PBS and Generic Medicines sold separate

[4th class citizen]

Andy32 -[quote]The committee may well be wrong on generics, but they control the money and that gives them power. You can take power by paying your own money or being politically active.[/quote]

Yes power is the truth and today without any ethics or morals unfortunately.

Power corrupts but absolute power etc and it is what is driving us all along with greed.

where are the checks and balances on this committee who select what is on the PBS anyway.

Some time back my wife said they put on Viagra for men and took off thrush treatment for women and Viagra is not life threatening if unchecked whilst thrush can be.

NO one actually cares what happens to the patients if these generics dont work like the one I mentioned. They just shrug and say like you - this is how it is.

[computerflyer]

Hi Andy32, Good to have a rational, informed, intelligent voice on the site

[Andy32]

The committee may well be wrong on generics, but they control the money and that gives them power. You can take power by paying your own money or being politically active.

Remember, the government want to save money and opting to pay only the lower price option is one method that they employ.

Remember too that pharmacists are (mostly) highly trained and skilled professionals. Their remuneration should be on a comparable level to other, similarly skilled professionals. They take on significant risks, both financial and professional, to bring this service. Unfortunately there are bad eggs, as in all professions.

[4th class citizen]

Andy [quote]Their committee of experts decided that the generics are just as good as the originals so they won't be paying extra to cover peoples' expensive tastes.[/quote]

My argument with the above statement is that not all generics are as good as the original drug which underwent stringent trials before being approved and generics get a random check now and then and we all know about the random checks that didn't get done on Pan Pharmaceuticals in Australia, who got shut down for dodgy practices and cutting corners for greed and profit, now don't we?

Plus are we really meant to believe the Inspectors trot off to say Turkey to check that the generic factory is on par with Aussie standards?

Mum has to have Panadeine Forte and is charged $22 for these (120) as a levy because there is a generic. Now once the local chemist slipped in Cobran Forte* in its place and I didn't check the bag - and gave them to her at 6pm after chemist shut and she had no others left.
Took 1 as usual - last around 1 hour 20 minutes and gets her off to sleep - didn't work. Took a second one so now had 60mg of Codeine and guess what still no reduction in her pain at all. She sat up and waited out the time then took 2 over the counter Panadeine with 8mg of codeine in each.

That made 16 mg of codeine and they worked well enough to get her to sleep lightly she said still felt the leg as it is worse in bed for some reason - but worked better than 60mg of Codeine she reckons they forgot to put in the generic pack.
Bit of a rip off but what can you do apart from what I did demand they exchange them for the real thing. They did as her file was marked no generics - only re-badges which I find out for her as locals dont seem to know the difference. No rebadge for Panadeine Forte that I have found anyway - wish there were.

* You do know that the chemists got caught by Tony Abbott in Dec 2006 ripping off the PBS on generics with the co-operation and encouragement from the generic companies and pocketing the profits? Which is why they push them so hard. Wont cease to profit until 2012 under the agreement seemingly - couldn't gaol the lot of them for fraud which it what is was and is still.

[Andy32]

Hi computerflyer, thanks for your comments.

I have no problem with auto refills as such, my contention is that the frequency of supply should match the frequency of consumption, not significantly outstrip it as a ploy to take advantage of Medicare. Although it's not technically breaking the law to try and exploit Medicare in that way, it's sad to see pharmacies be actively complicit in such a scheme. Admittedly, if I was taking several regular medications I probably would try use the Safety Net in that way (within reason). However, I wouldn't dream of setting up automatic refills on the highest frequency possible to achieve this (read: engage a 3rd party to carry out systematic unprofessional conduct, under threat of taking my business elsewhere, because it's too difficult to make a phone call every 21 days). I don't mean to come across as narky about this, I was stunned yesterday when a patient expected me to engineer and operate such a scheme for him. I'm surprised he didn't ask me to wipe his bum too.

As for the government bureaucracy, Medicare take it upon themselves to create extra work and hassle for pharmacists in the real world. They operate as an insurance company, denying often substantial payment on technicalities such as the doctor forgetting to write the patient's address on the prescription, or the date being stamped or written by the pharmacy rather than being handwritten personally by the patient. The standard of record-keeping with Privates is typically sufficient; identical computer data entry is done. In fact, Private scripts are archived securely locally in the pharmacy whereas PBS scripts are sent away to Medicare's massive warehouse and typically no copy is kept. Personally I prefer dispensing as Private due to less workload and burden on the taxpayer. Discount pharmacies would say the same. Background info: I'm not a pharmacy owner.

[computerflyer]

Andy,

Very good start, but also self serving.

Ref your reference to "government bureaucracy". Many would just call it proper record keeping in context.

Re services, it is a great service for auto-refills for those of us on long term medications. I have been on cholesterol medication for 15 years, and for the previous few it has been really good that each month I get a reminder my next month supply is ready for pickup. it saves me $0.25 for a phone call, or 15-20 minutes waiting. Not a bad outcome for me! The pharmacy is also a low price leader for non-PBS, if not the low price leader. They also offer good advice and good customer service when required!

Your one sided view may reflect that your own pharmacy does not provide such customer service - or enjoys traditionally high prices supported by government not allowing groceries to have pharmacies, but you will eventually need to compete with one of those or close shop.

OTOH, I agree with you for medications such as antibiotics and others that are not long term requirements. And for the factual bits of your post, very well covered!

[Andy32]

4th class citizen:

PBS is a government subsidy that partly covers the cost of medicines.

The money comes from TAX paid by taxpayers ($7.7 billion in the 08-09 year).

For 'Private' prescriptions, you pay 100% of the cost. PBS contributes none and has no involvement.

Even though you might expect 'Private' prescriptions to cost more, they are often cheaper, for 2 main reasons:

1. Less paperwork-based labour is involved for the pharmacist (less Govt bureaucracy).

2. It's often illegal for pharmacies to alter the prices of medicines while PBS is involved. When PBS is not involved (i.e. Private), the price can float with the market and be discounted.

PBS fixes medicine prices to ensure that they are affordable for almost all Australians. Pharmacy has an agreement with PBS about receiving a fixed dispensing fee for each dispensing. However, the deal is off if the pharmacy provides a discount to the customer. (Why should PBS pay the full dispensing fee like chumps if the pharmacy's giving a discount to the the customer?). The way around is to not involve PBS and its rules and go Private. Some pharmacies take a financial loss for this, in order to appear 'cheap' and get you in the door so you buy other, more profitable things.

PBS charge a levy on brand-name drugs because it costs them more. Their committee of experts decided that the generics are just as good as the originals so they won't be paying extra to cover peoples' expensive tastes.

PBS will never be hurt by Private selling since Private selling costs nothing to the Australian taxpayer.

However, with Private prescriptions the patient misses out on Safety Net credits and this can cost them more in the long run (this isn't advertised).

aayla199:

"If you have a good pharmacy they can keep your mothers scripts on file and every 21 days they will dispense the script ready for you to collect so you have a better chance of making it to the safety net. This is a service we offer. "

You should take a long hard look at this 'good pharmacy' 'service', which amounts to professional negligence. Sure it makes you more cash, but:

1. You are causing drug stockpiling which is a risk for poisoning and suicide.

2. You are creating unnecessary burden on the taxpayer ($7.7 billion, is it enough?).

3. Less Medicare money available for seriously ill people.

4. Waste of medicines.

5. Waste of money.

6. Shows cynical attitude towards Medicare's '20 day rule'.

Andy
Pharmacist

[4th class citizen]

Thanks aylaa199 for that explanation.

I do get why people want to save money and I do get why some companies set up E pharmacies and do it cheaper - I am a business man.

But today for example I went with Mum to see her Doctor as he had prescribed Minax 50 for her to try as her Coversyl was not working well - she eats up meds and cant be put under easy - me too which is a pain as meds get thrown out faster - anyway Minax is a generic OK but he prescribed it even though she has allegies,swollen feet plus takes Somac for acid and looking up the info says not to be prescribed for these, so went with her. His explanation was yes it is a generic but is being prescribed a lot and is working fine it works for 12 hours and that is why he says take it twice a day - and the info on the internet - which is same as printed out at the pharmacy btw - is wrong!

But she had told him many times that she cant be put under and that a 2 hour local lasts 20 minutes. Dentists have no problems with understanding that but Doctors do. Minax just didn't last the 12 hours as she took 1/2 at 7am and 1/2 at 7 pm and evening one lasts less than morning - or because it is quiet she hears it more - heart banging away loud in her ear so she has trouble getting off to sleep and thinks is it about to stop! Not a nice thought for a 72 year old who is feeling mortal anyway with friends popping their clogs all around her.

I hope this new lot will be okay and I wont have to go with her again but he is very overbearing and can see why she needed support. Her hubbie wont even to to the same Doctor as he cant get along with him but rural area - hard to change.

Anyway I had asked our pharmacy and they said sorry for not pointing out it was a generic - as on her file (and mine) no generics ever.

I asked the doctor if, like the Pharmacist can switch a original drug for a generic drug, can they switch an generic for a original - he said 'don't know'.

But gave her a script for Lopresa 50(turkey country of origin)to take one twice a day so upping the dosage.



Now she had to pay $7.75 because the cost was 13.19 and a generic exists Minax but she can buy Minax for $7 privately and not count it against her safety net but not Lopresa as it is PBS. Duh!

So taking the $5.40 away fm $7.75 leaves $2.35 which brings the price charged to PBS for Minax to $10.74. If I have worked that out correctly. Didn't show a price on her current one.

I did know that pharmacists get a fee for prescribing the drug and on the PBS it is charged direct to PBS but I think - maybe wrong - that is is not included in the cost shown on the label of the drug itself. Correct me if wrong.


So you agree in last post that PBS will be hurt by this private selling when less than worker co-payment $33.

I think you are right that it will hit the pensioner and those least able to afford meds in the near future.

[aayla199]

The PBS won't be deprived of our money if we go to private scripts.

Sorry having re-read my post and I made an error in this statement.

Yes the PBS will be deprived of money if we go to private scripts by this way - less PBS scripts being claimed, if the amount less is significant then the government will re-think the amount they budget for the PBS, which could then mean a reduced amount of money being allocated to the PBS. This will not fair well for our aging population.

Personally, I am not a fan of discount warehouse pharmacies. I find them impersonal and lacking in customer service - even the basic asking of quesitons when people purchase over the counter medications. Many times I have wished I was a mystery shopper for the pharmacy guild.......... but that is my personal opinion.

4th class citizen, any good pharmacy would have made note that you only want the original brand of scripts against your name in the computer and they would have made sure they always had one instock for you. If this pharmacy is not doing that then I would go elsewhere.

[aayla199]

cont..

As for your mother, if she is on a pension then I would recommend having it as a PBS script all the time so she can reach her safety net.

If you have a good pharmacy they can keep your mothers scripts on file and every 21 days they will dispense the script ready for you to collect so you have a better chance of making it to the safety net. This is a service we offer.

Zocor is a perfect example of why the customer pays a co-op on it. When it first came out it was the only one on the market and get a 20-30year patent on the molecule. So the drug company could charge whatever it wanted to the government for this drug cause it a/was the only one of its kind and b/how else are they going to re-coup the amount of money the company spent on reasearch and development. 20-30 years later the patent is no more and now other companies can make the same molecule for less so they can offer a lower cost to the government. This is why a lot of drug companies create their own 'generics' because they can have two pieces of the government funding pie. If the product costs the government more and the company won't come to the party on there prices and their is a 'generic' available at less cost - what else is the government to do?

[aayla199]

Hi 4th class citizen

Say I have a script for Plavix 75mg. On the dispense label I will see a figure next to the words Full Cost - $80.90. I have been charged $33.30. The PBS looks at all the drugs available on the Australian market and determins which drugs they will subsidise for the consumer for what ever reason. The PBS has covered $47.40 of the price of this product. By that, they will pay the pharmacy that amount to cover the cost of the item - $33.30 + $47.40 =$80.90. If I am on a healthcare or pension card then the government covers more of the money - $75.50.

If I have a script for Coversyl 10mg, my dispense label now has Full Cost - $24.35. Ahh less then the PBS cost you say, so why was I charged $31.20 for the item?

Every pharmacy has a dispense fee. This dispense fee is governed by the pharmacy guild and is a fee charged on every single script that comes in to the pharmacy - I mean we are a business after all. How much money do you think we make on toilet paper and panadol 24 to compete with the shopping centre two doors down? It would shock a lot of people as to how much money we don't make on these items, but I digress.

So with my Plavix script the government is charged the dispense fee (because it is a high cost item) and with the Coversyl I am charged the dispense fee. But I am paying under the PBS amount. If I have a safety net card then a sticker is placed on this card for me to make my safety net limit.

If I choose to go to a warehouse/discount pharmacy that promotes lower prices on certain script items and get my Coversyl at say $19.10 what has happened is that I have gone from having a PBS script to a private script. Once you have a private script it loses its PBS value which means I don't get that little sticker that goes on my safety net card. This can mean a loss for some people as they miss out on reaching their safety net or it means a win for some people who don't ever reach their safety net.

The PBS won't be deprived of our money if we go to private scripts. If anything having the 'original' product then the generic will deprive the PBS of money as then the PBS have to pay extra (just as your mum does) on an item - sometimes even more then the co-payment that gets passed onto the consumer! So if you are concerned about the PBS - take the generic.

[4th class citizen]

I keep finding price lists with meds for my Mum when I collect hers. She is on the pension and has to pay $5.40 per item.

But from the lists seems you can buy cheaper medicines.



so thought what is going on? I must have missed out on the revolution! when did you go to the Doc and get a script and if it is cheaper than the PBS did you become able to choose to pay the lesser fee.

Sounds great to the individual. But - does this not mean then that the PBS is being deprived of our money if the item is less than our $33 for whatever we need and buy privately?

If so doesn't this mean that eventually the PBS will collapse? I thought the idea was a sort of collective that we all get to pay a certain sum whatever the actual cost so that those who have a very expensive medicine were protected as long of course as it was listed on PBS.

Anyway rang the Chemist and was told this is the way it is now and you have to pay the PBS co payment if it is on the PBS but not if it is a generic.

Duh!

why then does Mum have to pay a levy on top of her $5.40 for her meds because of a generic being available but also it is on the list to be sold privately and get this cheaper than the actual cost shown on her meds.

Please explain! someone - maybe Druggist
:D/ Doing a Pauline here....