Early intervention through HMRs could save thousands per patient

Greater access to Home Medicines Reviews (HMRs) offers opportunities to intervene earlier, improve patient outcomes and use healthcare funding more effectively. 

For Tasmanian-based Stewart Mearns MPS, HMRs are not an administrative program. They are an early warning system – preventing falls, reducing adverse drug events and averting hospital admissions. 

When patients don’t have this opportunity, the consequences can be serious. And expensive.

‘If I prevent one hospitalisation, there’s [around] $30,000 right there,’ Mr Mearns said. ‘That’s my funding for the next 6 months, which has to be cost positive.’

This blunt economic calculation reflects the realities of credentialed pharmacists in practice.

Catching problems before they escalate

When providing HMRs, Mr Mearns regularly identifies medicine-related risks that have gone unnoticed.

In one case, he arrived at a patient’s home to find she appeared confused and cognitively impaired. But the issue wasn’t dementia.

‘We’re having a medical emergency here,’ he realised.

The patient was experiencing hypoglycaemia and her husband hadn’t recognised the warning signs.

In another case, he discovered a patient had been taking aspirin without telling her doctors, worsening severe reflux.

‘None of her doctors were aware,’ he said. Once the aspirin was stopped, ‘she said I’d changed her life’.

These professional observations in living rooms help avoid escalation before an ambulance is called; this is the value of early intervention.

The hidden cost of delay

HMRs are designed to reduce medicine-related harm – one of Australia’s National Health Priority Areas. But access constraints mean some patients wait months for a review.

Like many other pharmacists, Mr Mearns sees the human cost of these restrictions. ‘I’ve had several patients die [while waiting for a HMR],’ Mr Mearns said of those referred but not seen in time due to the restrictive cap of 30 HMRs per month.

With medicines misadventure a known contributor to hospitalisations and deaths, particularly in older Australians and those with complex regimens, Mr Mearns sees the link clearly.

‘If they [Federal Government] are serious about improving Australian health, this is a good program to fund,’ he said.

The logic is simple: prevent harm upstream, reduce the downstream burden on hospitals.

Complex patients, preventable harm

Polypharmacy is common among the patients referred for HMRs. Multiple prescribers, fragmented care and long medicine lists increase the risk of duplication, interaction and adverse effects.

Mr Mearns recalls a young patient with autism and Tourette’s syndrome who was taking multiple antiepileptic medicines and was experiencing daily falls.

‘Once the aspirin was stopped, ‘she said I’d changed her life.‘

Stewart Mearns MPS 

‘She was getting pushed around in a wheelchair at 18 because she was taking six or so [different] antiepileptics. There was no one removing medications that weren’t effective.’

Rather than an access-to-care issue, the core problem was a lack of a coordinated medicines review.

HMRs allow credentialed pharmacists to step back, assess the full picture and make recommendations to optimise therapy. 

While this intervention might not make headlines, preventing one serious fall or hospital admission has both human and financial implications.

The price of a single medicine-related hospital admission can far exceed the cost of dozens of HMRs, with medicine-related problems reported to cost the economy $1.4 billion annually.

Mr Mearns believes the economics are compelling.

‘We’re pretty well-studied as pharmacists. We’re a cost-saving intervention,’ he said. ‘[Improving HMR funding] seems like a bit of a no-brainer.’

Prevention before crisis

HMRs are not emergency medicine, they are preventive care. But delivering that care requires time, expertise and a system that allows pharmacists to intervene before problems escalate.

For Mr Mearns, the value of the service is clear even if the current funding model makes it difficult to sustain.

‘Trying to make money out of HMRs these days is very challenging,’ he said. ‘It’s absolutely a labour of love.’

Reform that matches need with value

PSA’s 2026–27 Federal Budget Submission, released 25 February 2026, identifies reform of HMRs as a priority under the First Pharmacy Programs Reform Package.

Recommendation 1.1 calls for removal of monthly provider caps re-basing and applying annual Wage Cost Index indexation to restore service viability, and improved support for rural delivery and complexity.

For patients at risk of medicine-related harm, these changes are not about expanding scope. They are about enabling earlier intervention and avoiding preventable hospitalisations.

Read PSA’s full 2026–27 Federal Budget Submission.