From Mr M. A. Hughes, MRPharmS
SIR,-In reply to Mr Hind's letter on reducing waste (PJ, February 19, p296), he should research the Australian Pharmaceutical Benefits System (PBS). Everything he would do to reduce wastage and overprescribing is already in effect in Australia.
Briefly, the system is governed by the "yellow PBS book" which must be followed by doctors, dentists and pharmacists wishing to operate within the PBS system. The book informs the professionals of the drugs, quantities allowed, repeats (if any) allowed, special restrictions and prices for which the government will pay. For example, a doctor is only allowed to prescribe, say, 20 Amoxil or 25 Mogadon or 30 Renitec. The rule is a month's supply although there are exceptions. Should the doctor wish to prescribe larger quantities he can do so but the patient must pay as the prescription is treated as private. Naturally, prescribing follows the book. The pharmacist also will be paid as per the book so even if the doctor orders, say, 28 of a drug and the pack is 30 the patient gets 30 and the pharmacist is paid for 30. Additionally, there is a patient contribution of $3.30 per item for pensioners and welfare card holders and up to $20.60 for non-welfare patients. A safety net system is in place for high users of medicines.
There are other advantages of the PBS for pharmacy. Since all claimable prescriptions comply with PBS regulations, computerisation means accurate and quick payment. I claim twice a month and get paid, in full, in 21 days. I also know to within a few dollars how much I will be paid. This means cash flow planning is made much easier.
The foregoing is a brief outline of the Australian system which is widely acknowledged to produce affordable medicines to the public while adequately rewarding the practioners working in the health industry.
As can be seen, a system as wished for by Mr Hind can operate successfully. All it takes is to learn from experience elsewhere. Any other pharmacists wishing to know more about pharmacy in Australia can contact me on MichaelHughesM@AOL.com.au.
Michael Hughes
West Pennant Hills, Sydney, Australia