A win for pharmacies -

a win for the community

On the 75th anniversary of the Chifley Labor Government’s introduction of the Pharmaceutical Benefits Scheme (PBS), Australia’s strong and sustainable pharmacy sector gets a major financial boost in changes that took effect from 1 July.

 

Community pharmacies will be paid more for dispensing medicines, pharmacies outside the big cities will have their location allowance doubled, patients needing opioid dependency treatment will save hundreds of dollars, and pharmacy medicine stocks will be assured.

5 July 2023

 

FROM this month, all community pharmacies will be paid more for dispensing PBS medicines, giving the average metropolitan pharmacy more than $41,000 extra per year.

 

Government payments to community pharmacies increased by 7% from July 1, meaning significant increases in payments for services like dispensing, handling, administration and infrastructure.

 

The 7% indexation boost to pharmacy payments is nearly double the 3.6% indexation of Medicare rebates that also took effect on 1 July.

 

For a standard script for a ready prepared item, such as atorvastatin, pharmacies will receive an extra $0.85, taking the fee to $12.99 per script.

 

Support for regional, rural, and remote pharmacies doubles

 

Regional, rural and remote pharmacies will benefit from the doubling of the total annual budget for the Regional Pharmacy Maintenance Allowance (RPMA), which also took effect from 1 July.

 

The rate of the RPMA depends on the volume of scripts a pharmacy dispenses. Some of Australia’s most remote pharmacies may be eligible to receive more than $90,000 per year in assistance to keep their pharmacies open and services available to rural communities.

 

Pharmacies and patients in win-win on opioid dependency treatment

 

For too long tens of thousands of Australians with opioid dependency have been locked out of getting the same benefits under Medicare that every other Australian gets.

 

From 1 July, Australians with opioid dependency will no longer have to pay uncapped out of pocket fees for their medication. Instead, they will have access to the medicine they need on the PBS, with the Government paying pharmacies to provide these medications.

 

Rather than paying up to $200 a month in out-of-pocket costs, patients will simply pay the usual PBS co-payment – up to $30 for everyone with a Medicare card or $7.30 for concession card holders. These co-payments will also contribute towards the PBS Safety Net threshold.

 

This amounts to a $377 million investment in community pharmacies and will provide much needed cost of living relief for tens of thousands of patients. 4 out of 5 Australians receiving treatment for opioid dependency are on income support.

 

Transition arrangements will apply until 30 November 2023, which will ensure that private clinics, non-PBS pharmacies and other dosing sites can still provide these medicines to patients while they transition to a PBS-approved pharmacy.

 

Medicine availability more secure with new rules

 

From 1 July, new rules take effect, which mean manufacturers of more than 2,900 brands of common medicine are required to hold a minimum of four or six months’ worth of stock on shore in Australia.

 

These minimum stockholding requirements are designed to help protect Australian patients, pharmacists, and prescribers from the impact of global medicines shortages, by ensuring that Australian manufacturers are better placed to continue supply.

 

Minister for Health Mark Butler said, “The Albanese Government is delivering cheaper medicines through 60 day dispensing for more than 6 million Australians.”

 

“This will halve the cost of more than 300 medicines for millions of Australians, including pensioners, who are living with a chronic condition and doing it tough on cost of living,” he said.

 

“Cheaper medicines has been enthusiastically welcomed by patient groups and doctors’ groups, including the Consumers Health Forum, the Heart Foundation, the Lung Foundation, Breast Cancer Network, Rural Doctors Association, the AMA, RACGP and many others.

 

“Dispensing medicines is complex and critical, but it’s not the only reason Australian pharmacies are so highly valued.

 

“Every single dollar saved by the Government will go back into pharmacy services, so pharmacists play an even more central role in the healthcare of Australians.”

 

Widened eligibility for oral antiviral paxlovid, plus new medicines on PBS

 

From 1 July, Australians with severe thrombocytopenia and diabetic kidney disease will have access to new medicines through the Pharmaceutical Benefits Scheme (PBS).

 

Avatrombopag (Doptelet®) will be listed on the PBS for the first time to treat severe thrombocytopenia in patients with chronic idiopathic thrombocytopenia purpura (ITP).

 

ITP is a rare, autoimmune blood disorder where the immune system attacks platelets, which are cell fragments that are found in the blood and normally help the blood to clot. Patients with ITP have fewer platelets to help stop bleeding.

 

This can cause spontaneous bruising, bleeding in the mouth, gums, nose, heavy menstrual periods, and internal bleeding which can be life-threatening.

 

In 2022, more than 600 patients accessed a comparable treatment through the PBS. Without the subsidy, patients could pay around $35,500 per year of treatment.

 

Finerenone (Kerendia®) will also be listed on the PBS for the first time to treat chronic kidney disease in patients with type 2 diabetes (diabetic kidney disease).

 

Diabetes is one of the leading causes of chronic kidney disease. Chronic kidney disease is characterised by the gradual loss of kidney function over time which decreases the ability to filter waste products from the blood.

 

Patients with both diabetes and chronic kidney disease are also at a higher risk of developing other complications, such as nerve and eye damage.

 

Without the subsidy over 26,000 patients could pay more $1,000 per year of treatment.

 

From 1 July, the Pharmaceutical Benefits Scheme (PBS) eligibility criteria for the COVID-19 oral antiviral treatment nirmatrelvir and ritonavir (Paxlovid®) will be further expanded to include individuals aged 50‑59 years with one risk factor. The change will ensure greater access to Paxlovid for people who are at risk of severe disease.

 

The change was recommended by the independent, expert Pharmaceutical Benefits Advisory Committee (PBAC) and means Australians in this age group with only one risk factor for severe illness – instead of two – may be eligible for PBS-subsidised Paxlovid.

 

Individuals should have early discussions with their doctor or nurse practitioner about whether an oral antiviral treatment suits their health needs, and develop a plan should they test positive.

 

Further information about eligibility criteria, including links to the full list of risk factors, is available at www.pbs.gov.au and searching by drug or brand name.

 

The PBS eligibly criteria for molnupiravir (Lagevrio®) remains unchanged.

 

Minister Butler said, “Listing Doptelet on the PBS will be life changing for patients living with ITP.

 

“Without the government listing Doptelet on the PBS patients would have to pay around $35,000 per year of treatment – now the maximum they will pay is $30 per month.

 

“Subsidising Kerendia will be life changing for Australians living with diabetic kidney disease.

 

“Over 26,000 Australians could benefit from the government listing Kerendia on the PBS.

 

“Instead of paying more than $1,000 per treatment thanks to the Albanese Government, Kerendia will cost no more than $30 per script.”

 

Since July 2022, the Australian Government has approved extra funding for 102 new and amended listings on the PBS.