December 2001 issue Pharmacy Today magazine

ALMOST A DEAL

Paying the price for doctor over-prescribing could soon be little more than a bad memory for pharmacists.

As the new national pharmacy services contract nears completion, the Ministry of Health has hinted that sharing the risk for prescription volume blowouts could be over if the draft contract is accepted by District Health Boards (DHBs) and Pharmacy Guild members.

The guild has argued vigorously against the "pool arrangement" on the grounds pharmacists have little influence on prescription volumes.

Although the ministry had signalled some willingness to move prescription volume risk sharing from pharmacy, it continued to argue up until October that pharmacy should help carry the can. At the time, ministry director general David Lambie agreed, pharmacy holds little sway over doctors' prescribing habits.

Few details

Both the Pharmacy Guild or Ministry of Health refuse to give details until the DHBs and guild members have considered the draft agreement.

The DHBs were expected to respond by November 30. Guild CEO Murray Burns hopes to provide full details to members after the DHBs reply and contract "road shows" will tour the country in late January or early February. If given the go ahead, the wording of the contract will then be finalised. If signed off, the contract will run until June 2003.

While details remain sketchy, David Lambie says the terms of agreement have been reached within the ministry's planned $218 million dispensing budget.

Under the proposed agreement, pharmacists will not be able to charge for dispensing over and above patient co-payments, he says.

The guild had argued for the right to add patient charges if the dispensing fee did not cover the cost of services around dispensing. The guild said its analysis showed a fee of $6 was justified.

On legal advice, the guild is seeking authorisation from the Commerce Commission in case a nationally consistent dispensing fee is in breach of the Commerce Act. The application is based on potential problems with price fixing and anti-competition regulations.

Progress

Both parties appear to be happy with the agreement, saying the contract holds benefits for pharmacy, patients and the ministry.

But relations between the ministry and guild had soured after the ministry announced a lowering of the triple region dispensing fee in early October, because of a prescription volume blowout. The guild responded by calling for mediation and threatening legal action.

The breakthrough came around the time former Labour health minister David Caygill was called in to facilitate contract negotiations.

While David Lambie says negotiations had been heading in the right direction, Murray Burns says David Caygill's inclusion in talks was "a very effective way of bringing the issue to conclusion."

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