There has been little enthusiasm for the Otago and Southland district health boards' plans to save money by bulk-funding community medicines through primary health organisations.
At its meeting this week, the Otago board considered a report analysing last year's feedback from PHOs, general practices and pharmacies on the community pharmaceuticals initiative.
The report, which was originally considered in closed session at the community and public health advisory committee last month, has been altered to remove content which was considered commercially sensitive.
Twenty-three written submissions were received to the proposal, 15 of them from the pharmacy sector, including three national organisations. Six responses came from general practice, one from the Otago board and one from Pharmac.
No written responses came from any of the nine PHO boards in the two regions, but the boards did meet PHO management representatives to discuss the proposal.
In his report on the feedback, project manager Mark Miller said the most common response was about the ability and appropriateness of PHOs managing the initiative.
Under the proposal, which would be optional, participating PHOs would hold the money for pharmacy professional services and contract pharmacies to provide dispensing services.
Savings made would then be distributed by the PHOs to participating general practices and pharmacies .
This would not change the way patients paid fees or got prescriptions.
The goals of the proposal were to encourage greater collaboration between pharmacies, PHOs and general practices to make the most of community medicine funding and cut down on any wasteful practices and ineffective treatments.
While most respondents supported these objectives, they did not support the PHO-funded model.
One of the respondents said there was a high risk PHOs were not sufficiently knowledgeable on pharmacy issues, skilled or robust enough to take on developing and implementing an unproven and potentially complicated system of funding an already complex service.
There were also concerns about insufficient data to allow business owners to compare the proposal with the status quo.
Mr Miller suggested gaining agreement to access data from community pharmacists' patient management systems could be a future solution to this.
Another common theme was that everyone in the primary health sector needed to be involved for the initiative to achieve its objectives.
A representative comment on this was that huge savings could be made if the focus went on general practitioners' prescribing habits.
A standard updated computer programme could be introduced for all GPs to reduce prescribing errors and information on the cost of GPs' prescribing habits could be obtained, the responder said.
Many of those who had expressed opinions thought the initiative was capable of making savings, but not to the extent presented, which the original report suggested could be as high as $9 million over three years.
