In recent Guild Government Agreements the focus has been on funding for provision for value added professional services such as Home Medication Reviews (HMRs), Dosage Administration Aids (DAAs) etc. However, when margins are being screwed it is hard to justify employing an extra pharmacist to perform these duties in the first place. We have to farm out HMRs and are limited to handle DAAs for only the most needy due to time constraints and quality assurance. No way is the current owner going to provide extra staff looking down the barrel of further attacks on margins.
The Pharmacy Guild has had very little success in negotiating adequate basic dispensing reimbursement over many years. Many Pharmacies depend on the extra margins provided by pushing generics purchased with discounts to provide adequate returns which is essentially a flawed model and possibly unethical the way pharmacy staff are being forced by owners and suppliers to promote. Half truths are being told to patients because in many cases it is not about saving the patient or the tax payer money but about more cash for the business. I specifically refer to the higher priced subsidised items with no brand premiums that can be supplied at discounts in excess of 50% to the pharmacy. Pharmacist are being force to take advantage of this situation because basic levels of reimbursment are not adequate. Discount Pharmacy Chains are therfore able to "loss lead" non-subsidised lower priced generics because of the "super profits" made on the dearer non-discountable PBS subsidised items. Every day I get accused of over charging on items supplied at the normal list cost to us plus 10% mark-up and government approved professional fees. I will never discount a professional fee as modest as it already is. An example yesterday was a kids antibiotic mixture which our charge was $16 dollars compared with $6.50 at a discount pharmacy (lower than our dispensing fee). I don't blame the parent at all for choosing to get it at the lesser price. However in truth their "subsidy" is being provided by a system that promotes business ethics not much better than the tourist markets of North Africa.
Things have to change and are probably going to change over the next couple of years as the cost prices of generics to pharmacies becomes more transparent and equitable. It will be nice to see pharmacy staff not being pressured to pressure patients choice for want of extra profit by suggesting "the pharmacy preferred brand". Thoughts of confusing elderly patients are not paramount by changing them to a generic brand with a different shape or colour because they make a bigger profit.
An interstate pharmacy graduate I know desperate to move here to be with his partner was offered a position in a discount pharmacy. He declined - most admirable!
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