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Political Football With Medication

Keryn Coghill
A Pharmacy Health Informatics Perspective

Issue 63: August 2007
Page: 1 of 1 Author's Profile | Send to a Friend | Printer Version
Medication mismanagement and wastage is not the domain of the uninformed population who use and often abuse our sacred Pharmaceutical Benefits Scheme (PBS).
The reality is that statistics are highlighting a number of serious mismanagement issues in terms of policies, procedures and blatant cost shifting between the States and the Commonwealth.
We are in a dynamic phase as far as a rapidly expanding ageing population and an increasing requirement for complex and expensive medications to manage wellbeing in the elderly.
This, combined with the reduction in professional resources, provides the ingredients for a volatile cocktail with the winners or losers being the elderly and the average Australian tax payer.

Medications in aged care are generally being repacked into Dose Administration Aids of various structures with the intention of safeguarding residents.
These repackages of medication cost significant dollars and are very effective at increasing medication wastage.
Every time a medication regime changes, the pack in which there is a change is discarded and another Dose Administration Aid packed for the rest of the week, or packing cycle.

When a resident is discharged from a hospital, the pharmacy department now with its PBS license provides a months supply or NHS quantity of medication to the resident and the Commonwealth funds the supply.
This is opposed to the good old days when residents received between 3 to 7 days of medication which was not covered by the PBS but funded by the State health system.
Hospital Pharmacy departments are now regarded as profit centers and it is their interest to maximize the PBS sales.

This leaves our aged care resident with a bag of often very expensive medication which when taken back to the aged care facility is returned to the supply pharmacy and discarded.
Why?
The law states that medication cannot be repacked and the issue of storage and integrity are cited as reasons for this regulation.
So the supply pharmacy re-dispenses another lot of medication and repackages the medication regime for the resident at the facility to comply with all legislation.

Along comes the resident doctor post the hospital discharge and often changes the medication regime.

Well we all know what happens next.
Yes more wastage and more Dose Administration packs produced.
Who wins?
  * Suppliers of Dose Administration Aids
  * Drug wholesalersSupply
  * Pharmacists
  * Drug Manufacturers

Let’s ask the question why hospital pharmacies are supplying PBS quantities on discharge?
Let’s ask the question on PBS quantities and whether the New Zealand model is worth considering
as an alternative.

Keryn Coghill


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