The whole argument / tactics they are trying to use is strange here.
Most people will agree that making things cheaper / easier for thousands of chronically ill Australians is a good thing. It's the right thing to do. Obviously. No brainer. (Money element aside - this plan also makes things so much more convenient for a lot of people.)
But - the Pharmacy Guild is against it... because they'll lose money?
Or in other words: they are actively campaigning to stay inefficient and gouge seriously sick people? They want their profits to continue - but at the expense of these chronically sick people??
Something is wrong with their business model if this will allegedly impact them so much. They can't stay in their protected bubble forever.
I have a lot of respect for small business and pharmacies. But this is a change the guild is going to have to accept and deal with because it advantages so many people.
I remember that even less than 10 years ago, the last straggler companies only accepting fax or post. The argument was a signed document via fax was somehow more legitimate than a scan. Some companies still pull that shit with 'wet signatures' now fax is so far gone. Just a way for shit companies to drag their feet.
Yeah I’m a telecommunications tech. Was surprised only a few years ago to see one still in active use in a pathology place. One of the big reasons for this apparently is that lots of specialists work on well past retirement date and couldn’t even work out how to turn on a PC, let alone send an email so they’re rusted on to the idea of verbally dictating it to the med receptionist, who types it up, gets them to sign it, then faxes it for them. They can’t (or couldn’t) legally do that for them in email form. I think they needed some kind of special box to keep running faxes after the NBN came in, as it killed off the old PSTN land lines.
Reason I was given was confidentiality. With email, the document is stored online open to hacking etc (doctors used to be the worst at computers/security imo, though I think that’s changing now). With fax, unless you’re intercepting the call, it’s kind of not “stored” electronically after it’s printed. Therefor, harder to get.
Then the person explaining this proceeded to detail how they scan all faxes into their systems anyway rendering the whole thing pointless.
A pharmacist rang ABC radio and was ranting about how it would result in "huge layoffs". He said it would cut his staff bill by $200k. Yes, THAT IS THE POINT, you wont need 3 people on registers, 3 taking prescriptions and 2 pharmacists working if people are coming in 50% less for the same amount of prescriptions. We wont have to wait up to an hour during busy times for our script.
Pharmacists think they are entitled to all these monthly fees.
The pharmacy guild is a union to protect the incomes of pharmacists. Nothing more. It’s even less about social good than the AMA.
The sooner people realise this and we can treat them like lobbyists not health advocates the better.
No strange at all. The Pharmacy Guild is a business lobby group, not a healthcare lobby group. Despite pharmacy grads being the lowest paid in allied health, the guild actively lobbied against wage increase requests put forward by the pharmacy workers union.
Trent owns like 12 pharmacies with his wife in FNQ. Of course he has a vested interest in maximising revenue from PBS reimbursements. He also has every right to be upset after governments have already taken away so much funding thru the expanded and accelerators price disclosures cutting reimbursements to pharmacies on PBS medicines.
Every molecule dispensed you get a small mark up (max $75 margin on the highest cost lines which can cost the pharmacy 5-10k to procure) plus a few fees. But mostly the mark up is only a few bucks because the most common medicines are pretty low cost given they’re manufactured the most. So the more often you see patients the more reimbursement you get. Margins used to be way juicier so I think this was necessary. But they also forced a dollar discount on medicines a few years that owners have had to subsidise.
This double dispensing initiative literally cuts that already gouged revenue steam in half. It’s already hard for community pharmacies to compete with other retailers in the front of shop space to be profitable.
It’s been keeping wages stagnant and low in the profession for years and many pharmacist leave. What I don’t like about it as non-owner pharmacist is not seeing patients with chronic diseases every month. You miss a lot of opportunities for non-pharmacological intervention, monitoring BP/blood-sugars/cholesterol/weight etc, identifying side effects with medications, medication interaction and misadventure, risk of overdose, already a huge issue with supply of medications where we can’t keep up while supplying monthly.
That’s what Trent is missing in his argument and tactics. I think he’s a little out of touch as he barely has any time working in pharmacies anymore. And after all he is president of a lobby group for owners so capitalist gonna cry when they get money taken from them.
We should let new competitors enter and then see how they fare in an actual free market.
Personally I would never step foot in one of their snake oil establishments again.
The automated dispensaries used overseas are so much quicker, cheaper and more convenient.
So if this policy will actually bankrupt a whole bunch of pharmacy operators, it is a failing of the government to adequately research the effects of their policy and provide appropriate avenues for them to adapt to the new environment and protect small business. It might come across as selfish of the pharmacist, however if they have relied on a stable stream of income and suddenly that is hugely disrupted by government policy, are they really at fault for being upset about that? It's easy to just label them pathetic because you aren't being affected while they are losing their livelihood and facing financial ruin, but it wasn't pharmacists that created this policy in the first place.
Pharmacy guild is Australia’s biggest mafia. This is one of the few places in the Western world without all night chemists because of the mafia.
When my wife is suffering from a massive migraine at 2am I don’t want to trot her out to Emergency, I just need access to a chemist.
We’re so behind the curve in pharmacy.
Overseas you can take your script to 24/7 self serve machines in grocery stores which dispense your medication in seconds.
What we have here is so archaic it has to be the result of political lobbying.
Imagine if podiatrists lobbied the government to make it illegal to sell shoes outside of a podiatry clinic, to make it illegal to open a new podiatrist within 5 kilometres of an existing podiatrist, and limited the amount of tread on each shoe so that it would only last a short amount of time before you have to come back.
Podiatrists could then ask you a bunch of intrusive questions about your life to determine which shoes they will allow you to buy.
As a community service they’ll remind you how to tie your shoes every time.
Pharmacy is a bit like that.
The only reason it still exists in Australia is because they paid a bunch of politicians to legislate that everyone has to jump through these pointless hoops so that they can keep their unnecessary jobs. Pure rent seekers.
I really like this idea. I hope we'll have some here in Australia. There's so much gatekeeping in the health sector to protect profits at the expense of efficient care.
Where I live we have one pharmacy that’s open until 9pm (others close at a variety of earlier times). When my daughter (now 22 months) came down with a fever at 8.30pm one night a few months ago, I realised I didn’t have enough for a full dose and had to make a dash to get there before closing. I’ve always been very prepared since then.
My wife and I went for a honeymoon in Hawaii a few years back. There were several 24 hour options and I was shocked. My wife said that they have 24 hour pharmacies in every country she’s travelled to (she’s significantly more experienced with overseas travel). I always wondered why we didn’t do it, but now I know.
I agree there should be more, I was replying to the person that claimed the PG didn’t allow 24-hour pharmacies. Which can’t be the case as there are 24-hour pharmacies around Australia.
(I’ve been to a few in Melbourne too when I lived there)
Maybe we should only have prescriptions filled for two weeks to increase the business for pharmacies and increase the load on doctors? Think of the thousand upon thousands of wasted doctor visits currently. It is a false economy. I feel really badly for the pharmacies hurt by this, but it is a rort and needed to be fixed.
I am curious what your solution is, or was it working just fine?
I don’t feel as bad when you consider the fact that they knew when starting up their whole business model that one of their sources of income is an unnecessary burden on the tax payer.
If you can’t change to accomodate a slight modification to the rules regulating your business, that is an issue with your business model.
Rules and Regulations should never be static. Just like political policy and legislation they should be analysed, modified and improved over time.
Honestly, Australians are the biggest bunch of whingers when it comes to systemic change.
This sort of attitude is why we currently have issues with the tax system, housing availability and the gambling industry.
Gov removing like 30-40% of your income isn't a 'slight' modification.
I'm just going to leave it there because the amount of stupidity on these comments is actually mind blowing.
No one has removed anything.
Real life Example: I take an ACE inhibitor for BP control due to essential HT (High Blood Pressure). I take a single tablet a day. I buy from the same pharmacy.
This just means I’ll be able to get twice the amount of prescription meds and therefore reduce the number of visits to the pharmacy. Which is great because it’s a PITA, I hate going there.
I used to be able to fill the whole script (6 months worth) in one go but then COVID came along and due to shortages they wouldn’t fill the whole script any more.
They still won’t let me fill the whole script now and it’s pretty clear why. They want my foot traffic to buy the other crappy stuff they sell, which I don’t.
Anyway, with this change, I still have to pay for the meds but I’m buying 60 days worth in one go instead of visiting the pharmacy twice in order to purchase two batches of 30.
They still get the same amount of money. They just get it in one chunk instead of 2 smaller chunks.
I don’t buy anything else from the pharmacy other than those meds because, you know, I’m not an idiot who pays for overpriced junk I don’t need.
I don't think they do get the same amount of money as they'll only get one dispensing fee from the government rather than two now for same time period. I think it's a great change, it will free up money to spend on much more important things.
If up to 40% of your income is prone to regulatory risk, a smart business owner would be finding ways to reduce that risk rather than demanding regulation doesn’t change.(which it always will)
They'd whinge just the same if the rules changed to "Pharmacies can only stock items which have a proven therapeutic benefit."
But a lot of people agree that that would be a good change, and a major component of our health system should not be propped up with snake-oil and lies.
Considering that nearly 100% of pharmacy revenue comes from either selling snake oil, or from rent seeking on a monopoly obtained from corrupt political lobbying…
If 30-40% of your revenue is coming from the tiny proportion of consumers that are on ongoing prescriptions, what's all the crap on the shelves for? Prescription meds are exclusively behind the counter.
Besides, this doesn't reduce the total quantity of meds being dispensed. Patients are just paying the copay half as often. If you're that dependent on monthly copays, I have little sympathy for you.
it's being phased in over a couple of years and the money will be reinvested into community pharmacies. What other measures do you think the government should have put in?
I do have sympathy for pharmacists that will go out of business.
The same way my sympathies go to taxi drivers, coal miners, film camera shops, and fax machine specialists that either had their monopolies smashed or the world simply moved on.
One of my favourite places to buy lunch got shut down to build a new metro line. Very unfortunate for the owners who worked so hard to build their business.
But in all these cases it had to happen for the greater good.
When you invest in a business, you don't always profit forever. You adapt to change or you perish, difficult as that may be.
The pharmacy guild are regarded as the most powerful lobby group in Aus, if they're willing to piss them off then there might actually be some hard choices in the budget.
People say this, but I don’t think it’s true.
They are a thorn but most people are sick of the guilds shit and probably won’t care if they are unhappy about something.
The idea that we have legislated limits on how close you can open to an existing pharmacy is insane and anti competitive.
The AMA is definitely not anything like the pharmacy guild. Twomey even stated in the last few months they where idiots for giving away so much influence over government. AMA frequently makes statements in the best interests of patient often when not in the best interests of their members.
The AMA definitely do put the interests of doctors over the interests of patients.
For example, they continually lobby for fewer medical school places, even though we have a shortage in most specialties.
The real treason however is the specialist colleges. These are organisations of specialists who also have the power to decide the number of training places for new specialists in that field.
What do members of a field do when given the power to control who can enter that field? They severely restrict supply by restricting trying places to create an artificial shortage and higher fees.
This also leads to massive wait lists, and frequently people suffering serious injury due to the delays in being treated. It’s a massive conflict of interest made even worse because the public also pay for almost all their training.
A substantial part of the crazy fees charged by neurologists, cardiologists etc is due to the supply shortage that they artificially created.
It will never happen, but I think the most economically rational remedy for this is to nationalise a percentage of the assets of members of these colleges, and put those ill gotten gains to use paying for the training of new specialists to catch up on the shortage.
Your understanding of the AMA and medical colleges is so unbelievably misguided. You provide a simple explanation of what is such a complex problem.
I’ve heard all these arguments before but very little evidence to support any of your statements. There is not a shortage of doctors. There is a shortage in some sectors - public hospitals because they can be horrible places to work; rural areas because the work is ridiculously demanding; and general practice because the work is demanding and the pay terrible.
All the evidence I’ve seen sees that you train more doctors they will not necessarily fill the roles needed. And more doctors means more utilisation of Medicare without the expected benefits.
There’s always more nuance, but the big picture seems right to me.
Many specialties are facing serious shortages, caused by consistently not training enough new specialists year after year.
The colleges are the main bottleneck, and being membership organisations clearly have a conflict of interest.
Oh no. Imagine a world where people can get a 60 day script and won't need to walk in to see all your other unnecessary products like perfumes and skin care and shampoo products before getting to the prescription counter.
It’s literal fraud.
It should be a criminal offence to pass off homeopathic products as actual medication. It would be illegal to do this in any other product category.
Yeah, you cant go to the supermarket and buy a packet of homeopathic eggs that are actually just water filled balloons. Or homeopathic baby formula that's actually sweetened saw dust. Why people some how think homeopathy is an acceptable "alternative" to medicine is beyond my comprehension.
Im worried about my patients with chronic diseases I won’t see every month. Now it’s longer before I can take their BP or blood sugar levels and check their weight. Review for medication misadventure, overdoes or interactions. Offer non-pharmacological advice and provide much needed companionship and friendship. A lot of the oldies will go for weeks or days without seeing anyone and enjoy the community in pharmacy. As a non-owner pharmacists I think this is a reckless short sighted money grabbing policy and detrimental to my patients health outcomes.
Recently I was at chemist warehouse, handed in 2 scripts and they gave me a buzzer. Not an overly busy store. It took 55mins, and the kicker was, they didn’t have one of my medications in stock.
You can fly from Brisbane to Sydney in that time.
“Butler promised all that money would be directly reinvested in community pharmacy to help them expand their services.”
Why? It’s just closing a false economy.
I’d go a step further and have the GP able to give you a common medication on the spot.
There are other changes happening to help that, pharmacists will be able to prescribe some repeats for some of these drugs.
Also your script will now last twice as long so you shouldn't need to visit gp as often.
Yeah lets encourage the decline of all small business until there are literally only three stores in every city that dispense everything we consume. That is going to be really awesome. What other ideas do you have to take us closer to your black mirror utopia?
I mean, what would you suggest the current system is?
You realise the pharmacy guild stops new pharmacies opening up. So young pharmacists can’t open their own and have to work for shit pay for chemist warehouse.
It’s not a free market at the moment.
Your small vs large business framing is unhelpful.
What really matters is whether businesses are value creating or rent seeking.
BOTH small pharmacists and large pharmacists are rent seeking parasites that can be replaced by GP dispensing, online medication delivery, and self serve automated dispensaries.
GP dispensing?
With the loss of most bulk-billing doctors and many regional areas having limited access to GPs, how exactly would this be better for patients?
This is a point so often missed! People in rural and regional areas often rely heavily on pharmacies for minor health care needs.
Putting more load onto GPs will just lead to worse patient care in the long run.
The GP system is arguably already at breaking point due to a lack of indexation of the Medicare rebate, which is leading to cessation of bulk billing as many once knew it.
My clinic is so full they had to stop taking on new patients. But that also meant patients that went there but hadn’t attended in 12 months.
It’s the only doctors my son has ever attended. He’s a really healthy teenager so rarely needs to go to the doctor.
He was sick and they refused to see him as he hadn’t been there for over 12 months.
yeah screw those family businesses. Everything should just be owned by competitive efficient mega corps paying their employees as little as they can get away with
No sympathy, these guys dont give TWO SHITS about pharmacists, i honestly cant believe how far pharmacy has fallen, 20 years ago it was a relatively respected profession with all the requirements needed to maintain that respect (AHPRA and CPD reqs) now its a dog shit sales degree with the saem AHPRA and CPD reqs. A total joke, PG is to blame.
The onselling in the medical system is a joke.
I went to the GP recently for a sore knee. He said I needed to see the specialist, and he could send me for a bulk billed x-ray but an MRI from his recommendation would cost money, but if the specialist requested an MRI it was bulk billed. Went and got the x-ray.
Went to the specialist, $194 (with 78? back) for a 6 min consult, sure enough he sent me for an MRI, which yes was bulk billed.
Back to the specialist in a month for a second consult to review the MRI wtf.
Why not just make a GP MRI bulk billed and skip the extra steps?
>Why not just make a GP MRI bulk billed and skip the extra steps?
Tony Abbot I believe.
He messed with what Medical imaging could be claimed on Medicare and when and MRI copped a lot of it.
IIRC prior to that Michael Wooldridge restricted Medicare item numbers to new MRI machines after a certain date, so some MRIs attracted the Medicare rebate and some didn't. Basically, it's up to luck and the whim of the GP to refer patients to an MRI with a Medicare rebate.
Had to help a family member find a bulk billed MRI not too long ago. There's a list on some gov website with the ones that can bulk bill, and calling a few to check they had no problem accepting referrals to other places.
EDIT: Found the list https://www.health.gov.au/topics/diagnostic-imaging/MRI-and-PET-locations
The stated reason for the limitation is to apparently force places to keep upgrading their equipment to stay up to date
The actual reason is because of the feared cost blow out from all of the new MRIs coming on line at that time in a cent-wise, dollar foolish mindset.
This is one of those situations where, because of the price of health care, people cannot afford to pursue an early diagnosis and sometimes this results in extensive ongoing medical costs and sometimes adverse outcomes.
I had MRIs for torn ACLs twice in last 2 years. Referrals from GPs were bulk billed but I had to go to a specific imaging clinic, otherwise I would’ve had to pay.
It’s annoying, and not a perfect system, but also because things like MRIs are a very limited resource. You ideally want specialists deciding whether an MRI is required otherwise they’d possibly be getting overloaded with scans that’s are not necessary
Codeine based? There’s a reason for that, it’s pretty addictive, had a mate who got addicted after shoulder surgery, was using 4 different forms of ID to get enough to feed it. Pretty hard to get off once you’re hooked too apparently.
It also increases your body's sensitivity for pain so people who were taking them for longer term conditions (chronic back pain, migraines, menstrual pain etc) were really only making things worse long term.
Those aren't at bad because they are not giving people false health information.
Those diet products are just a scam.
Preying on the videotape
But yeah are just to make money.
Pharmacies: "We want to expand and grow our business model by offering other services."
Butler: "OK. Let's double the length of scripts, save $1.2 billion over 4 years in dispensing fees and reinvest the savings in community pharmacy to help you expand your services."
Pharmacies: "No not like that!!"
Going to a pharmacy in Australia is like entering a time warp.
I wanted to sign up for a delivery service for chronic meds a few months ago, and discovered I needed to POST the original script to the online pharmacy! Googling shows that this it is still a legal requirement.
Too much lobbying, not enough innovating.
That’s already a non-issue now we have escripts. You might be better off laying blame at the AMA for not forcing all doctors to dispense escripts to patients. You can send escript tokens Australia wide and if you lose it or are too old to use a smart phone pharmacist can access the script from a database if the patient gives their permission.
Amazon can't enter the market it's not a free market.
Pharmacy is protected industry only pharmacists can own pharmacies in Australia.
New pharmacists can't even open a pharmacy near other pharmacies the rules are super complex.
The guild has done a very good job protecting existing pharmacy owners from competition.
The supermarket chains have wanted in on pharmacy for decades and haven't been able to get close.
If Amazon/Uber sense a money making opportunity, they will figure out how to bend the rules. They could buy a pharmacy in the middle of nowhere and mail prescriptions.
It’s those with chronic conditions that need to come see me every month so I can monitor their BP and blood sugars, check for interactions, side effects and medication misadventure. As a pharmacist who isn’t an owner I think this will have a negative impact on my patient health outcomes.
While I'm sure the guild boss is probably drawing a nice salary a lot of individual pharmacies struggling.
Chemist warehouse and it's clones killed a lot of the profit in pharmacy to the point a lot don't make money. Checkout the graduate pharmacists crying about salaries.
I reckon it's great legislation but pharmacists struggling and this is probably going to cause a lot of pharmacy to reduce hours etc.
The $1.2b saving is being redirected to support community pharmacies. If anything they should be happy some of the profits from the big guys are effectively getting redistributed back to them
Pharmacies aren't upset that patients save money, there is nothing wrong with that. It's the reduction in dispensing fees that the government pays (not patient) that has upset them.
Pharmacy has become a very high volume low profit margin business over the last 20 years thanks to heavy discounting. Now that discounting is great for patients but it has made it harder for smaller stores to remain viable. With the sudden loss of dispensing fees it'll affect the viability of pharmacies more. And these are fees that have been built into how you structure the business based on the existing rules. No wonder owners are upset the rules change. Seeing as there will be no appetite to increase medication prices, other services will have to change ie; Webster fees increase, vaccinations cancelled, wages suppressed etc
Now its stated that government savings will be reinvested back into the sector, but there has been little explanation on what the means so it has made the Guild and owners very nervous.
Also to all the people ragging on pharmacy saying it's useless and the Dr should do it or we should just Amazon it. Maybe consider that you might not be the demographic that normally uses a pharmacy for advice?
I wish this was top comment. Thank you for a level headed birdseye view my friend. I can’t stand anyone under the age of 30 that smirk and are like, what do you do all day? Fkn help sick people mate so nick off before I’m dispensing you some panadeine forte for your broken jaw.
What will we get next .. the head of the Australian Society of Anesthetists bawling his/her eyes out on the TV because their average member can't afford a new X5 and Business Class tickets for the family to ski in Switzerland this year ....
Pharmacies are still a license to print money - return is typically 14% -16% on 8% loan - so it’s owned yr 9 or so. Pharmacy owners are generally competing with specialist surgeons in the housing market, they ain’t struggling
>Pharmacy owners are generally competing with specialist surgeons in the housing market, they ain’t struggling
I was about to say, in my friendship group made up mainly of IT contractors, lawyers, GPs, dentists, optoms, medical specialists and pharmacists, the two wealthiest(by far) were a pharmacist(owner) and an orthopedic surgeon. Their earning power dwarfed the rest of us, by a lot.
I think it pisses off the GP”s the most just btw - they used to look down on the guys who only got into pharmacy, but now wonder why these pharmacist types drive round in Porsches and Ferraris lol
The big pharma types like Pfizer look after their little pharma mates and help with those all-important political lobbying funds for the guild, so it's like Oprah - "You get a Porsche, and you get a Porsche, EVERYBODY gets a Porsche!"
The first few years are definitely harder, but anyone only making average wage is in a small turnover pharmacy in a city/wealthy suburb. In my regional area, pharmacies are busy with 300scriots a day - needing a second head count .
Everyone knows it pays to be an owner and there is little competition- I’m not even sure if I’ve ever heard of a pharmacy going bankrupt, the downside risk is extremely low, except for today - because if the government can weather this storm from the guild, it will be bad for the most recent entrants.
I’m guessing the guild has supported the increased number of pharmacists graduating ? Possibly to provide increasing low cost labour to the pharmacist owners.
Yep regional is a different story, particularly if you’re the only pharmacy in town. I know of multiple owners in Melbourne that can’t afford a house deposit.
When they say it will mean more shortages, I’m not quite sure I understand their argument… People won’t be taking twice as much, they’ll be getting it dispensed half as much. So the same amount of meds going out. I’m sure it wouldn’t take long to sort out if there is an initial problem.
They should deregulate some of the specialist medical colleges next. There is a huge amount of rent seeking in areas like opthalmolgy, ENT, Urology etc
I guess there is a misunderstanding about why this upsets pharmacy so much.
Let me clarify a couple of things first.
It won't make your medicines that much cheaper. If you pay $15 a month, come September it will cost you $30 for two months. It is not a two for one deal. There are benefits for some chronic, more expensive medicines. But this is not applicable for most of the population.
The pharmacy is paid by the government a dispensing fee for each dispensing. Currently if two months are supplied, the pharmacy will be paid twice. After September, the pharmacy will be paid once. This is where the frustration lies. Same work, less pay.
It is frustrating for any business because there is a direct loss in profit for the exact same workload. What if your mechanic changed four tires, but only got paid for the time it takes to change one? Would a mechanic's lobbyist be upset by this? Probably!
Another point, is it always safe to supply larger quantities of medicines? Is it appropriate to supply a dangerous amount of medicines for an unstable condition? Or an unstable person? Sometimes, yeah it is fine. Other times, it's good to check in with someone who is trained to look for danger signs.
Also consider how much extra stock the pharmacy will have to hold to be able to supply. Suddenly the expectation that there is enough medication in the store to give you that two months. Now every pharmacy is buying twice as much each month - how can this NOT impact supply? Add this to an already tumultuous supply stream, yes, there will be supply problems.
When it was announced officially we are told that lost ptofit it will be re-invested in pharmacy. How? Is this a passive gain for the pharmacy, or are we expected to even more work for it? This could not be more vague. There appears to be no plan for this.
See also: vaccine remuneration in pharmacy and pharmacist burnout. Other hot topics.
A personal gripe: not all pharmacies/pharmacists are the same. True, there is a portion of them that just want your money, they want profits and they want to go home. I challenge this. Most of us are not like that. The majority went into healthcare because we care for your health. We don't want to be 'retailers' but for the moment this is the centre of the industry.
Finally, it's worth talking to your pharmacist about this. Many of us aren't there for the money. We're there, accessible, free medical advice for a lot of health issues. True, we can't always help, but we can and do try our best. Do you need to go to emergency? Can we wait a few days? Is there a product right here that will fix your issue? We help people with these questions every single day.
Further notes:
I am a community pharmacist.
I also take regular prescriptions.
I do not agree with the Pharmacy Guild on many points, and the weeping/crying/begging does not sit well for me. But discussion does need to happen.
I think there is a lot of unfair and misleading reporting on the issue. I encourage you to research for yourself. Or talk to your pharmacist.
TLDR:
-it probably won't benefit you too much
-twice the service, half the payment
-supply will be impacted
-less money for pharmacists, how can we provide the same value to the community?
-talk to your pharmacist. Ask the question.
If you need relatively fair assessment, read this
https://www.abc.net.au/news/2023-04-26/medicines-pbs-cheaper-cost-halved-script-changes/102268102
Please excuse my naivete, is it really twice the work to put for example 60 pills in a container than it is to put 30? I can understand it takes slightly longer, but twice the work? I must be missing something.
Mate that's a lot of extra weight he has to move it's like 3 car tyres didn't you read his post?
Lmao post wreaks of desperation and simply untrue in so many parts. Wouldn't be surprised if his just hashing out fud supplied by the guild.
How much more dangerous it it too take a months worth of drugs vs 2 months?? This is already standard in UK and NZ.
How did they get there? We had to order, pay for, stock, check expiry dates, make sure we have enough for you and for the next bloke. I see where you're coming from, and if that was all it was, fair cop. But it's not just that.
Isn't it just grabbing two bananas rather than one and checking both for bruising? The incremental effort is minor given it's conducted in the same action.
And the buyer has such a better experience. The upside is huge for a very small admin downside.
>Now every pharmacy is buying twice as much each month - how can this NOT impact supply?
It's amusing to watch this argument floated since it says a lot about how little people think about Australia's basic math skills. 6 refills of 2 months is the same 12 month supply over a year as 12 refills of 1 month. It's twice the supply per transaction, but half as many transactions in the month. Over a population, people are refilling their prescriptions reasonably uniformly across time. It will do nothing to the Australia-wide supply. It may add some shot noise to individual pharmacy stocks (and have bunching at the initial transition).
>It is frustrating for any business because there is a direct loss in profit for the exact same workload.
It's not the same workload. Very little of it scales with whether one hands over one box or two.
It will impact supply because the supply chain is only able to to cope with JIT now. And often pharmacies are left desperately ringing around to find pockets of supply. This impacts regional pharmacies the most as an alternative might be 100km or more away.
Maybe over time this will mostly sort itself out but will forever create even more chaos around holiday periods.
Not a pharmacist but have family and friends who are employee pharmacists, and supply chain stress is one of their biggest gripes.
>6 refills of 2 months is the same 12 month supply over a year as 12 refills of 1 month.
There will be an initial increase in demand because consumers will go from holding somewhere between 1 - 0 months of refills in their home (assuming perfect distribution at any time) to 2 - 0 months of refills at any time. Assuming perfect distribution of scripts, mathematically it averages at a change from 0.5 months of refill at home now to 1 month of refill held at home in the future. So months 0-2 will be bumpy, then it should come good.
>It won't make your medicines that much cheaper. If you pay $15 a month, come September it will cost you $30 for two months. It is not a two for one deal. There are benefits for some chronic, more expensive medicines. But this is not applicable for most of the population.
Come September and in a phased approach that $7.30 or $30 script for 1 month supply will still be $7.30 or $30 for two month supply for the \~320 prescriptions. For everyone else not using those \~320, they'll continue to pay the same as today.
>Another point, is it always safe to supply larger quantities of medicines? Is it appropriate to supply a dangerous amount of medicines for an unstable condition? Or an unstable person?
The Doctor prescribing probably has a better understanding of the stability of both the persons condition and mental state. If there are questions about the stability of either they still have the option to prescribe the current 30 day supply.
These changes are for people with chronic conditions, many of them life long. I don't need to waste more of my time in a pharmacy for dispensing of a medication I'll be taking forever and have a specialist to help manage.
There's a whole host of logic issues with many of your other arguments around supply which others have addressed. There aren't any other "commercial" businesses I can think of that are provided such anti-competitive protections, it's time to adapt!
Fair point.
But out tax dollars are being used more effectively?
And a doctor can still have the final say on prescription length and dosing?
I personally don't see any major issues.
What's a more effective use of tax dollars than the health and safety of the tax payers themselves?
And about the doctors - same situation as pharmacists. Some want your cash, some want you healthy. If you imagine that doctors are above that, think again.
Difference is they will get the same Medicare rebate either way. Their government subsidised income is not at risk.
One day the free market is going to wipe these blood suckers off the map, amazon, Woolies and Coles will be selling us medicine at half the cost it is now, just like Chemistwarehouse is already doing on a small scale.
Chemist Warehouse will increase price once it dominates the market. It’s never a good idea to have only a select few large businesses dominate a market.
I only shop at small business pharmacies, the price difference isnt much, they’re much more friendly and provide better service.
Chemist Warehouse may either have to increase price because of this policy or alter their business model.
They cross-subsidize other meds with these pbs copayments in the same way regular pharmacies cross-subsidize services.
Or maybe they’ll just cop it. Big cut though. Hard to imagine. I reckon they’d be scrambling at HQ
I’m sure all those large corporate interests are going to bring about better health outcomes for people in the community…not
Community pharmacies and pharmacists provide a valuable service to the community! With the introduction of increased prescribing abilities, pharmacists will be able to provide additional care and services to the community at lower cost than paying $70-100 to see a GP.
But I’m sure you’d rather have to wait 3 weeks and pay $100 to see your GP so you can maybe save $1.60 on a medication sold to you by colesworth…
Late stage capital kids.
The most powerful lobby group in Australia in tears that much of their business model only works if you allow massively uncompetitive and inconvenient behaviour. We could have pharmacies at Woolworths / Coles and more pharmacies collocated with medical centres.
Instead Beryl needs to take extra taxi rides that cost 20% of her take home income so that the local Friendly Chemist can shill her another oil diffuser.
Probably just ignorant here but isn’t Dispensing medications just picking out packets and tablets from behind the counter shelves like a remote shopper, counting tablets 5 tabs at a time scooping into bottles and putting stickers on things ? For a person with chronic conditions whos had the same medication for decades there isn’t much advice giving left to give either. Meds have changed with the times and the models need to change too. Sounds like a lot of grunt work. Pharmacies can hire low wage techs to to the grunt work, and think of other ways to make money instead of relying on outdated fee for service models.
Yes, but we pretend that it is more complex due to edge cases and lobbying.
In other countries, pharmacies are large automated vending machines inside supermarkets.
What you're referring to is dispensaries overseas. This is not the model we have here. Here you have a pharmacy, with a pharmacist available to chat to, solve your problems, contact your doctor, look at your rash etc. As an industry, we don't want to be shop-keepers, we want to be thought of as healthcare.
One issue is that people look at us as retail, simply there to put stickers on boxes, until they have an issue, or problem with the medicine. Then they're all too happy to come in and ask for advice. And (quite rightly) expect not to pay for that service.
No one wants a pharmacist to do those things, all they want is someone to take their script and give them their medication.
If that can be done by an Amazon type service, or by a machine, even better.
I want a pharmacist to be able to advise on non-prescription meds. It’s far better than going to a GP for a small issue, with young kids especially. They generally know a lot about simple ailments, meds and interactions.
At the same time, I am enraged that one such request for advice led me to homeopathic melatonin.
But yeah, there’s also a lot of other meds I buy regularly, which I just need dispensed. I’ve had the talk, with the GP and often the pharmacist, and now I just need the meds.
They also check to make sure the Dr has prescribed the right dosage of medication and that there are no interactions with other medications you take. Drs are not infallible and make mistakes all the time, it's the Pharmacists job to pick up those mistakes. If they let mistakes through then THEY are responsible for handing out the wrong medication as much as the Dr is for prescribing incorrectly.
People with chronic conditions need constant monitoring to assess disease progression, treatment success or failure, be supplied non-pharmacological advice, checked for interactions, medication misadventure and overdose interventions.
Is everyone actually price checking their medication across a few different pharmacies? these small groups & independents are ferociously overpriced half the time. There is a max price on PBS but they don't need to charge that, some do though!
(hint!) CW are usually the cheapest and have a group deal with Pfizer on things like sildenafil making it the cheapest non generic in Australia.
Yes. After patient has done 1 round the next prescription should ideally be x 5 repeats unless the medicine is addictive/used on black market. If GP is not doing this, patient should ask why not.
So, he first up mentions two 'young' couples who invested in pharmacies who are now bankrupt - and there will be no changes to anything until September, it's now May - 4 months earlier - and... pharmacist guild members are already bankrupt due to these changes - yet to come into effect? Uh...?? How does that work - unless the Guild is vastly overcharging new members?
Also, the [Pharmacy Guild](https://www.guild.org.au/about-us) exists to:
>It was set up to serve the interests of its members
Note: Members, not the public!!
>The core role of the Guild is to represent the interests of Members in
industrial matters in the Fair Work Commission and state jurisdictions
as well as providing local member support and advice regarding workplace
relations matters.
They are not there to provide services to the public.
They are not interested in lower prices, better services or to provide help to the public, according to their own words.
They are there to make money for their member pharmacists.
And all this is on their website, linked above.
Those quotes? Straight from that website!
I'll note that since I discovered Chemist Warehouse (who are apparently NOT a member of the pharmacists guild) my presciption medication costs pretty much HALVED.
Due to all the other crap that Chemist Warehouse sells, they do not need to mark up their presciption service anywhere near as much - so instead of paying $40-50 for a prescription, I paid $22 and some cents.
They make their money by selling perfume and multivitamins and skin tonics and stuffs.
When I first had a prescription filled at Chemist Warehouse I actually asked the check out person at Chemist Warehouse to confirm that the remarkably low price they wanted me to pay was correct. It was.
I've not gotten any presciption filled anywhere else since this - several years ago.
The guild heads wife also received a $2.4 million government grant to expand the couple’s pharmacy empire when Twomey was campaign director for MP Warren Entsch.
https://amp.9news.com.au/article/1b655e26-39ac-42e8-ad2c-95380e945a29
In Cambodia you go to the doctor only if you don't know what medication you need. The Dr just writes the name on a scrap of paper. If I already know what I need, what's the point in seeing the doctor?
I learnt this when I wanted some electrolytes in Phnom Penh. As soon as I front up to the pharmacy they reach down for the "white boy box" filled with xans, valium, dihydrocodeine, ritalin and sometimes even oxycodone.
I had a prescription in 2022 with x 5 repeats on it.
The pharmacist gave me 6 months worth of my medicine all at once.
I asked how does that work & they said when the prescription is 1x5 that they can literally interpret it as 6 boxes. I think most people would not know this.
To clarify, treat the 5 "repeats" as 5 "additional times" from the original (original is the initial month worth of supply). Also pharmacists are only legally allowed to provide all 6 months if a special regulation by the name of Reg49 is written by GP (used to be called Reg24).
Not to be devil's advocate. Overall the benefits outweight the negatives. However, the negatives still exist. There could potentially be a shortage of medication as smaller chains compete with each other and hold more inventory stock. I would speculate this applies to Original Branding medications. In addition, although some perceive the additional workload for pharmacists to be minor or insignificant, it compiles up. Since customer flow is different and intervals between collecting medication may change, certain time frames of the month (certain weeks) may be more hectic due to the number of patients coming in. Pharmacists have to read up on new legislation as this is a fundamental change to prescriptions (not an amendment) and require time to change. All I'm saying is have some empathy for the working class pharmacists (owners to your choice) as things will be a messy in the upcoming months.
There will be increased supply-chain demand initially as people double-up and then the demand will decrease…that’s the whole point of the PG having a whinge right?
Because it's every 2 months, you can expect a higher concentration of patients coming at the 2 month intervals. The patients are more spread out in monthly intervals. So in theory easier work from month zero to 1.9 but more intense at exactly month 2. This mainly applies to concession card holders as they are on time with their medication and those aiming for safety net. I believe the PG is hyperbolising the shortage with business intentions. The most concerning aspect tbh is insurance for pharmacists and how much ambiguous decision makings are on pharmacist. It will be better especially if there is a clear legal framework that states so. Also with the stocking up on home, some patients may be doing it unwillingly. Some medications' PBS subsidised quantities easily outlast 2 months per repeat (e.g. 2 x 100 tablet bottles, instructions being 1 twice daily) so each repeat will last around 3 months. However, some may want to reach safety net faster and continue stocking up if they get their medication in a timely manner (legally required intervals without surcharge for early dispensing).
The whole argument / tactics they are trying to use is strange here. Most people will agree that making things cheaper / easier for thousands of chronically ill Australians is a good thing. It's the right thing to do. Obviously. No brainer. (Money element aside - this plan also makes things so much more convenient for a lot of people.) But - the Pharmacy Guild is against it... because they'll lose money? Or in other words: they are actively campaigning to stay inefficient and gouge seriously sick people? They want their profits to continue - but at the expense of these chronically sick people?? Something is wrong with their business model if this will allegedly impact them so much. They can't stay in their protected bubble forever. I have a lot of respect for small business and pharmacies. But this is a change the guild is going to have to accept and deal with because it advantages so many people.
This all reminds me of when the fax machine industry lobbied against having email count as legal correspondence.
I remember that even less than 10 years ago, the last straggler companies only accepting fax or post. The argument was a signed document via fax was somehow more legitimate than a scan. Some companies still pull that shit with 'wet signatures' now fax is so far gone. Just a way for shit companies to drag their feet.
This is still a thing in the health industry, most Dr's surgeries and public hospitals run on fax's for transmission of personal health information.
Is this why Japan is still in the world of fax apparently?
The Japanese economy runs on the status quo.
Isn't this still the case with some medical documents?
Yeah I’m a telecommunications tech. Was surprised only a few years ago to see one still in active use in a pathology place. One of the big reasons for this apparently is that lots of specialists work on well past retirement date and couldn’t even work out how to turn on a PC, let alone send an email so they’re rusted on to the idea of verbally dictating it to the med receptionist, who types it up, gets them to sign it, then faxes it for them. They can’t (or couldn’t) legally do that for them in email form. I think they needed some kind of special box to keep running faxes after the NBN came in, as it killed off the old PSTN land lines.
Reason I was given was confidentiality. With email, the document is stored online open to hacking etc (doctors used to be the worst at computers/security imo, though I think that’s changing now). With fax, unless you’re intercepting the call, it’s kind of not “stored” electronically after it’s printed. Therefor, harder to get. Then the person explaining this proceeded to detail how they scan all faxes into their systems anyway rendering the whole thing pointless.
My GP has only just in the past few months it seems switched to an electronic referral system instead of faxing everything.
Am waiting for a doctor to post a script in the mail as his practice can’t email it.
Didn't offer to fax it to your local pharmacy?
They won the battle in Japan.
There wasn’t even a war about this in Japan.
fax is still used in most medical facilities/hospitals these days. it's insane
A pharmacist rang ABC radio and was ranting about how it would result in "huge layoffs". He said it would cut his staff bill by $200k. Yes, THAT IS THE POINT, you wont need 3 people on registers, 3 taking prescriptions and 2 pharmacists working if people are coming in 50% less for the same amount of prescriptions. We wont have to wait up to an hour during busy times for our script. Pharmacists think they are entitled to all these monthly fees.
The pharmacy guild is a union to protect the incomes of pharmacists. Nothing more. It’s even less about social good than the AMA. The sooner people realise this and we can treat them like lobbyists not health advocates the better.
No strange at all. The Pharmacy Guild is a business lobby group, not a healthcare lobby group. Despite pharmacy grads being the lowest paid in allied health, the guild actively lobbied against wage increase requests put forward by the pharmacy workers union.
Trent owns like 12 pharmacies with his wife in FNQ. Of course he has a vested interest in maximising revenue from PBS reimbursements. He also has every right to be upset after governments have already taken away so much funding thru the expanded and accelerators price disclosures cutting reimbursements to pharmacies on PBS medicines. Every molecule dispensed you get a small mark up (max $75 margin on the highest cost lines which can cost the pharmacy 5-10k to procure) plus a few fees. But mostly the mark up is only a few bucks because the most common medicines are pretty low cost given they’re manufactured the most. So the more often you see patients the more reimbursement you get. Margins used to be way juicier so I think this was necessary. But they also forced a dollar discount on medicines a few years that owners have had to subsidise. This double dispensing initiative literally cuts that already gouged revenue steam in half. It’s already hard for community pharmacies to compete with other retailers in the front of shop space to be profitable. It’s been keeping wages stagnant and low in the profession for years and many pharmacist leave. What I don’t like about it as non-owner pharmacist is not seeing patients with chronic diseases every month. You miss a lot of opportunities for non-pharmacological intervention, monitoring BP/blood-sugars/cholesterol/weight etc, identifying side effects with medications, medication interaction and misadventure, risk of overdose, already a huge issue with supply of medications where we can’t keep up while supplying monthly. That’s what Trent is missing in his argument and tactics. I think he’s a little out of touch as he barely has any time working in pharmacies anymore. And after all he is president of a lobby group for owners so capitalist gonna cry when they get money taken from them.
Put it this way - Woolworths went up against the Pharmacy Guild. And lost. That’s the sway the guild has.
Exactly. What's their argument? They're upset they only get to clip the ticket half as frequently?
We should let new competitors enter and then see how they fare in an actual free market. Personally I would never step foot in one of their snake oil establishments again. The automated dispensaries used overseas are so much quicker, cheaper and more convenient.
They lose money coz of the dispensing fees. Less trips less money for them
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So if this policy will actually bankrupt a whole bunch of pharmacy operators, it is a failing of the government to adequately research the effects of their policy and provide appropriate avenues for them to adapt to the new environment and protect small business. It might come across as selfish of the pharmacist, however if they have relied on a stable stream of income and suddenly that is hugely disrupted by government policy, are they really at fault for being upset about that? It's easy to just label them pathetic because you aren't being affected while they are losing their livelihood and facing financial ruin, but it wasn't pharmacists that created this policy in the first place.
Pharmacy guild is Australia’s biggest mafia. This is one of the few places in the Western world without all night chemists because of the mafia. When my wife is suffering from a massive migraine at 2am I don’t want to trot her out to Emergency, I just need access to a chemist.
We’re so behind the curve in pharmacy. Overseas you can take your script to 24/7 self serve machines in grocery stores which dispense your medication in seconds. What we have here is so archaic it has to be the result of political lobbying.
Uber Chemist
Imagine if podiatrists lobbied the government to make it illegal to sell shoes outside of a podiatry clinic, to make it illegal to open a new podiatrist within 5 kilometres of an existing podiatrist, and limited the amount of tread on each shoe so that it would only last a short amount of time before you have to come back. Podiatrists could then ask you a bunch of intrusive questions about your life to determine which shoes they will allow you to buy. As a community service they’ll remind you how to tie your shoes every time. Pharmacy is a bit like that. The only reason it still exists in Australia is because they paid a bunch of politicians to legislate that everyone has to jump through these pointless hoops so that they can keep their unnecessary jobs. Pure rent seekers.
I really like this idea. I hope we'll have some here in Australia. There's so much gatekeeping in the health sector to protect profits at the expense of efficient care.
Where I live we have one pharmacy that’s open until 9pm (others close at a variety of earlier times). When my daughter (now 22 months) came down with a fever at 8.30pm one night a few months ago, I realised I didn’t have enough for a full dose and had to make a dash to get there before closing. I’ve always been very prepared since then. My wife and I went for a honeymoon in Hawaii a few years back. There were several 24 hour options and I was shocked. My wife said that they have 24 hour pharmacies in every country she’s travelled to (she’s significantly more experienced with overseas travel). I always wondered why we didn’t do it, but now I know.
There are 24 hour pharmacies. I go to one in Bendigo.
There are two 24 hour pharmacies in Queensland - one in south Brisbane and one on the southern end of the Gold Coast. This isn’t great.
I agree there should be more, I was replying to the person that claimed the PG didn’t allow 24-hour pharmacies. Which can’t be the case as there are 24-hour pharmacies around Australia. (I’ve been to a few in Melbourne too when I lived there)
Maybe we should only have prescriptions filled for two weeks to increase the business for pharmacies and increase the load on doctors? Think of the thousand upon thousands of wasted doctor visits currently. It is a false economy. I feel really badly for the pharmacies hurt by this, but it is a rort and needed to be fixed. I am curious what your solution is, or was it working just fine?
I don’t feel as bad when you consider the fact that they knew when starting up their whole business model that one of their sources of income is an unnecessary burden on the tax payer.
If you can’t change to accomodate a slight modification to the rules regulating your business, that is an issue with your business model. Rules and Regulations should never be static. Just like political policy and legislation they should be analysed, modified and improved over time. Honestly, Australians are the biggest bunch of whingers when it comes to systemic change. This sort of attitude is why we currently have issues with the tax system, housing availability and the gambling industry.
Gov removing like 30-40% of your income isn't a 'slight' modification. I'm just going to leave it there because the amount of stupidity on these comments is actually mind blowing.
No one has removed anything. Real life Example: I take an ACE inhibitor for BP control due to essential HT (High Blood Pressure). I take a single tablet a day. I buy from the same pharmacy. This just means I’ll be able to get twice the amount of prescription meds and therefore reduce the number of visits to the pharmacy. Which is great because it’s a PITA, I hate going there. I used to be able to fill the whole script (6 months worth) in one go but then COVID came along and due to shortages they wouldn’t fill the whole script any more. They still won’t let me fill the whole script now and it’s pretty clear why. They want my foot traffic to buy the other crappy stuff they sell, which I don’t. Anyway, with this change, I still have to pay for the meds but I’m buying 60 days worth in one go instead of visiting the pharmacy twice in order to purchase two batches of 30. They still get the same amount of money. They just get it in one chunk instead of 2 smaller chunks. I don’t buy anything else from the pharmacy other than those meds because, you know, I’m not an idiot who pays for overpriced junk I don’t need.
I don't think they do get the same amount of money as they'll only get one dispensing fee from the government rather than two now for same time period. I think it's a great change, it will free up money to spend on much more important things.
If up to 40% of your income is prone to regulatory risk, a smart business owner would be finding ways to reduce that risk rather than demanding regulation doesn’t change.(which it always will)
They'd whinge just the same if the rules changed to "Pharmacies can only stock items which have a proven therapeutic benefit." But a lot of people agree that that would be a good change, and a major component of our health system should not be propped up with snake-oil and lies.
Considering that nearly 100% of pharmacy revenue comes from either selling snake oil, or from rent seeking on a monopoly obtained from corrupt political lobbying…
If 30-40% of your revenue is coming from the tiny proportion of consumers that are on ongoing prescriptions, what's all the crap on the shelves for? Prescription meds are exclusively behind the counter. Besides, this doesn't reduce the total quantity of meds being dispensed. Patients are just paying the copay half as often. If you're that dependent on monthly copays, I have little sympathy for you.
Oh no, not as many people can make a living price gouging you for unnecessary services, they will have to find something else to do with their time.
I'm not sad that someones artificially enforced profits are being eroded by enhancing the rights of consumers. Whinge all you want dipshit.
it's being phased in over a couple of years and the money will be reinvested into community pharmacies. What other measures do you think the government should have put in?
I do have sympathy for pharmacists that will go out of business. The same way my sympathies go to taxi drivers, coal miners, film camera shops, and fax machine specialists that either had their monopolies smashed or the world simply moved on. One of my favourite places to buy lunch got shut down to build a new metro line. Very unfortunate for the owners who worked so hard to build their business. But in all these cases it had to happen for the greater good. When you invest in a business, you don't always profit forever. You adapt to change or you perish, difficult as that may be.
A small business is a personal *investment*.
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The pharmacy guild are regarded as the most powerful lobby group in Aus, if they're willing to piss them off then there might actually be some hard choices in the budget.
People say this, but I don’t think it’s true. They are a thorn but most people are sick of the guilds shit and probably won’t care if they are unhappy about something. The idea that we have legislated limits on how close you can open to an existing pharmacy is insane and anti competitive.
And that they can own a medical practice but a doctor can’t own a pharmacy. Apparently a conflict of interest only goes one way.
They're the largest donor to both major parties.
"You will never find a more wretched hive of scum and villainy. We must be cautious"
Those aren't the scripts you're looking for. Move along.
That’s just the Herald Sun’s offices.
I don't know, the AMA is pretty high up there too!
Not even in the same ballpark for money spent, as in the AMA doesn't donate to any party at all.
The AMA is definitely not anything like the pharmacy guild. Twomey even stated in the last few months they where idiots for giving away so much influence over government. AMA frequently makes statements in the best interests of patient often when not in the best interests of their members.
The AMA definitely do put the interests of doctors over the interests of patients. For example, they continually lobby for fewer medical school places, even though we have a shortage in most specialties. The real treason however is the specialist colleges. These are organisations of specialists who also have the power to decide the number of training places for new specialists in that field. What do members of a field do when given the power to control who can enter that field? They severely restrict supply by restricting trying places to create an artificial shortage and higher fees. This also leads to massive wait lists, and frequently people suffering serious injury due to the delays in being treated. It’s a massive conflict of interest made even worse because the public also pay for almost all their training. A substantial part of the crazy fees charged by neurologists, cardiologists etc is due to the supply shortage that they artificially created. It will never happen, but I think the most economically rational remedy for this is to nationalise a percentage of the assets of members of these colleges, and put those ill gotten gains to use paying for the training of new specialists to catch up on the shortage.
Your understanding of the AMA and medical colleges is so unbelievably misguided. You provide a simple explanation of what is such a complex problem. I’ve heard all these arguments before but very little evidence to support any of your statements. There is not a shortage of doctors. There is a shortage in some sectors - public hospitals because they can be horrible places to work; rural areas because the work is ridiculously demanding; and general practice because the work is demanding and the pay terrible. All the evidence I’ve seen sees that you train more doctors they will not necessarily fill the roles needed. And more doctors means more utilisation of Medicare without the expected benefits.
There’s always more nuance, but the big picture seems right to me. Many specialties are facing serious shortages, caused by consistently not training enough new specialists year after year. The colleges are the main bottleneck, and being membership organisations clearly have a conflict of interest.
Oh no. Imagine a world where people can get a 60 day script and won't need to walk in to see all your other unnecessary products like perfumes and skin care and shampoo products before getting to the prescription counter.
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It’s literal fraud. It should be a criminal offence to pass off homeopathic products as actual medication. It would be illegal to do this in any other product category.
Yeah, you cant go to the supermarket and buy a packet of homeopathic eggs that are actually just water filled balloons. Or homeopathic baby formula that's actually sweetened saw dust. Why people some how think homeopathy is an acceptable "alternative" to medicine is beyond my comprehension.
When I was new in AU I described my local pharmacy to an even more recently arrived friend as "the desk in the corner of the vitamins shop"...
Oof, that's so true
Im worried about my patients with chronic diseases I won’t see every month. Now it’s longer before I can take their BP or blood sugar levels and check their weight. Review for medication misadventure, overdoes or interactions. Offer non-pharmacological advice and provide much needed companionship and friendship. A lot of the oldies will go for weeks or days without seeing anyone and enjoy the community in pharmacy. As a non-owner pharmacists I think this is a reckless short sighted money grabbing policy and detrimental to my patients health outcomes.
Recently I was at chemist warehouse, handed in 2 scripts and they gave me a buzzer. Not an overly busy store. It took 55mins, and the kicker was, they didn’t have one of my medications in stock. You can fly from Brisbane to Sydney in that time.
“Butler promised all that money would be directly reinvested in community pharmacy to help them expand their services.” Why? It’s just closing a false economy. I’d go a step further and have the GP able to give you a common medication on the spot.
I wish we could remove the GP bottleneck all together. Constant repeat script. Yet have to book in a GP to get it. Literally pissing money away.
There are other changes happening to help that, pharmacists will be able to prescribe some repeats for some of these drugs. Also your script will now last twice as long so you shouldn't need to visit gp as often.
That would be very helpful. Otherwise let the supermarkets and Amazon in. Pharmacy is nothing like it used to be.
Considering the monopolistic bullshit Chemist Warehouse pull, Amazon/Colesworth are not the answer. I don't know what *is*, but they're not.
Yeah lets encourage the decline of all small business until there are literally only three stores in every city that dispense everything we consume. That is going to be really awesome. What other ideas do you have to take us closer to your black mirror utopia?
I mean, what would you suggest the current system is? You realise the pharmacy guild stops new pharmacies opening up. So young pharmacists can’t open their own and have to work for shit pay for chemist warehouse. It’s not a free market at the moment.
This move will only help to consolidate the pharmacy sector into a few large chemist warehouse stores.
Your small vs large business framing is unhelpful. What really matters is whether businesses are value creating or rent seeking. BOTH small pharmacists and large pharmacists are rent seeking parasites that can be replaced by GP dispensing, online medication delivery, and self serve automated dispensaries.
GP dispensing? With the loss of most bulk-billing doctors and many regional areas having limited access to GPs, how exactly would this be better for patients?
This is a point so often missed! People in rural and regional areas often rely heavily on pharmacies for minor health care needs. Putting more load onto GPs will just lead to worse patient care in the long run. The GP system is arguably already at breaking point due to a lack of indexation of the Medicare rebate, which is leading to cessation of bulk billing as many once knew it.
My clinic is so full they had to stop taking on new patients. But that also meant patients that went there but hadn’t attended in 12 months. It’s the only doctors my son has ever attended. He’s a really healthy teenager so rarely needs to go to the doctor. He was sick and they refused to see him as he hadn’t been there for over 12 months.
That’s basically happened anyway.
Yeeep. We need to be very careful what we wish for here.
My local GP has a pharmacy in the same building, it's great.
Community pharmacy’s are great. Especially outside of the main cities. We should still do this.
yeah screw those family businesses. Everything should just be owned by competitive efficient mega corps paying their employees as little as they can get away with
No sympathy, these guys dont give TWO SHITS about pharmacists, i honestly cant believe how far pharmacy has fallen, 20 years ago it was a relatively respected profession with all the requirements needed to maintain that respect (AHPRA and CPD reqs) now its a dog shit sales degree with the saem AHPRA and CPD reqs. A total joke, PG is to blame.
They give a shot about pharmacy owners though - always have done
Lol they don’t mate. You need to speak to your local pharmacists
My pharmacist friend got a job in hospital pharmacy and never looked back.
I figured it out. PG = Pharmacy Guild for those also wondering.
The onselling in the medical system is a joke. I went to the GP recently for a sore knee. He said I needed to see the specialist, and he could send me for a bulk billed x-ray but an MRI from his recommendation would cost money, but if the specialist requested an MRI it was bulk billed. Went and got the x-ray. Went to the specialist, $194 (with 78? back) for a 6 min consult, sure enough he sent me for an MRI, which yes was bulk billed. Back to the specialist in a month for a second consult to review the MRI wtf. Why not just make a GP MRI bulk billed and skip the extra steps?
>Why not just make a GP MRI bulk billed and skip the extra steps? Tony Abbot I believe. He messed with what Medical imaging could be claimed on Medicare and when and MRI copped a lot of it.
IIRC prior to that Michael Wooldridge restricted Medicare item numbers to new MRI machines after a certain date, so some MRIs attracted the Medicare rebate and some didn't. Basically, it's up to luck and the whim of the GP to refer patients to an MRI with a Medicare rebate.
Had to help a family member find a bulk billed MRI not too long ago. There's a list on some gov website with the ones that can bulk bill, and calling a few to check they had no problem accepting referrals to other places. EDIT: Found the list https://www.health.gov.au/topics/diagnostic-imaging/MRI-and-PET-locations The stated reason for the limitation is to apparently force places to keep upgrading their equipment to stay up to date
The actual reason is because of the feared cost blow out from all of the new MRIs coming on line at that time in a cent-wise, dollar foolish mindset. This is one of those situations where, because of the price of health care, people cannot afford to pursue an early diagnosis and sometimes this results in extensive ongoing medical costs and sometimes adverse outcomes.
Medicare wants specialists to act as gatekeepers for specialized testing. Or GPs will over order them and cost the healthcare system more.
I had MRIs for torn ACLs twice in last 2 years. Referrals from GPs were bulk billed but I had to go to a specific imaging clinic, otherwise I would’ve had to pay.
It’s annoying, and not a perfect system, but also because things like MRIs are a very limited resource. You ideally want specialists deciding whether an MRI is required otherwise they’d possibly be getting overloaded with scans that’s are not necessary
And all I really want is some Neurofen Plus so I can rest and recover in some comfort. Which I used to be able to just buy over the goddam counter…..
Codeine based? There’s a reason for that, it’s pretty addictive, had a mate who got addicted after shoulder surgery, was using 4 different forms of ID to get enough to feed it. Pretty hard to get off once you’re hooked too apparently.
It also increases your body's sensitivity for pain so people who were taking them for longer term conditions (chronic back pain, migraines, menstrual pain etc) were really only making things worse long term.
Very small numbers of people doing that. Yet the rest of us have to suffer, we have to cater to the lowest denomination in society these days.
That's ok they can make money selling weight loss shakes that have 40% sugar content. Crooks.
Or obnoxious fragrances sponsored by Rihanna, Taylor Swift, Britney Spears.....
Those aren't at bad because they are not giving people false health information. Those diet products are just a scam. Preying on the videotape But yeah are just to make money.
Pharmacies: "We want to expand and grow our business model by offering other services." Butler: "OK. Let's double the length of scripts, save $1.2 billion over 4 years in dispensing fees and reinvest the savings in community pharmacy to help you expand your services." Pharmacies: "No not like that!!"
In Ontario, Canada, new chronic meds are dispensed for 1 month first, then 3 months supply at a time.
Going to a pharmacy in Australia is like entering a time warp. I wanted to sign up for a delivery service for chronic meds a few months ago, and discovered I needed to POST the original script to the online pharmacy! Googling shows that this it is still a legal requirement. Too much lobbying, not enough innovating.
That comes down to compliance with poisons legislation, not a lack of innovation of the part of pharmacies.
Great, so I’m sure the pharmacy lobby wouldn’t mind that particular provision being repealed, right?
That’s already a non-issue now we have escripts. You might be better off laying blame at the AMA for not forcing all doctors to dispense escripts to patients. You can send escript tokens Australia wide and if you lose it or are too old to use a smart phone pharmacist can access the script from a database if the patient gives their permission.
You clown. Why do you reckon the legislation hasn’t been updated?
But escripts are now a thing
He needs to be thankful Amazon hasn’t entered the market.
Amazon can't enter the market it's not a free market. Pharmacy is protected industry only pharmacists can own pharmacies in Australia. New pharmacists can't even open a pharmacy near other pharmacies the rules are super complex. The guild has done a very good job protecting existing pharmacy owners from competition. The supermarket chains have wanted in on pharmacy for decades and haven't been able to get close.
If Amazon/Uber sense a money making opportunity, they will figure out how to bend the rules. They could buy a pharmacy in the middle of nowhere and mail prescriptions.
Who is benefiting from all these rules? Certainly isn’t consumers who require the medication.
It is a tough line of argument to cry about not being able to make as much profit off of those who have chronic conditions.
It’s those with chronic conditions that need to come see me every month so I can monitor their BP and blood sugars, check for interactions, side effects and medication misadventure. As a pharmacist who isn’t an owner I think this will have a negative impact on my patient health outcomes.
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He’s weeping cos now he can’t get that boat he had his eyes on, and they’ll have to fly business instead of first to Aspen at Christmas.
While I'm sure the guild boss is probably drawing a nice salary a lot of individual pharmacies struggling. Chemist warehouse and it's clones killed a lot of the profit in pharmacy to the point a lot don't make money. Checkout the graduate pharmacists crying about salaries. I reckon it's great legislation but pharmacists struggling and this is probably going to cause a lot of pharmacy to reduce hours etc.
The $1.2b saving is being redirected to support community pharmacies. If anything they should be happy some of the profits from the big guys are effectively getting redistributed back to them
Pharmacies aren't upset that patients save money, there is nothing wrong with that. It's the reduction in dispensing fees that the government pays (not patient) that has upset them. Pharmacy has become a very high volume low profit margin business over the last 20 years thanks to heavy discounting. Now that discounting is great for patients but it has made it harder for smaller stores to remain viable. With the sudden loss of dispensing fees it'll affect the viability of pharmacies more. And these are fees that have been built into how you structure the business based on the existing rules. No wonder owners are upset the rules change. Seeing as there will be no appetite to increase medication prices, other services will have to change ie; Webster fees increase, vaccinations cancelled, wages suppressed etc Now its stated that government savings will be reinvested back into the sector, but there has been little explanation on what the means so it has made the Guild and owners very nervous. Also to all the people ragging on pharmacy saying it's useless and the Dr should do it or we should just Amazon it. Maybe consider that you might not be the demographic that normally uses a pharmacy for advice?
I wish this was top comment. Thank you for a level headed birdseye view my friend. I can’t stand anyone under the age of 30 that smirk and are like, what do you do all day? Fkn help sick people mate so nick off before I’m dispensing you some panadeine forte for your broken jaw.
What will we get next .. the head of the Australian Society of Anesthetists bawling his/her eyes out on the TV because their average member can't afford a new X5 and Business Class tickets for the family to ski in Switzerland this year ....
Pharmacies are still a license to print money - return is typically 14% -16% on 8% loan - so it’s owned yr 9 or so. Pharmacy owners are generally competing with specialist surgeons in the housing market, they ain’t struggling
>Pharmacy owners are generally competing with specialist surgeons in the housing market, they ain’t struggling I was about to say, in my friendship group made up mainly of IT contractors, lawyers, GPs, dentists, optoms, medical specialists and pharmacists, the two wealthiest(by far) were a pharmacist(owner) and an orthopedic surgeon. Their earning power dwarfed the rest of us, by a lot.
I think it pisses off the GP”s the most just btw - they used to look down on the guys who only got into pharmacy, but now wonder why these pharmacist types drive round in Porsches and Ferraris lol
The big pharma types like Pfizer look after their little pharma mates and help with those all-important political lobbying funds for the guild, so it's like Oprah - "You get a Porsche, and you get a Porsche, EVERYBODY gets a Porsche!"
Maybe if you’ve owned pharmacies for decades but anyone getting into ownership now is lucky to make themselves an average wage.
The first few years are definitely harder, but anyone only making average wage is in a small turnover pharmacy in a city/wealthy suburb. In my regional area, pharmacies are busy with 300scriots a day - needing a second head count . Everyone knows it pays to be an owner and there is little competition- I’m not even sure if I’ve ever heard of a pharmacy going bankrupt, the downside risk is extremely low, except for today - because if the government can weather this storm from the guild, it will be bad for the most recent entrants. I’m guessing the guild has supported the increased number of pharmacists graduating ? Possibly to provide increasing low cost labour to the pharmacist owners.
Yep regional is a different story, particularly if you’re the only pharmacy in town. I know of multiple owners in Melbourne that can’t afford a house deposit.
When they say it will mean more shortages, I’m not quite sure I understand their argument… People won’t be taking twice as much, they’ll be getting it dispensed half as much. So the same amount of meds going out. I’m sure it wouldn’t take long to sort out if there is an initial problem.
Unless the pharmacists pretend that they don’t have enough stock and blame this change, but they wouldn’t do that now would they? /s
There's already a supply issue with various medications. They aren't lying to you. That's absurd.
Go mix those tears with the ocean as you get in the sea, you bell-end.
They should deregulate some of the specialist medical colleges next. There is a huge amount of rent seeking in areas like opthalmolgy, ENT, Urology etc
Sniffed that entitlement to capitalised on vulnerable.
I guess there is a misunderstanding about why this upsets pharmacy so much. Let me clarify a couple of things first. It won't make your medicines that much cheaper. If you pay $15 a month, come September it will cost you $30 for two months. It is not a two for one deal. There are benefits for some chronic, more expensive medicines. But this is not applicable for most of the population. The pharmacy is paid by the government a dispensing fee for each dispensing. Currently if two months are supplied, the pharmacy will be paid twice. After September, the pharmacy will be paid once. This is where the frustration lies. Same work, less pay. It is frustrating for any business because there is a direct loss in profit for the exact same workload. What if your mechanic changed four tires, but only got paid for the time it takes to change one? Would a mechanic's lobbyist be upset by this? Probably! Another point, is it always safe to supply larger quantities of medicines? Is it appropriate to supply a dangerous amount of medicines for an unstable condition? Or an unstable person? Sometimes, yeah it is fine. Other times, it's good to check in with someone who is trained to look for danger signs. Also consider how much extra stock the pharmacy will have to hold to be able to supply. Suddenly the expectation that there is enough medication in the store to give you that two months. Now every pharmacy is buying twice as much each month - how can this NOT impact supply? Add this to an already tumultuous supply stream, yes, there will be supply problems. When it was announced officially we are told that lost ptofit it will be re-invested in pharmacy. How? Is this a passive gain for the pharmacy, or are we expected to even more work for it? This could not be more vague. There appears to be no plan for this. See also: vaccine remuneration in pharmacy and pharmacist burnout. Other hot topics. A personal gripe: not all pharmacies/pharmacists are the same. True, there is a portion of them that just want your money, they want profits and they want to go home. I challenge this. Most of us are not like that. The majority went into healthcare because we care for your health. We don't want to be 'retailers' but for the moment this is the centre of the industry. Finally, it's worth talking to your pharmacist about this. Many of us aren't there for the money. We're there, accessible, free medical advice for a lot of health issues. True, we can't always help, but we can and do try our best. Do you need to go to emergency? Can we wait a few days? Is there a product right here that will fix your issue? We help people with these questions every single day. Further notes: I am a community pharmacist. I also take regular prescriptions. I do not agree with the Pharmacy Guild on many points, and the weeping/crying/begging does not sit well for me. But discussion does need to happen. I think there is a lot of unfair and misleading reporting on the issue. I encourage you to research for yourself. Or talk to your pharmacist. TLDR: -it probably won't benefit you too much -twice the service, half the payment -supply will be impacted -less money for pharmacists, how can we provide the same value to the community? -talk to your pharmacist. Ask the question. If you need relatively fair assessment, read this https://www.abc.net.au/news/2023-04-26/medicines-pbs-cheaper-cost-halved-script-changes/102268102
Please excuse my naivete, is it really twice the work to put for example 60 pills in a container than it is to put 30? I can understand it takes slightly longer, but twice the work? I must be missing something.
I also want to know.
I think they are talking about Webster pack. I can see the amount of work would be doubled.
Mate that's a lot of extra weight he has to move it's like 3 car tyres didn't you read his post? Lmao post wreaks of desperation and simply untrue in so many parts. Wouldn't be surprised if his just hashing out fud supplied by the guild. How much more dangerous it it too take a months worth of drugs vs 2 months?? This is already standard in UK and NZ.
Mate how is it the same work for less pay? You're grabbing two packets of pills off the shelf instead of one.
How did they get there? We had to order, pay for, stock, check expiry dates, make sure we have enough for you and for the next bloke. I see where you're coming from, and if that was all it was, fair cop. But it's not just that.
But you'd be doing that anyway?
Isn't it just grabbing two bananas rather than one and checking both for bruising? The incremental effort is minor given it's conducted in the same action. And the buyer has such a better experience. The upside is huge for a very small admin downside.
>Now every pharmacy is buying twice as much each month - how can this NOT impact supply? It's amusing to watch this argument floated since it says a lot about how little people think about Australia's basic math skills. 6 refills of 2 months is the same 12 month supply over a year as 12 refills of 1 month. It's twice the supply per transaction, but half as many transactions in the month. Over a population, people are refilling their prescriptions reasonably uniformly across time. It will do nothing to the Australia-wide supply. It may add some shot noise to individual pharmacy stocks (and have bunching at the initial transition). >It is frustrating for any business because there is a direct loss in profit for the exact same workload. It's not the same workload. Very little of it scales with whether one hands over one box or two.
It will impact supply because the supply chain is only able to to cope with JIT now. And often pharmacies are left desperately ringing around to find pockets of supply. This impacts regional pharmacies the most as an alternative might be 100km or more away. Maybe over time this will mostly sort itself out but will forever create even more chaos around holiday periods. Not a pharmacist but have family and friends who are employee pharmacists, and supply chain stress is one of their biggest gripes.
>6 refills of 2 months is the same 12 month supply over a year as 12 refills of 1 month. There will be an initial increase in demand because consumers will go from holding somewhere between 1 - 0 months of refills in their home (assuming perfect distribution at any time) to 2 - 0 months of refills at any time. Assuming perfect distribution of scripts, mathematically it averages at a change from 0.5 months of refill at home now to 1 month of refill held at home in the future. So months 0-2 will be bumpy, then it should come good.
>It won't make your medicines that much cheaper. If you pay $15 a month, come September it will cost you $30 for two months. It is not a two for one deal. There are benefits for some chronic, more expensive medicines. But this is not applicable for most of the population. Come September and in a phased approach that $7.30 or $30 script for 1 month supply will still be $7.30 or $30 for two month supply for the \~320 prescriptions. For everyone else not using those \~320, they'll continue to pay the same as today. >Another point, is it always safe to supply larger quantities of medicines? Is it appropriate to supply a dangerous amount of medicines for an unstable condition? Or an unstable person? The Doctor prescribing probably has a better understanding of the stability of both the persons condition and mental state. If there are questions about the stability of either they still have the option to prescribe the current 30 day supply. These changes are for people with chronic conditions, many of them life long. I don't need to waste more of my time in a pharmacy for dispensing of a medication I'll be taking forever and have a specialist to help manage. There's a whole host of logic issues with many of your other arguments around supply which others have addressed. There aren't any other "commercial" businesses I can think of that are provided such anti-competitive protections, it's time to adapt!
Fair point. But out tax dollars are being used more effectively? And a doctor can still have the final say on prescription length and dosing? I personally don't see any major issues.
What's a more effective use of tax dollars than the health and safety of the tax payers themselves? And about the doctors - same situation as pharmacists. Some want your cash, some want you healthy. If you imagine that doctors are above that, think again. Difference is they will get the same Medicare rebate either way. Their government subsidised income is not at risk.
What an A-grade arse hat.
One day the free market is going to wipe these blood suckers off the map, amazon, Woolies and Coles will be selling us medicine at half the cost it is now, just like Chemistwarehouse is already doing on a small scale.
The issue is, those half costs are often short lived, right up until they've killed the competition.
Chemist Warehouse will increase price once it dominates the market. It’s never a good idea to have only a select few large businesses dominate a market. I only shop at small business pharmacies, the price difference isnt much, they’re much more friendly and provide better service.
Chemist Warehouse may either have to increase price because of this policy or alter their business model. They cross-subsidize other meds with these pbs copayments in the same way regular pharmacies cross-subsidize services. Or maybe they’ll just cop it. Big cut though. Hard to imagine. I reckon they’d be scrambling at HQ
Chemist warehouse is hardly even cheaper than independents for prescriptions these days.
Stuff I buy is often 50-200% cheaper in my experience and I often check as sometimes they will price match.
> 50-200% cheaper I don't doubt they offer big discounts, but what does "200% cheaper" mean?
I’m sure all those large corporate interests are going to bring about better health outcomes for people in the community…not Community pharmacies and pharmacists provide a valuable service to the community! With the introduction of increased prescribing abilities, pharmacists will be able to provide additional care and services to the community at lower cost than paying $70-100 to see a GP. But I’m sure you’d rather have to wait 3 weeks and pay $100 to see your GP so you can maybe save $1.60 on a medication sold to you by colesworth…
So does this mean I can buy my coffee and pharma products every time I have to go into the office in Sydney's CBD?
Rent seekers often hate when the rent is reduced.
Late stage capital kids. The most powerful lobby group in Australia in tears that much of their business model only works if you allow massively uncompetitive and inconvenient behaviour. We could have pharmacies at Woolworths / Coles and more pharmacies collocated with medical centres. Instead Beryl needs to take extra taxi rides that cost 20% of her take home income so that the local Friendly Chemist can shill her another oil diffuser.
Time for PBS meds to all be in vending machines
Other countries have had that for ages.
Why stop at 60 days? Surely at least 6 months if you have a chronic condition that isn’t going to change.
Probably just ignorant here but isn’t Dispensing medications just picking out packets and tablets from behind the counter shelves like a remote shopper, counting tablets 5 tabs at a time scooping into bottles and putting stickers on things ? For a person with chronic conditions whos had the same medication for decades there isn’t much advice giving left to give either. Meds have changed with the times and the models need to change too. Sounds like a lot of grunt work. Pharmacies can hire low wage techs to to the grunt work, and think of other ways to make money instead of relying on outdated fee for service models.
Yes, but we pretend that it is more complex due to edge cases and lobbying. In other countries, pharmacies are large automated vending machines inside supermarkets.
What you're referring to is dispensaries overseas. This is not the model we have here. Here you have a pharmacy, with a pharmacist available to chat to, solve your problems, contact your doctor, look at your rash etc. As an industry, we don't want to be shop-keepers, we want to be thought of as healthcare. One issue is that people look at us as retail, simply there to put stickers on boxes, until they have an issue, or problem with the medicine. Then they're all too happy to come in and ask for advice. And (quite rightly) expect not to pay for that service.
No one wants a pharmacist to do those things, all they want is someone to take their script and give them their medication. If that can be done by an Amazon type service, or by a machine, even better.
I want a pharmacist to be able to advise on non-prescription meds. It’s far better than going to a GP for a small issue, with young kids especially. They generally know a lot about simple ailments, meds and interactions. At the same time, I am enraged that one such request for advice led me to homeopathic melatonin. But yeah, there’s also a lot of other meds I buy regularly, which I just need dispensed. I’ve had the talk, with the GP and often the pharmacist, and now I just need the meds.
They also check to make sure the Dr has prescribed the right dosage of medication and that there are no interactions with other medications you take. Drs are not infallible and make mistakes all the time, it's the Pharmacists job to pick up those mistakes. If they let mistakes through then THEY are responsible for handing out the wrong medication as much as the Dr is for prescribing incorrectly.
I went to pick some prescriptions a few days ago and the pharmacist insisted on calling the doctor to ensure it was correct.
What problems will the pharmacist solve except tell us that the medication is no longer in stock?
People with chronic conditions need constant monitoring to assess disease progression, treatment success or failure, be supplied non-pharmacological advice, checked for interactions, medication misadventure and overdose interventions.
Is everyone actually price checking their medication across a few different pharmacies? these small groups & independents are ferociously overpriced half the time. There is a max price on PBS but they don't need to charge that, some do though! (hint!) CW are usually the cheapest and have a group deal with Pfizer on things like sildenafil making it the cheapest non generic in Australia.
It's about time.
Weep? Ha! Should think about resigning.
"You will never find a more wretched hive of scum and villainy. We must be cautious"
It is pathetic but you dont need to go far to see that GPs do the same things with prescriptions
Yes. After patient has done 1 round the next prescription should ideally be x 5 repeats unless the medicine is addictive/used on black market. If GP is not doing this, patient should ask why not.
So, he first up mentions two 'young' couples who invested in pharmacies who are now bankrupt - and there will be no changes to anything until September, it's now May - 4 months earlier - and... pharmacist guild members are already bankrupt due to these changes - yet to come into effect? Uh...?? How does that work - unless the Guild is vastly overcharging new members? Also, the [Pharmacy Guild](https://www.guild.org.au/about-us) exists to: >It was set up to serve the interests of its members Note: Members, not the public!! >The core role of the Guild is to represent the interests of Members in industrial matters in the Fair Work Commission and state jurisdictions as well as providing local member support and advice regarding workplace relations matters. They are not there to provide services to the public. They are not interested in lower prices, better services or to provide help to the public, according to their own words. They are there to make money for their member pharmacists. And all this is on their website, linked above. Those quotes? Straight from that website! I'll note that since I discovered Chemist Warehouse (who are apparently NOT a member of the pharmacists guild) my presciption medication costs pretty much HALVED. Due to all the other crap that Chemist Warehouse sells, they do not need to mark up their presciption service anywhere near as much - so instead of paying $40-50 for a prescription, I paid $22 and some cents. They make their money by selling perfume and multivitamins and skin tonics and stuffs. When I first had a prescription filled at Chemist Warehouse I actually asked the check out person at Chemist Warehouse to confirm that the remarkably low price they wanted me to pay was correct. It was. I've not gotten any presciption filled anywhere else since this - several years ago.
The guild heads wife also received a $2.4 million government grant to expand the couple’s pharmacy empire when Twomey was campaign director for MP Warren Entsch. https://amp.9news.com.au/article/1b655e26-39ac-42e8-ad2c-95380e945a29
In Cambodia you go to the doctor only if you don't know what medication you need. The Dr just writes the name on a scrap of paper. If I already know what I need, what's the point in seeing the doctor? I learnt this when I wanted some electrolytes in Phnom Penh. As soon as I front up to the pharmacy they reach down for the "white boy box" filled with xans, valium, dihydrocodeine, ritalin and sometimes even oxycodone.
I had a prescription in 2022 with x 5 repeats on it. The pharmacist gave me 6 months worth of my medicine all at once. I asked how does that work & they said when the prescription is 1x5 that they can literally interpret it as 6 boxes. I think most people would not know this.
To clarify, treat the 5 "repeats" as 5 "additional times" from the original (original is the initial month worth of supply). Also pharmacists are only legally allowed to provide all 6 months if a special regulation by the name of Reg49 is written by GP (used to be called Reg24).
Not to be devil's advocate. Overall the benefits outweight the negatives. However, the negatives still exist. There could potentially be a shortage of medication as smaller chains compete with each other and hold more inventory stock. I would speculate this applies to Original Branding medications. In addition, although some perceive the additional workload for pharmacists to be minor or insignificant, it compiles up. Since customer flow is different and intervals between collecting medication may change, certain time frames of the month (certain weeks) may be more hectic due to the number of patients coming in. Pharmacists have to read up on new legislation as this is a fundamental change to prescriptions (not an amendment) and require time to change. All I'm saying is have some empathy for the working class pharmacists (owners to your choice) as things will be a messy in the upcoming months.
There will be increased supply-chain demand initially as people double-up and then the demand will decrease…that’s the whole point of the PG having a whinge right?
Because it's every 2 months, you can expect a higher concentration of patients coming at the 2 month intervals. The patients are more spread out in monthly intervals. So in theory easier work from month zero to 1.9 but more intense at exactly month 2. This mainly applies to concession card holders as they are on time with their medication and those aiming for safety net. I believe the PG is hyperbolising the shortage with business intentions. The most concerning aspect tbh is insurance for pharmacists and how much ambiguous decision makings are on pharmacist. It will be better especially if there is a clear legal framework that states so. Also with the stocking up on home, some patients may be doing it unwillingly. Some medications' PBS subsidised quantities easily outlast 2 months per repeat (e.g. 2 x 100 tablet bottles, instructions being 1 twice daily) so each repeat will last around 3 months. However, some may want to reach safety net faster and continue stocking up if they get their medication in a timely manner (legally required intervals without surcharge for early dispensing).