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Thursday, 23 August 1984
Page: 252

Senator HEARN —I direct my question to the Minister representing the Minister for Health. Is the Minister aware that even though prescription charges have not increased, there have been some instances in which the number of tablets for a prescription has been reduced? This means that those who are least able to afford this hidden cost are shouldering the burden. The people who are directly affected are pensioners, those on sickness benefits, and people who suffer from chronic illnesses. What action can the Minister take to overcome this problem?

Senator GRIMES —I had some warning that Senator Hearn was concerned about this matter. I am informed by the Minister for Health that the honourable senator must be referring to metoprolol tablets of 100 milligram strength, where the maximum quantity available on the National Health Service prescription has been reduced on the recommendation of the Pharmaceutical Benefits Advisory Committee from 50 tablets with two repeats to 30 tablets with two repeats. This change took effect from 1 April 1984. The Minister informs me that general marketing approval for these tablets and the 50 milligram tablets was given in 1976 and 1977, and it was listed as a pharmaceutical benefit in December 1977 as the 100 milligram tablet. The recommended dose for the management of hypertension has recently been reviewed. Arising from this review the approved prescribing information now states:

Some patients may respond to 50 milligrams once daily. However, a large number of patients will respond to 100 milligrams once daily as initial and maintenance therapy.

A recent review by the Pharmaceutical Benefits Advisory Committee indicates that many patients are taking in excess of 100 milligrams daily. Accordingly, to encourage more rational prescribing of the drug and to increase flexibility in dosing, the Pharmaceutical Benefits Advisory Committee recommends listing of a 50 milligram tablet-100 with two repeats-and for the 100 milligram tablet a reduction in the maximum quantity to 30, that is, one month's supply at normal dosage, plus two repeats.

In addition, special provisions exist under the pharmaceutical benefits system to assist chronically ill patients who require larger quantities of drugs. Under these provisions a doctor may, if he considers it to be in his patient's interest, apply to the Regional Director of the Commonwealth Department of Health in his State for authority to prescribe a quantity in excess of the listed maximum quantity. Normally a quanitity sufficient for approximately one month's treatment at the higher dosage levels, with two repeats, may be authorised by the Director. One patient contribution fee is payable for each supply of the benefit so authorised. However, I stress that action in this regard is a matter for the doctor to initiate at his own discretion.