Discounting of medicines in Australian community pharmacies
Loc P. Thai A C , Agnes I. Vitry A and John R. Moss BA Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, University of South Australia, GPO Box 2471, Adelaide, SA 5001. Australia. Email: agnes.vitry@unisa.edu.au
B School of Population Health, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia. Email: john.moss@adelaide.edu.au
C Corresponding author. Email: loc.thai@mymail.unisa.edu.au
Australian Health Review 38(5) 517-522 https://doi.org/10.1071/AH14012
Submitted: 23 January 2014 Accepted: 18 June 2014 Published: 7 August 2014
Abstract
Objective There are many medicines listed on the Australian Pharmaceutical Benefits Scheme (PBS) in which point of sale price is less than the level of the general patient co-payment. In these circumstances, the patient covers the total cost of the medicine from their own pocket with no government subsidy. The aim of the present study was to compare the consumer prices of under general co-payment prescription medicines between banner group pharmacies with open discounting policies and community pharmacies without; and to assess the impact of the April 2012 PBS price disclosure policies on the discounts offered.
Methods The consumer prices of 31 under co-payment medicines were collected from banner group pharmacy websites and individual pharmacies both before and after April 2012. PBS maximum prices were obtained from the PBS website. Absolute and relative price differences between PBS and pharmacy groups were calculated.
Results Before April 2012, banner group pharmacies provided discounts to patients of around 40% per prescription, whereas other pharmacies provided discounts of around 15%. Total price savings were on average $9 per prescription at banner group pharmacies and $3.50 at other pharmacies. Percentage discounts did not change greatly after April 2012, when price decreases occurred on the PBS.
Conclusions Banner group pharmacies with pricing strategies are able to provide greater discounts to patients compared with other pharmacies. Community pharmacies still have the ability to provide substantial discounts after the April 2012 price reductions.
What is known about the topic? There is currently little known about the under co-payment medicines market in Australia and the price discounts available to patients.
What does this paper add? This research shows that patients who purchase under co-payment medicines are able to save money if they purchase from pharmacies with openly advertised discounting policies. Price reductions related to the implementation of the price disclosure policy had a small effect on the discounts offered by community pharmacies to patients.
What are the impacts for practitioners? The effect of discounting on under co-payment medicines to patients may increase their ability to afford essential medicines. Questions remain on whether the effect of discounting on under co-payment medicines may affect the quality of professional services provided to patients by pharmacists.
References
[1] Parliament of Australia. The Pharmaceutical Benefits Scheme: an Overview. 2002. Available at http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/Publications_Archive/archive/pbs [verified 6 September 2013].[2] Australian Institute of Health and Welfare. Health Expenditure Australia 2010–11. Canberra: Australian Institute of Health and Welfare; 2012.
[3] Australian Government Department of Health and Ageing. Pharmaceutical Benefits Scheme Explanatory Notes. 2012. Available at http://pbs.gov.au/info/healthpro/explanatory-notes/section1/Section_1_4_Explanatory_Notes [verified 16 April 2012].
[4] Bulfone L. High prices for generics in Australia: more competition might help. Aust Health Rev 2009; 33 200–14.
| High prices for generics in Australia: more competition might help.Crossref | GoogleScholarGoogle Scholar | 19563309PubMed |
[5] Clarke PM, Fitzgerald EM. Expiry of patent protection on statins: effects on pharmaceutical expenditure in Australia. Med J Aust 2010; 192 633–6.
| 20528715PubMed |
[6] Australian Government Department of Health and Ageing. Price reductions for main, first transitional and second transitional cycles. 2012. Available at http://www.pbs.gov.au/info/industry/pricing/eapd/price-reductions [verified 24 August 2012].
[7] Sweeny K. The impact of further PBS reforms report to Medicines Australia. Melbourne: Victoria University, Centre for Strategic Economic Studies; 2013.
[8] Haggan M. Banner groups: what’s in a name? Aust J Pharmacy 2011; 92 62
[9] Chemist Warehouse. Who are we? 2012. Available at http://www.chemistwarehouse.com.au/AboutUs/ [verified 21 January 2012].
[10] Australian Government Department of Health and Ageing. Australian statistics on medicines 2010. Canberra: Australian Government Department of Health and Ageing; 2012.
[11] Vogler S. The impact of pharmaceutical pricing and reimbursement policies on generics uptake: implementation of policy options on generics in 29 european countries: an overview. GaBI J 2012; 1 93–100.
| The impact of pharmaceutical pricing and reimbursement policies on generics uptake: implementation of policy options on generics in 29 european countries: an overview.Crossref | GoogleScholarGoogle Scholar |
[12] Hynd A, Roughead EE, Preen DB, Glover J, Bulsara M, Semmens J. The impact of co-payment increases on dispensings of government-subsidised medicines in Australia. Pharmacoepidemiol Drug Saf 2008; 17 1091–9.
| The impact of co-payment increases on dispensings of government-subsidised medicines in Australia.Crossref | GoogleScholarGoogle Scholar | 18942671PubMed |
[13] Lexchin J, Grootendorst P. Effects of prescription drug user fees on drug and health services use and on health status in vulnerable populations: a systematic review of the evidence. Int J Health Serv 2004; 34 101–22.
| Effects of prescription drug user fees on drug and health services use and on health status in vulnerable populations: a systematic review of the evidence.Crossref | GoogleScholarGoogle Scholar | 15088676PubMed |
[14] Ortiz M. Are prescription copayments compromising patient care? Australian Prescriber 2013; 36 2–3.
[15] Pharmaceutical Benefits Pricing Authority. Annual report for the year ended 30 June 2010. Canberra: Pharmaceutical Benefits Pricing Authority; 2010.
[16] Terry White Chemists. Prescriptions. 2012. Available at http://www.terrywhitechemists.com.au/search/go?ts=prescriptions&p=D [verified 15 March 2012].
[17] Chemist Warehouse. Prescriptions. 2012. Available at http://www.chemistwarehouse.com.au/prescriptions.asp [verified 15 March 2012].
[18] Australian Government Department of Health and Ageing. The impact of PBS reform. Canberra: Australian Government Department of Health and Ageing; 2010.
[19] Australian Government Department of Health and Ageing. Australian statistics on medicines 2009. Canberra: Australian Government Department of Health and Ageing; 2011.
[20] Kanavos P, Taylor D. Pharmacy discounts on generic medicines in France: is there room for further efficiency savings? Curr Med Res Opin 2007; 23 2467–76.
| Pharmacy discounts on generic medicines in France: is there room for further efficiency savings?Crossref | GoogleScholarGoogle Scholar | 17764613PubMed |
[21] Kardachi G. From the PSA: generics and patient risk. Aust J Pharm 2012; 93 18
