Pharmaceuticals, pharmacists and profits

Editor, – In his article, ‘Pharmaceuticals, pharmacists and profits: a health policy perspective’ (Aust Prescr 2014;37:148-9), Professor Philip Clarke highlights the importance of the price disclosure policy in reducing government spending on pharmaceuticals. However, Professor Clarke blatantly disregards the important role that community pharmacists play by comparing pharmacies to ‘firms that sell computers or mobile phones’. He asks why community pharmacy should have the support of taxpayer funds in order to remain viable while electronics stores do not. What a ridiculous comparison!

Community pharmacies are staffed by highly trained health professionals and are essential in providing timely access to prescription medicines. This is an essential service that must remain a viable business for those involved. In addition to this, community pharmacists also provide a range of important services including counselling on the use of medicines, drug information and advice, primary health care, medication management services and delivery of medicines to the elderly and disabled. These services are generally provided free of charge and help to reduce medication-related hospital admissions which cost $1.2 billion annually.

Australian pharmacists are well attuned to the need to ensure that the Pharmaceutical Benefits Scheme (PBS) remains sustainable, especially in the context of our ageing population. They are calling for increased opportunities to provide funded health care and medication management services.

Pharmacists remain one of the most accessible health professionals with anyone being able to walk into a pharmacy (often open long hours) and obtain advice within 10 minutes. Community pharmacies are ideally placed to provide an expanded range of services where current gaps exist.

Melanie Frodsham
Pharmacist
Melbourne

Dr Philip Clarke, the author of the article, comments:

I fully agree with Ms Frodsham that community pharmacies are staffed by highly trained professionals who can play an important role in providing advice and information on the use of medicines to improve health outcomes. However, it is very unclear why this role depends on the pharmacy owners continuing to receive government subsidies from ‘discounts’ on the wholesale cost of generic drugs. These discounts mean that payments from government to pharmacies exceed the regulated markups of many generic drugs. This costs taxpayers hundreds of millions of dollars each year.

Paying high prices for generic drugs not only has a financial impact on some patients, but it also increases the chance they may discontinue their treatment, which may put them at risk. A far better way to remunerate pharmacists would be to look at ways to directly pay for the services they provide, rather than the current system, where profitability largely depends on the volume and margins on drugs sold.