Will aged care cover the cost of 60-day prescription dispensing?

The dust has started to settle on the Government’s 60-day prescription initiative after the Pharmacy Guild of Australia (The Guild) suspended its public information campaign to enter negotiations to secure an 8th Community Pharmacy Agreement. 

So after they campaigned heavily against the decision – which included a focus on potential costs for aged care residents – should the sector still be worried about increased dispensing costs?

Key points:

• 60-day prescriptions were introduced on September 1, allowing eligible patients to receive twice the medication for the cost of a single prescription on almost 100 Pharmaceutical Benefits Scheme (PBS)-listed medicines
• Eligible patients must have an ongoing health condition, be assessed as stable on their current medicines, and be approved for the 60-day quantity
• Additional changes will occur over the next 12 months as the approved list of medicines grows to 300-plus
• The Government expects patients to save a combined $1.6 billion over the next four years while also freeing up millions of General Practitioner appointments

Concerns over aged care costs

The Guild first raised concerns about a “looming aged care medicine crisis” when it identified that the $15.50 dispensing cost (weekly, per resident) would no longer be subsidised due to a 50% cut in pharmacy dispensing funding. Residents would therefore cop an additional $806 charge annually as pharmacists would have to push the cost onto them.

“We pack and deliver medicines free of charge to nine aged care facilities, and more than 800 residents. These people depend on us to get the care they need. Because of 60-day dispensing, we’re left with no choice and aged care residents will need to pay a new cost for these services and unfortunately, we may have to stop deliveries on weekends,” pharmacist Amanda Ward told The Guild. 

However, the Minister for Health and Aged Care, Mark Butler, expressed frustration at those claims in a 2GB interview last month, calling it a scare campaign.

“…The pharmacy lobby and the Coalition both know that aged care facilities are funded to deliver medicines, including Webster packs… And there is a specific legal prohibition against aged care residents being charged for Webster packs. I was very angry about it, and I hope it hasn’t frightened too many older Australians and their families. It will not be happening legally. It cannot happen,” Minister Butler said.

With both sides of the debate presenting contrasting information, Hello Leaders sought out advice directly from the Department of Health and Aged Care to confirm who could cop any additional dispensing costs in aged care – if any were to arise in the first place. 

A spokesperson for the Department reaffirmed that medication management is a core responsibility of residential aged care homes which should provide physical assistance with taking, ordering and reordering medicines. They must also maintain a system for safe ordering, reordering, storage and administration of medicines, including a medicine packaging system, such as Webster® packs.

The Department also confirmed no dispensing costs can be passed onto residents who will benefit from 60-day dispensing through PBS subsidies and concessions.

“Aged care homes cannot charge residents for these medication management services, regardless of whether they are managed internally or outsourced to a pharmacy through a commercial arrangement,” a spokesperson for the Department said.

“Whilst aged care homes are required to ensure prescriptions are filled, the resident is required to cover the cost of the medications. Normal PBS subsidies and safety net arrangements still apply to residents. Whether a pharmacy chooses to apply permittable PBS discounts will vary across pharmacies. Pharmacies may choose to discount the PBS patient co-payment amounts (concessional and/or general) by up to $1.00.”

“The discretionary discount (referred to as ‘increased discount’ under the National Health Act 1953) may be applied by pharmacies for general patients with a PBS prescription where the price of the medicine is between $30.00 and $45.60. This is unlikely to be applicable to most aged care home residents as most residents are concessional patients to which the discretionary discount does not apply.”

More detailed information on 60-day prescriptions in residential aged care can be found on the Department’s website. 

What’s next?

Providers may face a challenging time if dispensing costs are raised by pharmacies, although the Government is confident existing funding should cover any additional expenses. And even as The Guild’s campaign against 60-day dispensing has been suspended, it’s not quite smooth sailing yet for pharmacists. 

Many pharmacies are struggling with the changes, including rural and regional operators, with reduced hours, services and staffing as unintended results. Additional medicine shortages are also forcing some people to pay more for ad-hoc substitutions or to go without entirely until supply increases. 

Both issues are a big hit to people who rely on ongoing prescriptions and complex medicines, meaning aged care providers will have to keep on top of supply and dispensing to avoid putting residents at risk.