Independent review calls for evidence-first pharmacy reform to improve patient care and reduce waste

Royal Australian College of GPs Media Release

The Royal Australian College of GPs (RACGP) has urged the Federal Government to act on a major independent review of community pharmacy, saying its recommendations would improve patient care, deliver better value for taxpayers, and strengthen collaboration across the health system.

The Grattan Institute report recommendations include to:

• end Community Pharmacy Agreements or at least base them on public evidence
• make dispensing fees simpler and fairer
• make the Independent Health and Aged Care Pricing Authority responsible for determining pharmacy remuneration with pharmacies required to provide necessary data
• remove restrictions on where new pharmacies can be established and remove restrictions on who can own pharmacies
• direct the ACCC to do a market study of the community pharmacy sector and design appropriate safeguards to protect competition
• fund rigorous, large scale national trials of prescribing for other minor aliments, smoking cessation, and collaborative chronic disease management
• invest $80 million in pharmacists in general practice and Aboriginal Community Controlled Health Organisations.

The report also highlights the Pharmacy Guild’s ongoing donations to political parties – totalling $2.5 million over the past five years – and the impact that has had on policy decisions.

RACGP President Dr Michael Wright said the report highlights the importance of ensuring healthcare reform is evidence-based and focused on patient outcomes.

“This report highlights a number of issues within the pharmacy sector requiring greater transparency, and also ensuring future reform is delivered safely,” he said.

“This is not about limiting access to care – it is about ensuring access to safe, evidence-based and connected care. Australians deserve a healthcare system that delivers the best quality care for patients and the best possible value for taxpayers. We can’t have lobbyist led healthcare in Australia.

The report adds further weight to concerns raised by RACGP and other organisations that pharmacy policy in Australia is increasingly being driven by the lobbying of the Pharmacy Guild rather than based on evidence.

“We welcome recommendations that improve transparency, strengthen accountability and support greater integration and collaboration across the healthcare system,” Dr Wright said.

The College particularly welcomed the report’s recommendation to invest in integrated, non-dispensing pharmacists embedded in general practices and Aboriginal Community Controlled Health Organisations, noting this model supports collaboration between health professionals while maintaining continuity of care.

“The best patient outcomes occur when healthcare professionals work together as part of a coordinated team. Integrating pharmacists within general practice supports medication safety, improves communication and helps patients receive more coordinated care,” Dr Wright said.

The report also recommends tighter price disclosure arrangements to ensure medicine discounts are more effectively passed on to governments and patients, alongside reforms to dispensing fees and other funding arrangements.

The RACGP said any expansion of pharmacy services should continue to be guided by robust clinical evidence and strong clinical governance arrangements.

The report supports national rollout of pharmacist prescribing for uncomplicated access urinary tract infection (UTI) prescribing, while recommending rigorous large-scale trials before wider implementation expansion of most other new pharmacy services.

It also notes that if the significant investment and reforms focused on urgent care centres and multidisciplinary general practices prove cost-effective, the case for providing overlapping services in community pharmacists will get weaker.

“Patient safety must remain the overriding priority. Expanding healthcare services should be driven by evidence, appropriate governance and clear benefits for patients,” Dr Wright said.

The College also supported the report’s focus on improving information sharing and reducing fragmentation in healthcare delivery, noting that continuity of care remains one of the strongest predictors of better patient outcomes.

“There is no substitute for high-quality care delivered by a patient’s regular GP. Reforms that strengthen coordination between healthcare providers, improve medication safety and reduce fragmentation will benefit patients and the broader health system,” Dr Wright said.