Substitution key to survival

Simone Roberts

With the next stage in PBS reforms looming, measures pharmacists can adopt to lessen the financial impact of the changes were front of mind.

Professional pharmacy bodies, industry and government all agreed the best way for pharmacists to weather the revolutionary changes come 1 August was generic substitution.

"Focus on substitution," said Guild president, Kos Sclavos. "There is a squeeze on pharmacy income and generics is one way, with the $1.50 dispensing fee, that pharmacists can deal with it. It's going to be a big part of 2008 but it's not the number one priority for many pharmacists and it should be." 

Chief executive officer of generics giant, Alphapharm,  John Montgomery, said substitution was the simplest way for pharmacy to survive.

"The game is about to change. To win, it's got to be substitution. This whole PBS reform, from our perspective, would have failed if the substitution rate does not increase -- so go forth and substitute," he said. 

Bemoaning the fact that Australia lagged well behind the rest of the world in substitution rates, he said the $1.50 per generic prescription payment taking effect from August was an opportunity to kickstart the Australian generics market.

"There are certainly a large number of pharmacists who get it, who understand that substitution is an important service to offer patients, and is obviously something which is very attractive from an economic standpoint -- but even after all these years there are still a lot of pharmacists who don't get it. And I think that the $1.50 hopefully will awaken those people."

He estimated the dispensing fee at worth close to $45,000 a year for a pharmacy dispensing around 50,000 scripts even without any increase in substitution.

Stephen Dellar, assistant secretary for the pharmaceutical evaluation branch of the Department of Health and Ageing, said the PBS had been restructured to realise the efficiencies that generics can bring, and it was the pharmacist's role to persuade consumers generics were quality products equal to the innovator brand.

"I would join everyone else in telling you to take advantage of … the $1.50 -- enjoy it and use that as an opportunity to help the generics market remain strong and viable," he said.