Federal Budget 2022–23: what’s in it for pharmacists?

Neil Petrie MPS, aged care consultant pharmacist

Funding for pharmacy services was highlighted by Treasurer Josh Frydenberg in his 2022–23 Budget Speech last night. But what will the budget deliver for the profession?

The biggest win for pharmacists in the 2022–23 Budget is a promised $345.7 million to embed pharmacists in residential aged care facilities (RACFs). 

Announced by Federal Minister for Health Greg Hunt last week, the aim is to improve medicine safety for older Australians by providing access to valuable pharmacy services.

From 1 January 2023, every government-funded RACF will be able to employ or engage an on-site pharmacist or community pharmacy service. Implementation details will be finalised with PSA, the Pharmacy Guild of Australia and the aged care sector.

Minister Hunt said the funding was a response to the findings of the Royal Commission into Aged Care Quality and Safety, which identified medicine management as an essential area for improvement.

‘Embedded pharmacy within aged care … will make a difference to saving lives, protecting lives, and improving lives in aged care,’ he said.

‘Having a pharmacist and community pharmacy services on-site will give residents and their families confidence that medications are regularly reviewed, appropriate and needed.’

Embedding pharmacists in RACFs was a key recommendation in PSA’s 2020 Medicine safety: aged care report and in its 2022–23 pre-budget submission. National President Associate Professor Chris Freeman said Minister Hunt’s announcement was ‘a win for residents who will now have greater access to medicines experts’.

‘The Royal Commission into Aged Care detailed well-known issues like the overuse of psychotropic medicines, and since then, troubling data on medication misadventure has continued to emerge,’ he said.

‘With more than 19,000 Australians in residential aged care prescribed antipsychotics with no indication, the level of chemical restraint must be addressed. We also know that the more medicines someone is prescribed, the more likely it is to cause harm.

‘The evidence is clear – pharmacists need to be an embedded part of the aged care equation if medication misadventure is to be minimised and rectified.’

A/Prof Freeman said it was crucial that RACFs were allowed the flexibility to choose how they secure pharmacist services, whether through a community pharmacy, employing a pharmacist directly, or via a third party. 

‘We welcome the government’s commitment to funding pharmacist roles in aged care, and this initiative will present new and exciting career opportunities for Australian pharmacists,’ he said.

Find more information on becoming a Residential Aged Care Pharmacist here, in this webinar series or in the podcast episode below. PSA also offers a Residential Aged Care Pharmacist: Foundation Training Program.

No movement on remuneration

While the funding for RACFs was a welcome addition to the budget, A/Prof Freeman said he was frustrated that unfair disparities in pharmacist remuneration for key services had been overlooked. 

‘Despite the immense pressure they’ve been subjected to over the past 24 months and the overwhelming appreciation shown by politicians on Thank Your Pharmacist Day 2 weeks ago, the Government will continue to significantly undervalue pharmacists for their services for the foreseeable future,’ he said.

He said there were two key pharmacist services that required immediate financial support: case conferencing and vaccinations. 

Pharmacists are the only healthcare providers not remunerated for their time and participation in case conferencing. They are also paid substantially less than GPs to administer National Immunisation Program (NIP) vaccines, including the COVID-19 vaccine. 

The PSA recommended introducing a Medicare Benefits Schedule (MBS) rebate to remunerate pharmacists for participating in multidisciplinary case conferences and an MBS service payment for administering NIP vaccines.

‘The government’s failure to rectify these inequalities is unacceptable, and is a slap in the face for pharmacists who kept on delivering during the pandemic,’ A/Prof Freeman said.

‘If these pay disparities continue to exist, it will have dire consequences on Australian healthcare, jeopardising the future of the pharmacist workforce.

‘Ahead of the Federal Election, we are calling on the incoming government to prioritise these concerns, improving conditions for pharmacists and ensuring that Australians can continue to access high-quality care.’

Community pharmacist Taren Gill FPS, who owns Priceline Pharmacy Maryborough in rural Victoria, said pharmacists had ‘always been underpaid for the work we do’ and this feeling was only heightened due to COVID-19.

‘During the pandemic, the community has seen pharmacy as the go-to for everything, from vaccinations to rapid antigen tests and advice,’ she said. 

‘Wherever medicines get used, pharmacists should be involved because they’re experts in medicine [and] we should be paid our expert advice. 

‘For example, we aren’t paid for our time in a case conference. These things have value, and we have 5 years’ of training behind us – we need to be remunerated better.’

Still more to be done

Also of note in the budget was a commitment to make medicines cheaper for 2.4 million people.

The government will invest $525.3 million over 4 years to reduce the eligibility threshold to meet the Pharmaceutical Benefits Scheme Safety Net. Concession card holders will need 12 fewer prescriptions to reach the safety net, and general patients approximately two fewer scripts.

While A/Prof Freeman acknowledged the commitment, he said it didn’t go far enough.

‘In a budget aimed at tackling the cost of living, PSA agrees with the Pharmacy Guild of Australia that reducing PBS Safety Net thresholds does not adequately address the rising cost of prescription medicines,’ he said.

A/Prof Freeman said the PSA also strongly supports a $19.6 million commitment to a national take-home naloxone program. This followed a successful pilot, with results showing the trial helped save three lives per day.

Naloxone will be available in all states and territories at no cost and without a prescription for anyone who may experience, or witness, an opioid overdose or reaction. The Australian Department of Health is working with the Pharmacy Programs Administrator (PPA) to avoid disruption to community pharmacy pilot sites while the national program is worked up. It is expected existing pharmacies will be able to register with the PPA from 1 July 2022.