1. 6th Annual Future of the Pharmaceutical Benefits Scheme Friday 1st May 2009, Sydney Realising the impact of the PBS reforms on consumer demand for medicines and consumer choice Rollo Manning PhC GradDipPR MPRIA

2. THE INFRASTRUCTURE AROUND WHICH PHARMACY SERVICES ARE DELIVERED TO THE AUSTRALIAN CONSUMER NEEDS EXAMINATION WITH A VIEW TO OVERHAUL  10 years in pharmaceutical industry (Glaxo) in sales, marketing and public relations  15 years in public relations in Canberra (six years with Pharmacy Guild)  Eight years with own pharmacy business in Queanbeyan  12 years in the Northern Territory in practice, policy and consulting in Aboriginal health Compounding Ready prepared IT based systems ?

3. Assumptions to be tested 1.If half the pharmacies closed (PhARIA One) they would not be be missed 2.The Government cannot continue to pay large sums to pharmacists with no accountability 3.All consumers are not the same 4.Pharmacy schools cannot continue to pour out highly qualified graduates for a job in a retail shop 5.The TOTAL spend on PBS medicines must be known for efficient and effective policy planning 6.There should be no more five year “Community Pharmacy Agreements” until a review is done of the current supply infrastructure 7.An agency should be established – Pharmcare- to pay pharmacists a fee that is commensurate for the service provided

4. If half the pharmacies closed (PhARIA One) they would not be missed 3,800 in PhARIA One 57% owned by one owner $1.4 billion spread across too many No economies of scale viz 1988 review The tradition continues while the horizons change

5. The Government cannot continue to pay large sums to pharmacists with no accountability Cost $ 3.00 15% mark up 0.45 Dispensing fee $ 5.99 Generic Incentive fee$ 1.50 Additional fee $ 3.62 PRF recording fee $1.03 TOTAL$15.59 Same for all The consumer should be advised of this fee - 4CPA Clause 21.3 The consumer should be offered this facility OK for supermarket in pharmacy 0k Same for Gove, Toorak or Pitt Street

6. Fourth Community Pharmacy Agreement

7. Are we talking medicines as part of a primary health care system or items of commerce PBS is part of the NHS Supply is not the only function Clinical interventions also part of the mix

8. All consumers are not the same Information, education and communication Traditional dispensary Supermarket style pharmacy ATM style machine Telepharmacy Dispensing from doctor’s surgery Internet pharmacy Fees paid depending on level of service given

9. University Pharmacy Schools cannot continue to pour out highly qualified graduates for a job in a retail shop Who is driving who? Academics are right Marketplace is wrong Unlock the body of knowledge

10. “ By effectively standing still at the beginning of the decade (1990), the current restrictions arguably have not served the community well. “ They reflect, and to an extent have locked in, the pharmacy and health care outlook of the early 1990s, rather than looking ahead to needs of the decade ahead.” National Competition Policy Review of Pharmacy Final Report

11. The TOTAL spend on PBS medicines must be known for efficient and effective policy planning PBS/RPBS $,000 604672% Patient Copay124015% Under Copay107213% 8358 Who benefits when the co-payment increases?

12. There should be no more five year “Community Pharmacy Agreements” until a review is done of the current supply infrastructure AFR 4Jan 2009

13. The leaders are calling for change The National President of the Pharmaceutical Society of Australia (PSA), Warwick Plunkett recently wrote that: “Pharmacy’s operational structure needs an overhaul if it is to become an active participant in the Government’s preventative health strategy”. Aust Journal of Pharmacy December 2008

14. Today's pharmacy bulletin board

15. An agency should be established – Pharmcare- to pay pharmacists a fee that is commensurate for the service provided Pharmacists want to be remunerated for new clinical services Needs strategic approach as to how this can happen Must define areas of activity, cost them and Put forward a schedule of fees Redistribute the $1.4 billion to areas needed by consumers to maximise QUM

16. Summary Must review the structure of PBS supply to the public Must define and establish new models of practice Make the service meet the need Get rid of “one size fits all” Support a review of the infrastructure Be part of a forum to direct the 5 th Agreement Stop talking and just do it - Cf Canberra 1978

17. Thank you for your attention. FURTHER INQUIRIES OR COMMENTS: Rollo Manning RWM Consultancy PO Box 98 Parap NT 0804 Email: rollom@iinet.net.au