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30 ANNUAL REPORT FROM PAGE 29 community pharmacists participating in the pilot to provide empirical treatment to non-pregnant women with acute uncomplicated cystitis, through the supply of antibiotics. AUGUST PHARMACY ‘RISK SHARE’ THE ENVY OF MANUFACTURERS The recently signed 7CPA included what had been described as a ‘risk-share’ clause. It was similar but significantly different to a ‘risk-share’ clause included in the expired 6CPA: it was much better for pharmacy. The 7CPA ‘risk share’ would be unrecognisable to any medicine manufacturer – an ‘agreement with a penalty clause’. Yet, in practical terms, the government carried the entire risk of the penalty. In the 7CPA, the Pharmacy Guild secured what amounted to a ‘minimum spend’ commitment with an upward adjustment to the administration, handling and infrastructure (AHI) fee if prescription volume fell below a specified number. For the first two and a half years of the agreement, community pharmacy would be entirely compensated for the remuneration impact of a lower than forecast prescription volume. Any adjustment in this period would be based on a straightforward formula. For the first ‘assessment’ period for any adjustment, the six months from 1 July 1 to 31 December 2020, the 7CPA estimated 109.5 million subsidised PBS prescriptions. Yet, what if the actual volume is lower – maybe four per cent lower (105 million)? Assuming there is no significant shift of volume from subsidised to unsubsidised (under co-payment) prescriptions, which the 7CPA allows for, the tier one AHI fee (currently $4.28) paid to community pharmacy per prescription will increase by around $0.17. This is in addition to annual indexation and represents a one-year budget impact for the government of around $50 million. What if the actual volume is four per cent higher? Absolutely nothing happens. Any downward adjustment in the dispensing fee is not calculated until the actual prescription volume is five per cent higher than forecast, and it’s calculated based only on the growth above five per cent. In effect, the actual prescription volume would have to increase by around 20 million (forecast increase plus actual increase) before any impact on the government’s renumeration to community pharmacy in the two and a half years of the 7CPA: a level of growth virtually unprecedented in 20 years. Other stories making highlights at this time • As the race to find a vaccine for Covid-19 continued, researchers from the University of Oxford published a preliminary report in The Lancet showing promising results from phase 1 and 2 trials of its vaccine candidate, known as ChAdOx1 nCoV-19. • Australians were urged not to ignore long-term risk of chronic disease during the pandemic, as a new report highlighted overweight and obesity as a major risk factor affecting two in three Australian adults, and one in four children. • The annual Chronic Pain Australia survey found steep worsening of how people in pain feel pharmacists help them manage their pain, compared with last year’s survey. • RACGP President Dr Harry Nespolon died following a nine-month battle with pancreatic cancer. • Health Minister Greg Hunt announced a $2.55 million Medical Research Future Fund grant towards a Monash University-led project to develop and implement risk prediction tools for pregnant women at high risk of adverse lifestyle-related outcomes. • The Australian government announced changes to the JobKeeper initiative, extending the support beyond September 2020, and adjusting payments so that essential support is provided to those in need. • South Australia (SA) Health announced a two-week pilot that allowed pharmacists to test patients for Covid-19. • Discount Drug Stores promoted its medication home delivery service, which it said gave customers a more convenient way to get their medication while adhering to social distancing restrictions. • Med-tech company MedAdvisor reached a three-year strategic alliance agreement with US-based HMS, promoted as a leading provider of payment accuracy and population health management solutions. The alliance would facilitate MedAdvisor’s ability to integrate with HMS’s health engagement platform for up to 100 million insured lives in the US. • The PSA made a submission to the Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee, inquiring into the Queensland government’s health response to Covid-19, highlighting the serious challenges faced by pharmacists in the state during the pandemic. • Eligible Australians living with haemophilia gained access to extended half-life treatments Eloctate and Alprolix via national supply arrangements, a move welcomed by Sanofi Genzyme Australia and New Zealand General Manager Fiona Clark. • The Pharmacy Guild announced that APP2021 would move from the traditional March dates to May 20-23 to allow for more time for planning an event in this new Covid environment. • Kurtis Gray from the University of Western Australia won the 2020 PSA Mylan Pharmacy Student of the Year Award. • The South Australian Branch of the Pharmacy Guild welcomed amendments to the state’s Covid-19 emergency response legislation, which appropriately recognised the vital role of community pharmacies in the public health response to Covid-19. SEPTEMBER VACCINE DEAL PROMISING BUT HURDLES LIE AHEAD AstraZeneca was said to be pleased to have signed the letter of intent with the Australian government over early access to the Covid-19 vaccine it was developing RETAIL PHARMACY • NOV/DEC 2020