Advancing self care in Australia AFAMELA/WSMI October 2015 Deon Schoombie Australian Self Medication Industry

The key issues & challenges For the OTC industry Obstacles to increasing access to OTC medicines: –Risk-averse regulatory culture –No clear switch policy –Advertising restrictions For government Creating a sustainable healthcare system in the face of: –Ageing population –Increasing burden of disease –Increasing demand for services –Escalating costs of healthcare

Reshaping the switch environment What changes are necessary? A national scheduling policy to increase access to OTCs An Australian switch agenda (future switches) A regulatory framework & business processes supporting the policy: –Remove regulatory obstacles: S3 advertising restrictions –Introduce balanced benefit/risk decision-making Making better use of healthcare resources Empowering consumers to take more responsibility for health & wellbeing – raising health literacy

Australian OTC Schedules Schedules Supply channel Pharmacist intervention Advertising Pharmacist Only (S3)PharmacyMandatory  / Pharmacy Only (S2)PharmacyOn demand Open sale (GSL) Other retail channels None

Recent positive developments in Australia Launch of Global Access Partners (GAP) Report: Towards Responsible Self Care – the role of health literacy, pharmacy & non-prescription medicines Opportunities for regulatory reform: Independent expert review of the regulation of medicines & medical devices launched by Government in 2014

GAP Report Addressing 3 components of self care: Consumer health literacy The role of community pharmacy The role and value of OTC medicines

Benefits of health literacy Enables consumers to manage common ailments Improves their ability to manage more serious conditions Help them navigate the health system & make more appropriate choices about healthcare resources Assists in maintaining healthier lifestyles Keep appointments with healthcare professionals Improve adherence to treatment

The role of pharmacists Community pharmacist are well-positioned as first port of call, before going to GP With the right skills & tools they can play a greater role in primary healthcare They can help ease the workload on GPs Changes required: –Community pharmacies need to be transformed into health centres –Cultural shift: greater collaboration between GPs & pharmacist –Remuneration for pharmacist

The value of non-prescription medicines Total savings possible: A$12.54 –GP visits (75 million): A$5.00bn –Indirect value (lost productivity): A$7.54 Savings from current OTC medicines: A$10.41bn –Value of GP visits (58 million): A$3.86bn –Indirect costs (lost productivity): A$6.55bn Future savings through switch of 11 Rx medicines: A$2.13bn –Value of GP visits (17 million): A$1.14bn –Indirect costs (lost productivity): A$0.99bn Overall dollar spent/dollar saved: –Australia: A$1/A$4

GAP report recommendations Increase investment in health literacy Implement incentives for healthcare professionals to support greater self care Enhance the role of community pharmacists in primary healthcare Remove regulatory obstacles to increase access to medicines – switch & advertising Permit direct-to-consumer communications about OTCs

Opportunities for regulatory reforms Government launched a comprehensive review of the regulation of medicines & medical devices in 2014 Undertaken by an independent expert panel Aims of the review: –Identify opportunities for improving the regulation of medicines & medical devices –Continue harmonisation with international regulatory agencies & frameworks

Responses to the favourable environment OTC industry: –A new consumer communications model for S3 medicines developed in partnership with pharmacy –Advocate for adoption of benefit/risk decision-making methodology (Brass model) –Partnering with pharmacy to develop a switch agenda –Initiating policy development & oversight with government Australian Self Care Alliance Community pharmacy: –Health Destination Pharmacy – a new business model –Developing models for the management of minor ailments

A new Schedule 3 communications model Goals: To raise consumer awareness of Schedule 3 medicines in a manner that will support the quality use of medicines (QUM) To emphasise the role of the pharmacist in counselling & healthcare To encourage industry to invest in switch

Proposed model Standardised structured format: –Information about condition and/or symptoms –Branded product information –The role of pharmacist in determining appropriateness Default regulatory position: –All S3s advertisable but with provision for exceptions Preparing pharmacy staff: –Develop protocols & guidelines –Education programs –Counselling support

The Australian Self Care Alliance Why? Self care is beyond the capacity of Government to mandate or any single group to bring about. It requires: –Ownership and action by participants from all domains of the Health and Care Sector –Collaboration on the issues and solutions –Commitment by all participants to the solutions –Contribution by Government in the areas where only Government can move

What is the Self Care Alliance? The Alliance is a member based NFP organisation that: Is a neutral space to pool knowledge and expertise Acts as the umbrella body to foster dialogue and facilitate and initiate collaboration to develop policies and implement self care initiatives Acts as a repository of expert advice for stakeholders, media and the wider community

Who is involved? Universities Research Facilities Other Education & Training E Health Medical Devices Data Management & Analytics Funders (Public & Private) Financial & Professional Services Health Ageing Disability Carers Professional Bodies Peak Bodies, Health, Wellness, Ageing & Disability Provider Organisations PHN’s & LHHS’s Pharma Clinical & Service Delivery Consumer Voice Research & Education Technology & Industry Support

Vision & guiding principles Vision: Adoption and implementation of self care as a core element of a sustainable National Health and Care Sector for Australia that delivers: Improved Health Outcomes for all Australians Appropriate and innovative solutions that meet the needs of the Australian Community in the 21st Century Increased economic participation and productivity by all Australians Guiding principles: Whole of health and care Sector approach Evidence-based solutions Person-centred, whole of life continuum focus National framework with distributed action Collaborative partnerships and shared responsibility for action Empowered citizens

Changing pharmacy into health centres Health Destination Pharmacy - initiative of the Pharmaceutical Society of Australia (PSA) Repositions pharmacies as health destinations & pharmacists as providers of health solutions Comprehensive program to transitioning community pharmacy business & healthcare practices to: –ensure ongoing viability of pharmacy, and –improve consumer health through more cost-effective healthcare delivery

THANK YOU