60 Day Dispensing Will Impact Everyone
You may have heard about 60-Day Dispensing in the news, or noticed there have been some changes in store as a result of this scheme. I am writing this information leaflet to explain how 60-day dispensing will adversely impact you, and ask for your help.
Watson’s Friendly Pharmacy is a small, locally-owned and operated, family business. As a father providing for his family, and being acutely aware of the responsibility I have for my staff and their families, and also to the hundreds of patients we serve every day, I have been left with no option but to implement some changes as a direct result of the government’s 60-Day Dispensing policy.
We are asking our loyal patients to maintain their scripts at their usual 30-day supply. This will not only help our small business and its staff, who all spend money at other local small businesses, but will help everyone else as well by allowing us to make as few changes as possible to the level of service and prices of goods we provide.
From Curtis and the extended WFP family
What is 60-Day Dispensing?
The Australian Government announced that from 1 September 2023, eligible people living with a chronic condition will be able to buy 60 days’ supply of many PBS-listed medicines in a single visit to the pharmacy for the same price as a 30-day supply.
And What is Not Changing?
The price that pharmacies get paid for dispensing each PBS medicine on behalf of the government.
It is important to know that pharmacies are an agent for the government. The Australian government requires that everyone in Australia needs access to PBS medicines, but rather than the governments owning and operating pharmacies (ie and having to pay wages, rent, insurances, electricity, fittings, fixtures, IT infrastructure, hold stock, deal with wholesalers, etc.), they outsource this task to the private sector.
As a result, there is an agreement between community pharmacies and the Australian government called the Community Pharmacy Agreement (CPA). This states that the Australian government will pay an agreed amount to a pharmacy each time they dispense a PBS medicine to an Australian citizen, and that pharmacies have an obligation to do so in a safe and appropriate manner on behalf of the government.
The current “dispensing fees” were agreed upon by all parties in June 2020, and the agreement will be renegotiated in June 2025.
How will the change affect Watson’s Friendly Pharmacy?
Community pharmacies (and particularly small ones like us) take out business loans and employ staff according to the funds predicted from the CPA. We know there is money to pay for all the things we need to keep the pharmacy open, which is the very purpose of the CPA.
However, under the new 60-day dispensing reform, instead of being paid for every PBS prescription medicine we dispense, we potentially could only be paid for half of them. Unfortunately, many operating expenses like the cost of medicines, rent, insurance, electricity and IT infrastructure are fixed (and increasing). As a result of losing a large portion of income, small pharmacies are left with few options, and all of them will leave the patients who depend on us worse off.
What does that mean for me?
The short answer is everyone will be worse off as a direct result of 60-day dispensing. The precise answer to that depends if you hold a Concession card and how many PBS medicines you are prescribed, which you can explore on the next page.
The reason for this is due to the significant and abrupt nature of the change (we were given 3 months’ notice), which means that community pharmacies are unable to absorb this impact in their bottom line, so the cost must be passed on to the end consumer – you.
As a direct result of the government’s 60-day dispensing policy, all pharmacies will need to implement some or all of these initiatives in order to keep their doors open ;
- Increase the price of Non-PBS prescription items
- Increase the price of all the over-the-counter products people buy every day
- Pass on EFTPOS Merchant Fees (credit card surcharge) at the point of sale
- Either start charging for services that were previously provided free such as pharmacist consultations, wound care, blood pressure checks, notary public certifications, NDSS item supply and home deliveries that were free previously will now need to be charged for, or we may stop offering that service all together
- The price charged for Webster Packing will need to be increased
- The number of staff employed or the hours pharmacies can afford to pay them may need to be reduced
And the worst outcome of 60-day dispensing will be that some small community pharmacies will become unviable, and will be forced to close their doors. Don’t worry about the discount pharmacy giants – they will be fine. Their ‘pharmacy’ model operates on large margins for front-of-shop items like make-up, perfumes and baby formula, as well as high volume throughput of prescriptions, with little or no service offered. It is the small pharmacies that offer high levels of service and advice, and have minimal front-of-shop margins that will feel the impact the most.
Concession Card Holder Who Reaches the Safety Net Each Year
Mrs Smith suffers from 3 chronic conditions (high blood pressure, high cholesterol and diabetes), which she takes 6 medicines per month to help control. Mrs Smith pays $7.30 per PBS script per month, and once she pays for 36 PBS scripts ($262.80), she reaches the safety net. In July each year, her out-of-pocket expense is reduced to $0.00 per script.
With 60-day dispensing, rather than paying $7.30 per month for each of her scripts, Mrs Smith’s tablets will last 2 months. This means it will take her until December to reach her Safety Net, and she still would have paid the same amount as previously $262.80.
Mrs Smith also gets a Webster pack to help her manage her medicines. These previously cost her $2.50 per week, but now cost $6 due to the impact of 60-day dispensing. She now pays $182 per year more than she used. As Mrs Smith is unable to drive, the webster pack is delivered each week. This used to be a free service the pharmacy offered, but due to 60-day dispensing, she now pays $10 delivery, adding up to $520 throughout the year.
Concession Card Holder Who Does Not Reach the Safety Net
Mr Jones is only on 1 medicine to control his high blood pressure. If he pays $7.30 for 60 days supply rather than 30 days, Mr Jones will save $43.80 per year.
However, due to the changes brought about by 60-day dispensing, he now pays $5 every time he wants his blood pressure checked at the pharmacy which he used to have done for free; this now costs him $30 per year. One month he had a skin cancer cut out of his back, and as he lives alone, he needs the dressing changed at the pharmacy. This used to be free, but now costs him $5. He needs it done every day for 1 week, costing him $35. Mr Jones also takes a few vitamin supplements which have all increased in price as a result of 60-day dispensing, so he now pays an extra $40 than he used to last year.
General Patients (Patients Who Do Not Have a Concession Card)
Mr and Mrs Wilson don’t have a concession card and pay up to $30 for their PBS medicines. They each take 4 medicines for chronic conditions; 3 are inexpensive and each cost $12 per month, and 1 medication (their blood thinner) is expensive, but the government caps it at $30 per month.
Last year they paid $1,008 for their medicines. If they take up 60-day dispensing, they will pay $648, a yearly saving of $360. However, one day Mrs Wilson goes to her GP and they change her medicines. As a result of 60-day dispensing her usual pharmacy is now closed on the weekend, so she goes to a different pharmacy. Unfortunately, the new pharmacy doesn’t know the medicines have been changed and don’t reinforce to Mrs Wilson that she needs to stop the old one. Mrs Wilson inadvertently takes both and ends up in hospital.
What can you do to help?
I hope you can begin to see that everyone will be worse off as a direct result of 60-day dispensing.
60-Day dispensing was sold to the public as a plan to help the cost of living; I can say with certainty that is not. It will, in fact, make the most vulnerable patients – those on a concession card taking multiple medicines for chronic diseases – worse off. These people will receive no net benefit and be forced to pay more for products and services than they did previously, or those services will no longer be offered. Even with patients that may be better off with 60-day dispensing, any gains made on those items will be cancelled out for the numerous reasons listed above. In real terms, even the winners of this plan are losers.
Community Pharmacy should not be about how many Brittany Spears perfume a pharmacy can sell. It should be about patients having access to the best healthcare; this means PBS medicines supplied in a safe and appropriate manner by staff who know their community, and have the time and ability to convey important information for patients to use their medicines effectively.
This may not be possible with the government’s 60 Day dispensing scheme.
From September 1st, your GP can prescribe the same medicine they always have; your blood pressure / cholesterol / diabetes / reflux / blood thinning / etc. medications with the usual 30-day supply and 5 repeats, or there will be a new one they can prescribe with 60 days of tablets and 5 repeats.
We just ask you to consider the consequences of being prescribed 60 days’ supply as opposed to 30 days, and talk about it with your GP and Pharmacist.
It is worth noting that community pharmacies are not against a 60-day dispensing scheme in principle. Pharmacies just want to be involved in the planning process so we can help to implement a scheme that benefits ALL patients and ensures the continued viability of the pharmacies that provide the best healthcare.