Some of Australia’s most remote and vulnerable communities could be deprived of life-saving drugs because of a new federal government measure.
Pharmacist David Paulmert, who works in the Thursday Island Pharmacy that sits off the tip of Queensland‘s Cape York Peninsula at Australia’s northernmost extremity, issued the dire warning about changes to the Pharmaceutical Benefits Scheme (PBS).
Under a measure announced in May’s federal budget over 320 medicines subsidised under the PBS to keep them at a maximum cost of $30 will be handed out in 60-day rather than 30-day allotments as a ‘two-for-the price-of-one’ deal.
Mr Paulmert said this endangers the already depleted stocks his pharmacy sometimes ferries out by helicopter to the 15 Torres Strait islands and remote peninsula communities it serves.
‘It is not unreasonable to say there could be deaths because of people unable to access their medicines,’ he told Daily Mail Australia.
Pharmacists working on Thursday Island, off the northernmost tip of Queensland, visit the surrounding islands by helicopter
The particular concern is for people suffering from Type 2 diabetes, which Mr Paulmert was ‘running rife’ in the communities he serves.
‘It’s a terrible condition,’ Mr Paulmert said.
‘There are so many people who suffer from it up here’.
Pharmacies worldwide have been battling a shortage of Ozempic, a key drug for treating diabetes but which also has become a highly sought weight-loss aid in the US.
Mr Paulmert said his pharmacy had been dealing with shortages of that and other key antibiotics for the past few months.
A substitute pill was being given to diabetics but if that runs out Mr Paulmert said it would be ‘a real headache’.
‘Without treatment someone’s diabetes can go out of control, they are more likely to get an infection, the worst consequence is death,’ he said.
‘Asking me to give two months’ worth rather than one month of doses will mean suddenly some people are going to have way more than they need and a lot of people will have to go without because we can’t get it,’
Thursday Island pharmacist David Paulmert has issued a dire warning that changes to the PBS could create shortages of life-saving medicines for remote chemists
This risk was heightened by his pharmacy’s remote location, even though they attempted to stock up as much as they could.
‘When something is ordered the wholesaler has to get it to a normal pharmacy in 24 hours but we generally don’t get out stock for up to a week,’ Mr Paulmert said.
‘It feels like the remote and rural communities haven’t been remembered with this policy. I don’t think they’ve done a very good job of thinking about that kind of thing.’
Minister for Health Mark Butler told Daily Mail Australia that ‘the pharmacy lobby is deliberately misleading consumers with a dishonest scare campaign’.
Medicine shortages will not be exacerbated due to this initiative, nor will it directly lead to medicines going into chronic shortage,’ he said.
‘The policy spaces out medicine buying and does not add to demand.
‘Eligible Australians will buy the same amount of medicine overall, just with fewer trips to the pharmacy.’
The minister said pharmacies must notify the Therapeutic Goods Administration (TGA (TGA) when the supply of a medicine is not likely to meet the normal or projected consumer demand at any point during the next 6 months.
The TGA could then take a range of actions to assist, such as temporarily approving overseas substitute medicines to bolster supply.’
The minister said there had been no notifications of medicine shortage yet sent to the TGA.
He also said the government is making sure manufacturers make more drugs in Australia.
‘This will ensure there is stock in the supply chain for wholesalers to deliver to pharmacies to meet any temporary increase in demand,’ Mr Butler said.
Mr Mr Paulmert said that it takes a week for his pharmacy to get ordered medicines which it in turn often sends out by boat or plane
Mr Paulmert argued the new measures would increase drug wastage.
‘People chop and change a fair bit,’ he said.
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‘If we hand out 60 days there is a potential for six of those eight weeks to go to waste if they get changed off it immediately.
‘Instead of a maximum wastage of about two to three weeks it is a maximum wastage of six to seven weeks.’
Mr Paulmert believed pharmacists are being prevented from using their clinical training.
‘Clinically we are going be way behind the rest of the world in the way we deal with these issues,’ he said.
‘In other countries where they have put in 60 day dispensing pharmacists can veto it and say that for this person 60 days is not appropriate, 30 days in more appropriate,’ he said.
‘In those cases where the doctor has written a 60-day script and it becomes clear later it is not clinically appropriate there’s nothing we can do.
‘We can call the doctor and ask for another script but doctors are already pretty busy.
‘It’s one of those things once it happens it’s going to be pretty hard to stop it.’
The Thursday Island pharmacy serves 15 surrounding island and also remote communities on the Cape York Peninsula
Mr Butler said the main benefit of doubling the amount of drugs a person could get on a single script is ‘it will take the pressure off the cost of living for at least 6 million Australians who need regular medicines’.
On the flipside pharmacists have been bitterly complaining it will cut their income.
Mr Paulmert said this was a particular risk for rural and remote chemists.
‘The industry is having a cut of something like $2.8 billion,’ Mr Paulmert said.
‘The effect of that in a shop like the one I am is we have to hire less pharmacists or be open less hours because obviously we need to make money to run a business.
‘I know there are a lot of remote pharmacies where it would come to that point where they would have to close their doors.’
He said that would mean instead of driving 10 minutes to a local pharmacy those in rural and regional areas might have to drive two hours or more to the next town.
‘For those communities who are going to lose their local pharmacy it is not about being greedy it is about keeping their doors open,’ he said.
Mr Butler said his Government ‘recognises that rural and regional pharmacies face particular challenges’.
To assist the government has doubled the Rural Pharmacy Maintenance Allowance to $39.8m per year with base payments doubling from $3,000 per year to $6,000 year.
He said there was also additional funding of up to $100,000 for eligible pharmacies depending on total annual script volume and location.
Health Minister Mark Butler has defended the changes to the PBS as helping ease cost of living pressures for six million Australians
‘Through this funding, some of Australia’s most remote pharmacies may be eligible to receive nearly $95,000 per year in assistance to keep their pharmacies open and services available to rural communities,’ Mr Butler said.
Mr Paulmert admitted the government’s tinkering with the PBS was ‘probably well-intentioned’.
‘It’s great to want to save consumers money but I definitely support people paying less for their drugs and their prescriptions,’ he said.
‘The issue is it doesn’t pass the sniff test there’s no guarantees anyone is going to be better off or that some won’t be worse off.
‘There’s going to be a lot of people that are worse off.
Although it might have its disadvantages Mr Paulmert said working on Thursday Island ‘is a great job’.
‘It’s pretty cool all the islands we get to visit,’ he said.
‘We visit each community by helicopter twice a year and we also send drugs by plane or boat.
‘You can see PNG from the northernmost island we get to.’
