Extended prescriptions reforms a ‘no brainer’, but not a silver bullet

Australia’s peak body for doctors has welcomed a push to allow GPs to extend prescriptions for some medications, as Australia battles both a cost-of-living crisis and a healthcare system crisis.

The Royal Australian College of General Practitioners (RACGP) announced it wants the federal government to make it easier for people to access medications and for medications to be cheaper, and hopes extending prescription periods will help this. 

The proposed prescription reforms were endorsed by the Australian Medical Association’s vice-president Dr Danielle McMullen, who told The New Daily they were a “no brainer”.

The reforms include extending the length of some prescriptions, which the RACGP says could save time for patients and doctors.

The RACGP also wants to allow for a larger supply of medicines in one go, saying having a two-month supply could cut down dispensing fees, which in 2021-22 cost taxpayers $1.67 billion.

Dr McMullen said the reforms would not apply to all prescribed medications, but about 140 that are deemed “stable”.

“We’re talking chronic conditions [like] blood pressure, cholesterol, people who are stable on their medicines, and we know patients who have been crying out for that easier access to medicines,” she said.

“This frees up doctors’ visits as well and obviously also decreases the cost, particularly for people with a concession card.”

Drugs of dependence or medicines that have a difficult safety profile are not among the medications that would be applicable to the changes, she said.

The country’s largest representative body for GPs says the budget would be an opportunity for the government to reduce cost-of-living pressures by acting on the reforms.

Reforms not a ‘silver bullet’

While Dr McMullen backs the reforms, she says they won’t fix all the problems facing healthcare in Australia.

“There’s no silver bullet and I’m not going to promise that one solution is going to fix the access problem, but it’s certainly going to help,” she said.

Appointment availability should free up, with doctors being able to give 12-month prescriptions, which in theory would lead to less time in the waiting room.

The burden would then be lessened on patients, who wouldn’t have to go to the pharmacy as frequently.

There would still be clinical discretion, Dr McMullen said. Doctors are not likely to give a patient a two-month script if they are starting out on a new medication.

“You probably would only prescribe them a month at a time for the first few months,” she said.

“So that they can get stable on it, make sure that we’re not wasting medications if you end up changing the dose, making sure that people really understand how to use the medicine and what side-effects it might have.”

What else could change?

The RACGP doesn’t want the reforms to stop at extending prescriptions and allowing a larger supply.

RACGP president Dr Nicole Higgins wants the complex Pharmaceutical Benefits Schedule (PBS) to be more streamlined.

“It would result in shorter consults, lower Medicare billings, and GPs would have more time to spend with patients, rather than cumbersome administration,” Dr Higgins said.

The representative body also supports further investigation of the benefits in changing the $1 discount rule.

Dr Higgins said the rule prevents pharmacies from discounting medicines that cost more than the current co-payment of $30 by more than $1.

“Other countries like New Zealand don’t have this rule, so pharmacies can offer significant discounts on some medicines,” she said.

What do pharmacists say?

Not everyone is in favour of the reforms. The Pharmacy Guild has been long opposed to reforms.

A spokesperson for the Guild told the Sydney Morning Herald that the current system that generally allows for one month supply of medicine “strikes a practical balance between patient convenience and minimising the availability of medicines in a patient’s home”.

When a patient returns to their community pharmacy for a repeat supply of a prescription medicine, pharmacists have the opportunity to access patient compliance with the prescribed medicine, and can intervene if confusion or adverse reactions to medicines are identified,” the spokesperson said.

In 2022, several states in Australia promised trials that would see pharmacists being able to hand out prescriptions to some medications.

The Pharmacist Guild said the pilot programs would help reduce hospital stress, however, the RACGP did not support the various pilot programs across Australia.

The New Daily reached out to The Pharmacy Guild of Australia for comment.

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