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Thursday, 16 February 2012
Page: 1617


Ms PLIBERSEK (SydneyMinister for Health) (12:07): I thank the members for their contributions to the debate on the National Health Amendment (Fifth Community Pharmacy Agreement Initiatives) Bill 2011. The bill establishes the framework that will allow the implementation of the Supply and PBS Claiming from a Medication Chart in Residential Aged Care Facilities and Continued Dispensing of Pharmaceutical Benefits Scheme in Defined Circumstance initiatives. These initiatives are provided for as part of the Fifth Community Pharmacy Agreement and will assist the government in meeting the objectives of the agreement in delivering patient focused professional services through community pharmacy.

The medication chart initiative will address administrative issues faced by prescribers, community pharmacists and aged facilities staff alike in managing a resident's medication. Currently, a prescriber must write a medication order on a PBS prescription and duplicate that information on a medication chart. The initiative will remove the need for a separate PBS prescription and ensure medication charts within residential aged care facilities can be used as a prescription.

The removal of this administrative step will result in a number of benefits. Firstly, it will provide more time for practitioners to spend on clinical care rather than filling in paperwork. Further, a standardised national medication chart will be designed to include all elements that are currently required to be captured on a PBS prescription, allowing practitioners to review the chart in its entirety, making it easier for them to complete quality use of medicine reviews whenever a change to medication is made.

Residents of aged-care facilities can expect improvements to their safety through the introduction of prescribing, supplying and claiming from a single source. Transcription errors will be significantly reduced as there will no longer be a need to duplicate the medication chart entry. Improvements in the quality use of medicines will also be seen through the pharmacy being provided with timely notice of updates and changes to a resident's medication regime, ensuring that the prescriber's most recent intentions for the resident's clinical care are promptly implemented.

Through this bill the Continued Dispensing of Pharmaceutical Benefits Scheme in Defined Circumstance initiative will introduce a new mechanism for Australians to access certain PBS medicines in situations where the patient does not have a valid prescription available. The initiative will introduce supply and claiming mechanisms that allow the provision of a pharmaceutical benefit to a patient in accordance with specific conditions where a patient is unable to present a valid prescription. The decision of the community pharmacist to provide a continued dispensing supply will be governed by a professional protocol and made on the basis of evidence of the previous prescription. The use of a professional protocol by the community pharmacist will mean that the quality in patient safety will not be compromised and that the role of the prescriber continues to be paramount. The protocols will also equip the pharmacist with tools to ensure that a person is on a stable medication regimen before a decision is made to provide ongoing medication.

For consumers who are taking medication for the treatment of certain chronic conditions, continued dispensing means that their treatment may not be interrupted should they not be able to synchronise their medical appointments with their medication requirements. Patients will also benefit from not paying the full cost of the medication, as occurs with current emergency supply mechanisms. In the first instance, a continued dispensing supply will be limited to two therapeutic categories: oral hormonal contraceptives for systemic use in the prevention of pregnancy and lipid-modifying agents—that is, statins—specifically the HMG CoA reductase inhibitors for the treatment of high cholesterol.

It is important to note that a pharmacist can supply medicines by continued dispensing only under the following circumstances: firstly, there is an immediate and ongoing need to supply the medicine to facilitate continuity of therapy and the patient cannot get to a prescriber in time to get a valid prescription; secondly, the medicine has been previously prescribed for the person and there has been a prior clinical review by the prescriber that supports the continuation of the medicine; and, thirdly, the medicine is safe and appropriate for that consumer.

The pharmacist must also provide written communication to the most recent prescriber advising of the supply of the medicine to the consumer within 24 hours. These initiatives will complement already existing emergency or urgent supply mechanisms that are available to the community where a person has lost or run out of their medication and does not have a valid prescription available. Importantly, though, this initiative will ensure patients can get the medicines through the PBS, reducing their out-of-pocket expenses in the circumstances.

The Gillard government is committed to the evaluation of new initiatives, which is why it has always been proposed to review this program two years after implementation and to publish the annual data on scripts dispensed under this initiative as part of its annual PBS reporting processes. The amendments that are likely to be moved today are supported by the government; they fit in with the legislation as it was originally conceived. The technical changes proposed in the bill for prescribing certain quantities of pharmaceutical benefits are intended to enhance current policy providing efficiencies and certainty for prescribers and patients. The amendments will continue the government's commitment to its 2010 policy for expanding the criteria for streamlining authority required medicines and will complement the medication chart amendments contained in this bill by accommodating specific conditions in the residential aged care sector.

Question agreed to.

Bill read a second time.