Concerns over pharmacies funding

The proposal for Otago and Southland community pharmacies' dispensing fees to be bulk-funded is not practical and likely to pit pharmacists and family doctors against one another, Pharmacy Guild of New Zealand chief executive Annabel Young says.

The Otago and Southland district boards' community and public health advisory committees at their joint meeting last week recommended that the proposal go out to pharmacies and general practitioners for consultation.

If the planned schedule outlined in the discussion document on the plan is accepted, consultation will begin in Sep-tember, and a final report will go to the boards in April.

Ms Young said it appeared the proposal, which will not be compulsory, was in its early planning phase and would need much work yet.

There were major risks in any form of capped funding.

"It is extremely difficult to get the formula right, especially because the pharmacists who would be managing the funding do not write the prescriptions."

One of the difficulties which could arise would be with patients requiring high doses of drugs from a participating pharmacy.

There was a risk such patients might be referred to another pharmacy.

If people needed medication, then any system had to ensure they got the right medication at the right time.

"If the DHBs get it wrong, the biggest risk is that patients will be underserviced and will not have access to the necessary care and medicines they require."

There were major risks in any form of capped funding.

She would like to see more emphasis on making the most of the skills of pharmacists when it came to helping people to understand why they were taking medicines.

The number of unopened bottles of medicines in homes was startling.

Under the plan, participating community pharmacies would receive bulk funding from the district health boards for dispensing fees based on their previous prescription expenditure rather than be paid a set fee for every subsidised prescription medicine they dispense.

Primary health organisations, general practice teams and the pharmacies would be encouraged, through incentive payments, to work collaboratively to tackle waste and make the best use of community pharmaceutical expenditure, the committees was told.

The boards have been concerned about spending on community pharmaceuticals which has been rising by several million dollars a year since 2005 in both Otago and Southland.

In Otago last year $46.4 million was spent, 11% of the board's total health budget.

Savings from the proposed scheme would be distributed between participating primary health organisations, general practices and pharmacies and the boards.

The savings would depend on the level of participation and how successful organisations were at meeting their agreed targets, but it has been suggested it could save almost $9 million over three years in Otago and about $3.75 million in Southland.

The discussion document suggests 40% of the savings would go to the boards, with 30% going to primary health organisations and general practitioners and the other 30% to pharmacists.

If the planned schedule outlined in the discussion document on the plan is accepted by the boards, consultation will begin in September, a final report will go to the boards in April and the plan would begin in October 2009.


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