Government Must Drop PBS Drug Subsidy Plans
AMA President, Dr Mukesh Haikerwal, today urged the Government not to pursue restrictive reforms of the Pharmaceutical Benefits Scheme (PBS) that would put cost savings ahead of product quality and the best possible health outcome for patients.
Dr Haikerwal said the AMA is concerned that the plans - reported in the Daily Telegraph - seem to be based on bureaucratic recommendation without any specialised clinical input.
"It is our understanding that any predicted savings to the PBS would be achieved by measures that give preference to one medicine in a class, probably a generic medicine,' Dr Haikerwal said.
"This effectively amounts to compulsion on the medical practitioner to prescribe that generic drug because a decision to prescribe a different medicine would cost the patient more - amounting to health decisions for individual patients being based on economic, not medical, grounds.
"The AMA wants to ensure that clinical independence and judgement in prescribing is the preferred method of patient care in this country.
"Doctors have only one interest in these matters - the best health outcome for the patient. Doctors have nothing to gain or lose from their prescribing decisions, but patients have a lot to lose.
"Not everyone can be prescribed a generic. There are issues of patient confusion, double dosing, adverse drug reactions with other drugs, sensitivity, non-compliance or inter-current infection. Some drugs have a narrow therapeutic index (margin of safety), and modified release medicines are far more difficult to standardise.
"A decision to prescribe a generic or change to a generic - disregarding relevant clinical considerations - can be dangerous and is irresponsible.
"If the Government adopts these proposals, it may give further encouragement to pharmacists to substitute generic medicines despite the fact that the patient's treating doctor has warned against substitution.
"If a doctor considers, for sound clinical reasons, that another medicine is required other than the preferred generic, there should be no financial penalty to the patient arising from that professional clinical decision.
"In Australia, we must continue to put the best interests of the patient ahead of cost cutting that lowers the quality and integrity of our PBS," Dr Haikerwal said.