Pharmacist warns of changes driving costs

Warren Leonard
Warren Leonard
People should expect extra service charges at pharmacies to result from major funding changes hitting the sector, Balclutha pharmacist Daniel Haw says.

The pharmacy sector is about to undergo what the Pharmacy Guild has called its biggest change in more than 50 years.

From next month, the Government planned to fund pharmacies largely based on patient management, rather than just the number of medicines dispensed.

Transition payments are planned to ease pharmacies into the new system, which for some meant a drop in revenue.

Mr Haw, who owns Unichem Grays Pharmacy, said pharmacists did behind-the-scenes work like double-checking a prescription, or liaising over Pharmac requirements, usually for free.

Mr Haw believed pharmacists would increasingly start charging for their time on a minute-by-minute basis.

His income was likely to "erode" under the new system, which disadvantaged pharmacists serving smaller catchments.

Pharmacists would establish a register of long-term-condition patients, for which increased funding was provided. This involved a 10-minute interview, which posed logistical problems, such as providing a private space for them.

Wilkinson and Son Chemists owner Warren Leonard, of Dunedin, said pharmacies had very little leverage in the bargaining process, and had little choice but to sign up to the new system.

He agreed pharmacists did a lot of behind-the-scenes work, such as chasing up "bureaucracy", for which they could charge or simply tell patients to sort out themselves.

Mr Leonard already considered himself as actively monitoring his patients' medication, so the shift in emphasis would not greatly affect his business, apart from new requirements such as face-to-face interviews.

In his view, the changes were a somewhat cumbersome way of eradicating a problem with a small number of pharmacists "rorting" the system, by putting through as many dispensings as possible. The Pharmacy Guild, which represents about 700 of about 900 pharmacies nationally, supports the new model, but pointed out in a press release this week that it was the biggest change in the sector in more than 50 years.

Guild acting chief executive Karen Crisp agreed it was likely people would see new charges popping up at pharmacies, which was entirely reasonable if pharmacists had provided services for which they were not covered.

Mrs Crisp said the new funding model recognised the role pharmacists already played in patient care, and their important place in the primary health care system.

Concern around the new system would reduce as pharmacists became familiar with it, she said.

In Parliament this week, in response to a question, Health Minister Tony Ryall said: "I think if we are moving from a system where we pay pharmacists money for every bottle and container of medicine they pour some pills or some liquid into, to one that rewards them for the care and the use of their clinical skills. I think that is a win-win not only for pharmacy but also for high-needs patients."

A Southern District Health Board statement said some pharmacies requested extra time to consider the contract. The DHB was "... exploring how we will work with them to ensure they have the opportunity to further consider their agreements.

"Pharmacies have until July 23 to sign these agreements and we will work with pharmacies to make an initial transition payment to cover those who have not signed at the earlier opportunity of June 26," the statement said.

- eileen.goodwin@odt.co.nz

 

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