Dr Tony Bartone - ABC Radio - Default Generic Drugs

Subjects: Changes to the PBS that will make generic drugs the default option for prescriptions

RICHARD GLOVER: I wonder if you take, when you go to the chemist, and you're asked that question, which you're often asked, would you like the generic version of that. I do it with Ventolin, which is an asthma spray, I get a prescription for Ventolin very occasionally, I go into fill it, and the chemist very nicely says, well look, do you want the generic, it's pretty much the same, it costs a couple of dollars less I think, and so I usually go for the generic, because I'm worth it.

The whole issue, though, has become part of the budget, the pre-budget debate though because it has emerged that the- to be unveiled in the next week's budget is a change to doctor's software so that generic medicine is the default prescription, so the chemist won't even ask you that question, it'll say on the prescription to give you the slightly cheaper version. Does that matter? Well, Dr Tony Bartone is the Vice-President of the AMA and he joins us on the line. Tony, good afternoon.

TONY BARTONE:     Good afternoon.

RICHARD GLOVER: Does it matter if your prescription says the cheaper one?

TONY BARTONE:     Look, it doesn't matter per se as long as everyone is informed in the discussion and they're aware of exactly the variances, or the lack of … you know, the variances in the name being the same medication. But there are occasions where the generic option isn't a universally good option for some parts of our patient population.

RICHARD GLOVER: [Interrupts] I'm sorry, can I interrupt there, aren't they always the same, aren't they chemically the same?

TONY BARTONE:     Absolutely, absolutely. But for some of our patients, sometimes that engenders a level of confusion which could either result in not taking either, or delaying their implementation of their medication, or taking both the previous and the new one. So, that's- there's little nuances in this area and that's where I'm saying that it's not universally the best option, but as long as everyone's on the same page and aware of what is being alternatively supplied and understanding the nuances of that, it's a perfectly legitimate option to be offered.

RICHARD GLOVER: Okay, and presumably over time people will get used to it if I turn- to take my Ventolin example, if I turn up and I'm given the new one, which looks pretty similar each time, and maybe I might ask the chemist and he or she will say reassuringly, oh, it's the same it's just a little bit cheaper for the taxpayer and for you, then that's all to the good, isn't it?

TONY BARTONE:     Look, what we're talking about now is health literacy and being fully engaged and aware of the whole conversation around the issue. And, yes, ultimately, anything that allows a more efficient system, a more efficient PBS, and allows those savings to be ploughed back in to offer newer, more novel medications which are being developed all the time and continues to defend the reputation of the PBS as being one of those most valuable parts of the Australian health system which puts us at the forefront of world communities, well that's a good thing.

RICHARD GLOVER: That's right, because generics tend to be medicines that have been around for a long time and so they fall out of copyright, other people are allowed to come along and make a version of them, making way, hopefully for, as you say, newer medicines where there is only one, there's the fresh one that is not allowed to be copied.

TONY BARTONE:     And that's exactly the point. And just to be clear, I mean, what we were responding to initially were reports, and they were just reports but they were still not of a complete nature, where there was talk about this generic option being a mandatory or compulsory option. And that's- and what we responded to was that for some of our patient population, that's not a good thing, and now we've received assurances, even as recently as this morning from the minister's office, that this is not going to be mandatory, there won't be an arduous workaround, and it will allow us to maintain our clinical independence. And that is making sure …

RICHARD GLOVER: [Talks over] That's right, so …

TONY BARTONE:     … that the medication that we choose is in our patient's best interest and we know that our patient will be aware of it and will take it because they're used to taking it and there won't be the possibility of confusion. [Indistinct] …

RICHARD GLOVER: [Talks over] So, again, just to explain, the understanding is there'll be an ability of the doctor to override this system and say, no, no, for this particular patient for all these good reasons, I actually want it to be the Ventolin.

TONY BARTONE:     And that's only just been clarified as recently, as I say, from reports from the minister's office this morning. And we were initially, the reports that we were responding to in the media, were of a compulsory or a mandatory nature and now we've been assured that it's not mandatory, it's not going to be arduous, and that we can continue with our independence. Because at the end of the day, it's about patient safety and that's the issue that I've been trying to make clear in this whole process.

RICHARD GLOVER: Good on you. Hey, Tony thank you very much.

TONY BARTONE:     Thank you very much, have a good afternoon.

RICHARD GLOVER: Dr Tony Bartone, Vice-President of the AMA, essentially saying, look, this system as now explained, that the doctors will have an override, the right to override and say, look, I want the branded medicine for this particular person, but by and large people will now be given the generics automatically when they're available when they're chemically similar.

2 May 2017

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