews my scripts in lots of 6. One first prescription, then 5 repeats. As do most.
(I do pay for each one as they are dispensed). So how does the chemist work that out?
Do I go and ask for two each time?
Are the chemists required to dispense two at a time?
Clearly another trick by government to conn the people. Frequent or chronic users of medication spend either $326.40 as a concession card holder or $1542.10 for general patients and then get free or heavily discounted prescriptions. . Once you reach the threshold, you’ll need to apply for a PBS Safety Net Card in order to get the discount at the pharmacist.
Oops, previous post got away from me.
I was saying this is clearly another trick by government to conn the people. Frequent or chronic users of medication spend either $326.40 as a concession card holder or $1542.10 for general patients and then get heavily discounted prescriptions.
Once they reach the threshold, they apply for a PBS Safety Net Card in order to get the discount at the pharmacist.
Under the new scheme, many people will not reach the threshold until late in the year, so will end up paying more. Getting two months filled for the same price will not reduce the costs, but means I (and many like me), will end up not getting the PBS subsidy.
If the Health Department was serious about helping people, they would have brought down the threshold as part of this scheme. I normally hit the threshold after 5 months. By keeping the threshold where it was and making each script cheaper, it means we’ll spend more.
Doing the calculations, I now won’t hit the safety net until month 10 or 11, just as the PBS year comes to an end. When I do the numbers, instead of saving me, it will cost a little over 30% more. Instead of 7 months heavily reduced, I’ll be lucky if I get two months because the safety net resets each 12-months!
The price of some medications makes this a crazy model. I plan to keep getting a one-month supply, pay each month and from month 5 onwards, get free or minimal cost scripts. The numbers show it is the best way to proceed. Let’s see if the ‘boffins’ in Canberra block this approach. If they do, it shows it is all about cost cutting.
I’m sure they’ve done the same financial modeling as me and see that getting 2-scripts for one means many people will never hit the safety net and so save the PBS money. Those who do hit it will do so late in the year and still not get much if any benefit from it.