The August 2018 edition of the Australian Journal of Pharmacy includes a report card for the Sixth Community Pharmacy Agreement (6CPA) which came into effect on 1 July 2015.
Ten key initiatives are reviewed and graded:
|Grade||6CPA (1 July 2015-30 June 2020)||Impact||2017 Variation to 6CPA|
|A+||Introduction of the flat Administration, Handling & Infrastructure fee (AHI) with annual CPI indexation||Delinked Government payment for dispensing from downward cost of PBS medicines due to price disclosure, stabilising income||As total PBS script volumes in 2015-16 were 2.14% lower than forecast, a $ 200 million increase via the AHI for the remaining life of the 6CPA.
An additional $10 million due to impact of measures included in the Govt. Strategic Agreement with Medicines Australia.
|A||Dispensing fee +2.5% and annual CPI indexation||Linked dispensing fee to inflation|
|A||Dangerous Drug fee +8% and annual CPI indexation||First increase since 2006 and linked fee to inflation moving forward|
|A–||Location rules maintained to 2020||Regulates market by inhibiting competition||Govt. commitment to amend the National Health Act 1953 to remove the sunset provision|
|B||Pharmacy level substitution for biosimilars||The Government signed an agreement with the Generic Biosimilar Medicines Association around the same time|
|B||Intention of Government to restructure remuneration for chemotherapy infusions||Introduction of fair and transparent compensation after discovery of inappropriate practices by hospitals to generate funds|
|B–||Professional services funding ($1.26B over 5 years)||As PBS growth has been, and continues to be flat, this funding came from savings generated elsewhere||An additional $600 million for expanded pharmacy programs of which the Govt. commits to deliver the full $600 m within the life of the 6 CPA.|
|C+||Agreement to support a review of community pharmacy remuneration||Interestingly, the resulting ‘King Review’ was considered a pass as it is unlikely to change anything for the sector||Govt. commitment to ensure the response to the review secures a viable community pharmacy sector|
|C–||No increase to CSO remuneration||….and no delinking solution, leaving CSO distributors in a deteriorating financial position||$15 million due to impact of lower script volumes and measures included in the Govt. Strategic Agreement with Medicines Australia.|
|D||The co-payment $1 discount||Unpopular as the $1 is not reimbursed by the Govt.||Govt. commitment to review but is not of a predisposition to discontinue|
In addition to these initiatives, last year the 6CPA was varied via signing of a Compact between the Pharmacy Guild and the Government. In response to changed circumstances, the Pharmacy Guild successfully negotiated the additional funding shown above in return for agreeing to support ongoing PBS price reform, biosimilar uptake measures, and a role in implementation of Health Care Homes. These three being critical components of other ‘landmark’ agreements forged by the Minister of Health. An impressive outcome for both parties!