6th CPA finally signed – what are the Guild, the PSA, the CHF and the AMA’s views?

Federal Minister for Health Sussan Ley this week revealed that the government had signed 5 year agreements with the Pharmacy Guild of Australia, that is, the Sixth Community Pharmacy Agreement (6CPA) and also with the Generic Medicines industry Association (GMiA).

The Department of Health have touted the agreements as “landmark deals benefiting consumers,” citing that some of Australia’s most common medicines for cholesterol, heart conditions and depression could halve in price, by as much as $10 per prescription for some patients.

The Department of Health states that the 6CPA includes:

  • A doubling of the government investment in pharmacy primary care support programs for patients to $1.26 billion over 5 years
  • The option for pharmacists to offer a $1 discount per prescription on the patient co-payment

The Department of Health states that the GMiA agreement includes:

  • Improved rules and incentives for pharmacists to offer patients the option of cheaper generic medicines
  • A $20 million campaign to increase consumer confidence in the use of “biosimilar” medicines


Pharmacy Guild of Australia 

The Pharmacy Guild of Australia says that the 6CPA, which commences in 1st July, enables Australia’s 5,450 community pharmacies to continue meeting the health care needs of their patients.

According to the Pharmacy Guild of Australia, key features of the 6CPA include:

  • A new Administration, Handling and Infrastructure (AHI) Fee, which will mean pharmacies will be less susceptible to the ongoing impact of price disclosure. Dispensing remuneration will be indexed to Consumer Price Index6th Community Pharmacy Agreement signed
  • Nearly double the previous Agreement investment in community pharmacy programs and services.
  • Five years of certainty for community pharmacies in relation to dispensary remuneration and Location Rules. The Government has committed to legislating to extend the Location Rules until mid-2020, with an independent review to be conducted during the Agreement to inform future arrangements.

The Guild also says that the 6CPA is “contingent on the passage of legislation to implement the Government’s wider PBS package, which the Guild supports – with the exception of the discounted co-payment which is a matter for Government.”

George Tambassis, National President of the Pharmacy Guild of Australia, also commented on the renewal of the Pharmacy Location Rules in Australia. He said that this “provides a significant ongoing benefit to Australian health care consumers, ensuring that community pharmacies are highly accessible and well-distributed throughout Australia.”

The Government will maintain the Community Service Obligation, which is paid to pharmacy wholesalers to ensure that Australians have timely access to PBS medicines.
“The new Administration, Handling & Infrastructure Fee (AHI) is a structural reform which will replace mark up and substantially delink dispensing remuneration from the price of medicines, enabling the Government to continue its PBS reforms without jeopardising standards of patient care,” Mr Tambassis said.

The Guild also notes that there will be an independent health assessment body such as the Medical Services Advisory Committee (MSAC) or Pharmaceutical Benefits Advisory Committee (PBAC) to ensure that pharmacies are using the $1.26 billion to deliver evidence-based, patient focused programs and services. The Guild are expecting the Pharmaceutical Society of Australia to be a key stakeholder in this part of the 6CPA.6th CPA

The Guild has also announced:

  • That community pharmacy will receive remuneration for supplying products for the National Diabetes Support Scheme from July 2016
  • The Government’s commitment to $50 million for a Pharmacy Trial Program to expand the role of community pharmacists in the delivery of health care services, with a focus being on services to Aboriginal and Torres Strait Islanders and Australians living in rural and remote areas


Pharmaceutical Society of Australia

The Pharmaceutical Society of Australia’s National President Grant Kardachi said that the 6CPA “brought surety to the community pharmacy sector after a period of uncertainty for the whole profession.”

Mr Kardachi said that the PSA particularly welcomes the $1.26 billion in funding for the patient-focused professional services. He said that the PSA has long been advocating for an increase in pharmacist delivered professional services as it is important for pharmacists to play a part in health care delivery beyond their core dispensing role.

Mr Kardachi also said that “PSA looks forward to working on the development and implementation of evidence-based services which improve the health outcomes of the community.
“We also welcome the retention of the pharmacy location rules which we believe are in the best interests of consumers.”


Australian Medical Association

The Australian Medical Association (AMA) Vice President Dr Stephen Parnis expressed concern about the extra $600 million in funding pharmacists will receive to provide professional services to patients (taking the total to the $1.26 billion).6th Community Pharmacy Agreement details

Dr Parnis says ““This is a lot of money for programs that are yet to be devised. We have seen past proposals and worry about fragmentation of patient care because these pharmacy ‘services’ may not add any value to patient outcomes.

“The Health Minister said today that the Government wants pharmacists to play a greater role in the patient’s ‘medical team’ – but pharmacists are pharmacists, not doctors.

“Pharmacists are not medically trained to provide medical services, nor are they indemnified to do so.
“The best primary care is provided by the local family doctor, the GP – the most cost-efficient part of the health system.

“The Government has its health priorities all wrong.”


Consumers Health Forum of Australia

There has been significant criticism of the 6th CPA from the Consumers Health Forum of Australia (CHF), who say that consumers will pay billions of dollars more for prescribed medications over the 5 year 6CPA.

The CHF has said that under the current community pharmacy agreement, consumers pay $4.8 billion, or 29% of their medication costs, while under the new agreement they will pay an estimated $8.2 billion which equates to 34%.

CEO of the CHF Leanne Wells has also criticised the 6CPA, saying that consultation over the location rules needs to be with a broad group of stakeholders, not just the Pharmacy Guild of Australia.

Ms Wells has also expressed concerns about the redirection of product and supply delivery funding from the National Diabetes Services Scheme to pharmacies and wholesalers. She says this is “also an issue of significant concern and we will be seeking further information from the Minister on how the patient support and education services currently provided by Diabetes Australia and other services which cannot be provided within pharmacy will be maintained under the new arrangements.”

However, the CHF has welcomed the professional services funding for community pharmacy, saying that it should foster stronger support for projects like home medicine reviews. Although they question why the primary care programs are being rolled out through retail pharmacies and have said that they would like to see a more collaborative approach with pharmacists working in general practice.


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