Thursday Island pharmacy warns PBS two-for-price-of-one scheme risks drug supply and rural chemists

Some of Australia’s most remote and vulnerable communities are unable to receive life-saving medicines due to a new federal government measure.

Pharmacist David Paulmert, who works at the Thursday Island Pharmacy which lies off the tip of the Cape York Peninsula in Queensland at Australia’s most northerly end, has issued the dire warning about changes to the Pharmaceutical Benefits Scheme (PBS).

Under a measure announced in the May federal budget, more than 320 drugs subsidized under the PBS to keep them at a maximum cost of $30 will be distributed in 60-day allocations instead of 30 days as a ‘two-for-the-price-of-one’ deal.

Mr Paulmert said this jeopardized the already depleted supplies that his pharmacy sometimes ships by helicopter to the 15 Torres Strait islands and remote peninsular communities it serves.

“It is not unreasonable to say there could be deaths due to people not being able to access their medicines,” he told Daily Mail Australia.

The particular concern is for people suffering from type 2 diabetes, which Mr Paulmert was “widespread” in the communities he serves.

“It’s a terrible situation,” said Mr. Paulmert.

“There are so many people here who suffer from it.”

Pharmacies around the world are facing a shortage of Ozempic, an important drug for the treatment of diabetes but which has also become a highly sought-after weight loss aid in the US.

Mr Paulmert said his pharmacy had faced shortages of those and other important antibiotics in recent months.

A replacement pill was given to diabetics, but when it runs out it would be “a real headache,” according to Paulmert.

“Without treatment, someone’s diabetes can spiral out of control, they’re more likely to get an infection, the worst consequence is death,” he said.

“If you ask me to give two months’ worth of doses instead of one month, some people will suddenly have way more than they need and a lot of people will have to do without because we can’t get it”

This risk was compounded by the remote location of his pharmacy, even though they tried to stock up as much as possible.

“When something is ordered, the wholesaler has to deliver it to a normal pharmacy within 24 hours, but generally we don’t have stock for more than a week,” said Mr Paulmert.

“It feels like the remote and rural communities have not been remembered with this policy. I don’t think they thought things through very well.’

Health Minister Mark Butler told Daily Mail Australia that ‘the pharmacy lobby is deliberately misleading consumers with an unfair scare campaign’.

Drug shortages will not be exacerbated by this initiative, nor will it directly lead to a chronic drug shortage,” he said.

‘The policy extends the purchase of medicines and does not increase demand.

‘Eligible Australians will generally buy the same amount of medicine, just with fewer trips to the pharmacy.’

The minister said that pharmacies should notify the Therapeutic Goods Administration (TGA (TGA)) when the supply of a drug at any point in the next 6 months is unlikely to meet normal or expected consumer demand.

The TGA could then take a series of measures to help, such as temporarily approving overseas replacement drugs to bolster supplies.”

The minister said no reports of drug shortages had yet been sent to the TGA.

He also said the government is getting manufacturers to make more medicines in Australia.

“This ensures that there is stock in the supply chain for wholesalers to supply to pharmacies to meet a temporary increase in demand,” said Mr Butler.

Mr Paulmert argued that the new measures would increase the waste of medicines.

“People chop and change quite a bit,” he said.

“If we give out 60 days, there’s a chance that six of those eight weeks will be lost if they get off immediately.

“Instead of a maximum waste of about two to three weeks, it is a maximum waste of six to seven weeks.”

Mr Paulmert believed that pharmacists should not use their clinical training.

“Clinically, we are way behind the rest of the world in how we deal with these issues,” he said.

“In other countries where they have introduced 60 days, pharmacists can veto and say that 60 days is not appropriate for this person, 30 days is more appropriate,” he said.

“In those cases where the doctor has written a script for 60 days and it later becomes clear that it is not clinically appropriate, there is nothing we can do.

“We could call the doctor and ask for another script, but the doctors are pretty busy already.

“It’s one of those things once it happens it’s going to be pretty hard to stop it.”

Mr Butler said the main benefit of doubling the amount of medicines a person can get on a single script is that ‘it will reduce the cost of living for at least 6 million Australians who need regular medicines’.

On the other hand, pharmacists complain bitterly that it will reduce their income.

Mr Paulmert said this was a particular risk for rural and remote pharmacies.

“The industry is about $2.8 billion short,” said Paulmert.

“The effect of that in a store like the one I am in is that we have to hire fewer pharmacists or be open for fewer hours, because of course we need to make money to run a business.

“I know there are a lot of remote pharmacies where it would get to the point where they would have to close their doors.”

He said this would mean that instead of driving 10 minutes to a local pharmacy, people in rural and regional areas would have to drive two hours or more to the next town.

“For those communities that are going to lose their local pharmacy, it’s not about being greedy, it’s about keeping their doors open,” he said.

Mr Butler said his government ‘recognizes that rural and regional pharmacies face particular challenges’.

To assist the government has doubled the maintenance allowance for rural pharmacies to $39.8 million per year with base payments doubling from $3,000 per year to $6,000 per year.

He said there was also additional funding of up to $100,000 for eligible pharmacies, depending on total annual script volume and location.

“This funding will allow some of Australia’s most remote pharmacies to qualify for nearly $95,000 a year in assistance to keep their pharmacies open and services available to rural communities,” said Mr Butler.

Mr Paulmert admitted that the government’s tinkering with the PBS was ‘probably well-intentioned’.

“It’s great to want to save consumers money, but I definitely support people paying less for their medicines and their prescriptions,” he said.

“The problem is that it doesn’t pass the sniff test, there are no guarantees that someone will be better off or that some won’t be worse off.”

“There will be a lot of people who have it worse.

While it may have its drawbacks, Mr Paulmert said working on Thursday Island is ‘a great job’.

“It’s pretty cool all the islands we visit,” he said.

“Twice a year we visit each community by helicopter and also send drugs by plane or boat.

“You can see PNG from the northernmost island where we arrive.”