With 2022 being a year where there was a federal election in addition to the annual handing down of the federal budget, peak bodies have advocated for the pharmacy profession in Australia in a number of ways.

Pre-budget submissions

Pharmaceutical Society of Australia

In its 2022-2023 pre-budget submission, the Pharmaceutical Society of Australia (PSA) advocated for 4 key measures:

• Embedding pharmacists in Residential Aged Care Facilities to improve medication management, reduce medicine-related harm, and improve quality of life for residents
• The introduction of a Medicare Benefits Schedule service payment to pharmacists for administering National Immunisation Program vaccinations including COVID-19 vaccinations
• Supporting a GP-Pharmacist Collaborative Prescribing Pilot to address workforce shortages in regional, rural and remote General Practice
• Introduce a Medicare Benefits Schedule rebate for pharmacists to be remunerated for multi-disciplinary case conferences.

Immediate Past PSA National President, A/Prof Chris Freeman, said that embedded pharmacists in Australia’s aged care workforce is well overdue.

“Ahead of next month’s Federal Budget, PSA has outlined to the Federal Government four key asks aimed at improving access to medicines and health care for Australians, particularly for residents in aged care facilities.

“As medication experts and the custodians of medicine safety, pharmacists must play an even greater role in the nation’s healthcare system by supporting aged care providers.

“PSA has been calling on the Government to provide funding for embedded pharmacists in residential aged care facilities for quite some time, to improve medication management, reduce medication-related harm, and to improve quality of life for their vulnerable residents.

“This will ensure that aged care facilities can consistently deliver a patient-centred, multidisciplinary service aimed at identifying, resolving and preventing medication-related problems such as polypharmacy and chemical restraint.

“It is crucial that service providers are allowed the flexibility to determine how they secure pharmacist services. Some facilities may choose to contract pharmacists through community pharmacies, some may choose to employ a pharmacist directly, or via a third party. It can’t be a one size fits all approach, as every facility is different.

“Every day that a pharmacist is not working alongside aged care staff in caring for older Australians, is a day residents are in danger from medication harm.

The Society of Hospital Pharmacists of Australia

The Society of Hospital Pharmacists of Australia (SHPA) had 7 priorities in its 2022-2023 federal pre-budget submission:

1. Develop a more sustainable and resilient hospital pharmacy workforce.
2. Provide funding for regional and rural health services to implement Virtual Clinical Pharmacy Services (VCPS).
3. Tackle the pressures of ambulance ramping and time burdens on elective surgery wait-lists by funding Pre-Admission Partnered Pharmacist Medication Charting (PPMC) services to perform medication reconciliation and charting for emergency departments and admitting medical or surgical teams.
4. Hospital pharmacist-embedded stewardship programs for antimicrobials, anticoagulants, analgesics and antipsychotic treatments as endorsed by the Australian Commission on Safety and Quality in Health Care (ACSQHC) for antimicrobial stewardship under the National Safety and Quality Health Service Standards.
5. Enable Hospital Pharmacists to supply medicines to Indigenous Australians under Closing the Gap PBS Co-Payment system.
6. Embed geriatric medicine pharmacists into residential aged care facilities at 1:200 ratio.
7. Establish an Improving Sustainability in Pharmacy and Pharmaceutical Industries Strategy which sets best practice and aims for hospitals, community pharmacies and industry.

SHPA Chief Executive Kristin Michaels said a strong and sustainable workforce of pharmacists and technicians was crucial to maximising benefits to the health of Australians as well as investment in healthcare.

‘As custodians of 23 per cent of PBS expenditure, Hospital Pharmacists are essential to ensuring the safe and optimal use of the scheme, which supports patient access to lifesaving medicines.

‘Pharmacy is a relatively young workforce and recent data warns of declining student interest and the closure of some pharmacy schools. SHPA recommends prioritising an updated Pharmacy Workforce Planning study – it is now 14 years since the last iteration – to inform national strategies on growing and sustaining an experienced workforce.

‘Experience is key, as embedding expert hospital pharmacist-led stewardship programs around key medicines, such as antimicrobials, anticoagulants, analgesics and antipsychotic treatments, is an important step to achieving cost-savings for the healthcare system, reductions in medicines usage and resistance and overall better health outcomes.’

Ms Michaels said focus on equity of care in rural and remote communities and for Aboriginal and Torres Strait Islander Australians were also top priorities in 2022.

‘Often spurred by necessity during COVID-19 lockdowns, we’ve seen evidence of successful telehealth models in rural and remote outpatient settings and SHPA recommends national funding of virtual clinical pharmacists in rural and remote areas to reduce medication-related harms and costs, improve patient outcomes and reduce burdens on rural and remote healthcare services.

‘And while a key Closing the Gap Pharmaceutical Benefits Scheme (PBS) Co-payment Measure is designed to help Aboriginal and Torres Strait Islander Australians access low cost or free PBS medications, it currently excludes medications dispensed at discharge from public hospitals. This must change, through all hospitals in Australia, to improve equity of access of medications for Indigenous Australians as they return home.’

Ms Michaels said that Australia enters the third year of COVID-19, it was equally important to retain focus on the unfolding climate emergency in the wake of COP26.

‘A new Improving Sustainability in Pharmacy and Pharmaceutical Industries Strategy is needed to improve the sustainability of our sector and mitigate and reduce the known environmental impacts from the pharmacy and pharmaceutical industry.

‘By defining best practice and aims for hospitals, community pharmacies and industry we can work together to reduce pharmaceutical wastage and environmental damage, which is rightly expected from the Australian community as the impacts of the climate emergency become more readily apparent and clearly forecast.’

Budget opinion

Pharmaceutical Society of Australia

In March 2022. the PSA welcomed the Government’s commitment to provide funding of $345.7 million to embed pharmacists in residential aged care facilities.
A/Prof Chris Freeman, PSA National President at the time the 2022-2023 federal budget was handed down, said that the announcement had been long-awaited.

“This is a win for those residents who will now have greater access to medicines experts, our pharmacists, and I have no doubt that this sentiment will be shared by the aged care sector.

“PSA has been advocating for funding to improve medicine safety in residential aged care facilities since 2018, following the establishment of the Royal Commission into Aged Care – and now, almost four years later, the Government has taken action.

“The Royal Commission into Aged Care detailed well-known issues like the overuse of psychotropic medicines, and since then, troubling data on medication misadventure has continued to emerge.

“Since the Royal Commission was established, PSA has been working closely with all governments to implement recommendations outlined in our Medicine safety: aged care report from 2020, and it is incredibly pleasing to see that our advice has been heeded.

“With more than 19,000 Australians in residential aged care prescribed antipsychotics with no indication, the level of chemical restraint must be addressed. We also know that the more medicines someone is prescribed, the more likely it is to cause harm.

“The evidence is clear – pharmacists need to be an embedded part of the aged care equation if medication misadventure is to be minimised and rectified.

“As the custodians and experts of medication safety, embedding pharmacists in aged care is the obvious solution to address the longstanding issues of polypharmacy and chemical restraint in aged care facilities. We are delighted that the Government will now invest in our pharmacist workforce to improve the quality of care for aged care residents.

“Over the next four years, this $345.7 million contribution to supporting pharmacists embedded in aged care will make a significant difference to protecting and improving the quality of life for our aged care residents. Consultation on the most suitable model will occur over the next six months.

“It is crucial that aged care service providers are allowed the flexibility to determine how they secure pharmacist services. Some facilities may choose to contract pharmacists through community pharmacies, some may choose to employ a pharmacist directly, or via a third party.

“It can’t be a one size fits all approach as every facility is different. Therefore, all of these options must be accommodated.

“We look forward to working with the Minister and the Department of Health on the implementation.” A/Prof Freeman said.

However, PSA also expressed disappointment at the government’s failure to support case conferencing and vaccinations as advocated for in the pre-budget submission.

“As it stands, pharmacists are the only health provider that the Government does not remunerate for their time and participation in case conferencing. In addition to this, pharmacists are being remunerated at a significantly lower rate than other providers for providing exactly the same vaccination services, including vaccinations against COVID-19.

“Introducing an MBS service payment to pharmacists for administering National Immunisation Program vaccines, and a separate MBS rebate for pharmacists to be remunerated for multidisciplinary case conferences, would increase consumer access to pharmacist expertise and skills.

“We welcome the Government’s commitment to funding pharmacist roles in aged care, and this initiative will present new and exciting career opportunities for Australian pharmacists. However, if these pay disparities continue to exist, it will have dire consequences on Australian healthcare, jeopardising the future of the pharmacist workforce.

“In a budget aimed at tackling the cost of living, PSA agrees with the Pharmacy Guild of Australia that reducing PBS Safety Net thresholds does not adequately address the rising cost of prescription medicines,” A/Prof Freeman said.

The Society of Hospital Pharmacists of Australia

The SHPA welcomed the federal government’s budget which centred on easing cost of living pressures, but warned that the announced expenditure in hospitals and pandemic preparedness will have limited impact without developing Australia’s current and future workforce of Hospital Pharmacists.

SHPA Chief Executive Kristin Michaels said ‘Managing almost a quarter of PBS expenditure, Hospital Pharmacists are crucial to its sustainability and will play a key role as $2.4b was committed over five years for new PBS medicines, subsidising access to highly specialised and complex medicines initiated and supplied in the hospital setting, including medicines to treat breast cancer, advanced colorectal cancer, cystic fibrosis and COVID-19.

‘As we work to minimise COVID-19 hospitalisations, SHPA welcomes $6m to extend COVID Community Care Pathways to support effective coordination of care in the community, where Hospital Pharmacists are intimately involved in Hospital in The Home care models to care for patients and keep them out of hospital.

‘Hospital Pharmacists also welcome the advance purchases of vital medicines to treat COVID-19 for the National Medical Stockpile, the majority of which are administered in hospitals by Hospital Pharmacists.’

Ms Michaels says almost $1b to extend the National Partnership on COVID-19 Response, coupled with multifaceted spending on hospitals and aged care, underscores the importance of developing a National Pharmacy Workforce Plan, a key election priority for the Hospital Pharmacy sector, who are experiencing recruitment challenges all across Australian hospitals, both in metropolitan and regional areas.

‘Whilst the investment into the medical workforce in Budget 2022-23 is great news for our medical colleagues, at the same time, we must look ahead and fund the training and development of expert pharmacists, and plan the Hospital Pharmacy roles Australia needs, to safely and fully realise the benefit of these investments.

Ms Michaels says Hospital Pharmacists stand ready at the frontline of Australia’s pandemic preparedness, welcoming the Federal Government’s partnership with the Victorian Government to support Moderna’s new mRNA vaccine manufacturing facility.

‘SHPA’s leading work on medicines shortages the last few years has demonstrated the risks that come with limited sovereign capability to produce and manufacture medicines on our own shores, and the establishment of this new facility is to be commended.

‘Having supported the establishment of over 500 vaccine clinics in major hospitals from Phase 1a in early 2021, our Hospital Pharmacy workforce has the expertise and experience to drive future rollouts, if and when they are required to keep Australians safe.’

Pre-federal election

The Pharmacy Guild of Australia

The National President of the Pharmacy Guild of Australia, Professor Trent Twomey, said the Guild looked forward to working closely and constructively with Senator Anne Ruston who would be the Federal Minister for Health if the Coalition was re-elected.

“A priority is to ensure a commitment is made that the current model of community pharmacy, including the location rules which ensure accessibility to pharmacies for patient across the country, is maintained,” Professor Twomey said.

“The current model works, and works well.

“The past two years have been particularly challenging for the community pharmacy sector but the way pharmacies have risen to these challenges has underscored their just how critical role their role is in the healthcare sector.

“Senator Ruston would bring to the position of Heath Minister a range of skills and experience which will help further build on the strengths of community pharmacy.
“One area we will focus on is ensuring community pharmacists can work to their full scope of practice so their skills and training are fully utilised.

“Significant shortages of primary healthcare practitioners are putting huge pressure on doctors and emergency departments.

“Having community pharmacists prescribe, dispense, administer and review medicines is not only common sense, but good health policy that helps to improve patient outcomes.”

The Society of Hospital Pharmacists of Australia

Following the Labor campaign launch, The Society of Hospital Pharmacists Australia (SHPA) welcomed the Federal Labor Party’s announcement pledging to reduce the general patient Pharmaceutical Benefits Scheme (PBS) co-payment from $42.50 to $30 from 1 January 2023, and their bipartisan support to improve medicines affordability and access for Australians, guaranteeing Australians more affordable medicines from 2023.

SHPA Chief Executive Kristin Michaels says this equates to a saving of $150 per year for Australians taking a PBS medicine regularly, $30 more than what was pledged by the Coalition government over the weekend.

‘With the rising costs of living we know many Australians, particularly our most vulnerable patients – those belonging to lower socioeconomic groups, and those who suffer from multiple chronic conditions – are increasingly struggling to afford medicines.

Hospital Pharmacists are responsible for 24% of all PBS expenditure, supplying just under five million PBS prescriptions annually to patients, and these significant figures continue to grow year on year.

‘Hospital Pharmacists and their healthcare colleagues, who are keenly aware of the barriers patients face when attempting to receive timely and quality access to life-saving medicines, welcome this bipartisan support for guaranteeing significant savings for PBS medicines.’

Ms Michaels says Hospital Pharmacists often see patients presenting to emergency departments or being re-admitted to hospital, because they were unable to access their required medicines or suffered a decline in their health due to not being able to afford medicines.

‘Hospital Pharmacists provide care to the most unwell and complex patients in our healthcare system, many of whom find themselves discharged with a long list of medicines, and who privately admit they will struggle to meet the cost of their discharge medicines.’

‘We welcome the bipartisan support to further reduce co-payment amounts for PBS medicines and improved medicines affordability for patients, many of whom are still required to pay well above standard co-payment amounts for non-PBS medicines. This will inevitably reduce preventable admissions and keep more Australians out of the hospital system.’

‘On behalf of our members, we call for further action to address medicines access and affordability for Aboriginal and Torres Strait Islander people who currently face higher PBS co-payments in hospital settings.

This is central to SHPA’s Federal Election 2022 policy priorities, and we look forward to working on this issue with all parliamentarians.’

Post-federal election

Pharmaceutical Society of Australia

The Pharmaceutical Society of Australia (PSA) welcomed the announcement of the Hon. Mark Butler MP as Minister for Health and Aged Care, and Emma McBride MP MPS as Assistant Minister for Regional and Rural Health under the Albanese Labor Government.

PSA National President, A/Prof Chris Freeman, said he was looking forward to working with the new Federal Government to ensure pharmacists’ voices are being heard.

“We look forward to continuing our productive relationship with the Australian Labor Party, in particular with incoming Minister for Health and Aged Care, the Hon. Mark Butler MP,” he said.

“I would also like to congratulate fellow pharmacist and PSA member, Emma McBride MP MPS on her appointment as Assistant Minister for Regional and Rural Health.

“As one of Australia’s key frontline health professionals, pharmacists share the drive to deliver world-class healthcare to all Australians.

“PSA is ready to work with the Minister to progress the funding of onsite aged care pharmacists and ensuring all Australians have access to fully funded National Immunisation Program (NIP) vaccines, including influenza vaccinations.

“Patients still face out of pocket costs to receive an influenza vaccination under the NIP if delivered by a pharmacist, whilst this same service is subsidised if done at a general practice.

“It must also be a priority for the incoming Minister for Health and Aged Care to ensure that there is a consistent approach to the NIP vaccines and that all Australians can access fully funded vaccinations from their local pharmacist.”

A/Prof Freeman pointed to retention of pharmacists as the major challenges facing the sector.

“There are consistent challenges in recruiting and retaining pharmacists across all sectors, with many choosing to leave pharmacy because of low base rates of pay,” he said.

“We need investment in a whole of profession workforce strategy so that we can sustainably meet all the exciting opportunities in front of the profession, while provide rewarding careers, both professionally and financially.

“PSA has a long history of working with governments at all levels to achieve better outcomes for Australian pharmacists and their communities, and we look forward to continuing that work with the incoming ALP Health team,” said A/Prof Freeman.

The Society of Hospital Pharmacists of Australia

SHPA President Peter Fowler welcomed the commitments the Australian Labor Party had made to hospitals, Medicare, aged care, medicines access and affordability.

‘SHPA congratulates Prime Minister Anthony Albanese and the ALP, who are set to form government. We look forward to working constructively with the incoming Health ministry team to ensure Australians have more equitable access to vital, lifesaving medicines through the world-class Pharmaceutical Benefits Scheme (PBS) regardless of where they receive their hospital care.

‘We applaud the planned new Strengthening Medicare Fund, which seeks to improve access to GPs, including after-hours services. Hospital Pharmacists are acutely aware of the impact of medicines affordability, as the only bill Australians receive from public hospitals is for their PBS medicines. We welcome the ALP’s commitment to reduce PBS co-payments, as well as investing in and listing PBS medicines as a top priority, further strengthening this strong Labor initiative.

Mr Fowler said that medicine management remains an ongoing challenge, with the transition of care from the acute setting to primary care presenting a particular challenge for health policy.

‘With the implementation of My Health Record and associated electronic medical records, hospital pharmacists are well placed to lead changes that will reduce harmful and potentially fatal medication errors and support better patient outcomes.

‘This election has shown the importance of stability in crucial sectors such as hospitals and healthcare, and SHPA is keen to see that reflected in funding across pharmacy settings. In Prime Minister Albanese’s first term, several reviews into medicines will be finalised, including the National Medicines Policy, chemotherapy medicines and PBS medicines in hospitals.

‘It is therefore more important than ever for Hospital Pharmacists – who manage a quarter of the entire PBS expenditure and the majority of chemotherapy expenditure – to be engaged to help remove the barriers currently in place that contribute to Australians missing out on vital medicines.’

Mr Fowler welcomed Mr Albanese’s commitment to fifty new Medicare urgent care clinics, which will be delivered next financial year would help take pressure off emergency departments.

‘Hospital Pharmacists have been integral to the COVID-19 pandemic response, operating the state-run vaccination clinics which have delivered over 35% of doses to Australians. In this time, Hospital Pharmacists have also dealt with increased strain on public hospitals with overcrowded emergency departments and ambulance ramping, and a reduced healthcare workforce in which Hospital Pharmacists are being asked to do more with the same resources.

‘Hospital Pharmacists, along with our healthcare colleagues, call on the new government to further address these pressures, by commissioning a 10-year National Pharmacy Workforce Plan, one of SHPA’s election priorities, and increase Commonwealth hospital funding contribution to 50%, as requested by all State and Territory Health Ministers.

‘SHPA looks forward to a strong relationship with the Albanese Government, and ensuring the many campaign commitments have the maximum positive impact on our healthcare workers, hospital infrastructure and the health and wellbeing of Australians.’