New drug charges worry chemists

Press, 7 April 1978, Page 16

New drug charges worry chemists

The Canterbury division of the Chemists’ Guild is conicerned that under regulations introduced last Saturday, isome people could have to : pay up to $2O a month for I certain prescribed antij depressants and tranquil- ! lisers. Under the new' regulations five different preparations which were free now carry a part-charge to the patient. These include Concordin tablets (smg and lOmg), 2.23 c to 5.16 c per tablet, depending on whether they are strippackaged or loose; Librium capsules, lOmg: 2.18 c per capsule; Librium tablets, smg: 2.58 c; lOmg: 2.18 c; 25mg: 7.3 c; Prothiaden capsules, 25mg: 1.84 c; Surmontii capsules, 50mg: 6.42 c: Surmontii tablets, lOmg: 1.36 c. The division’s president (Mr B. H. Mclntosh) said that repeat-prescriptions held by chemists before April 1 would be dispensed at no cost to the patient. However, they were finding patients with new prescriptions unable to meet the charges. “The Government has not notified the' medical profession until several days after these regulations have come into force, and in many instances medication was prescribed with the cost to the patient unknown by the doctor. It is unacceptable that the Government has placed chemists in this position. ! “The Government did not treat the psychiatrists to the courtesy of notifying them of the magnitude" of these charges or the comparative cost per dose of the psychiatric medication they are compared with,” he said. That should have been done well before April 1 and only now were they receiving notification of the charges. When anti-histamine drugs had part-charges put on them last year, doctors had been notified and that had allowed them to alter their prescribing habits with no real inconvenience to either themselves or the patient, said Mr McIntosh.

Alternatives were available to the new charges but would take time or organise, he said. The position now was that each case involved with the new charges should either be submitted in writing to the Health Department in Wellington for waiving of the charges, or the patient should be reassessed and new medication found. “These are both timeconsuming procedures and therefore if patients cannot afford the charges they should contact their psychiatrist or doctor as soon as possible.”

The anomalies arising ■ from the new charges could i be seen with the drug Surmontii. said Mr Mclntosh. Capsules of 50mg now carried a charge, while 25mg tablets did not. Patients could be taken off 50mg capsules and prescribed double the number of tablets so they received the equivalent medication level, and the patient would not have to P ay - The Government would have to pay exactly the same, as one capsule was . twice the price of the tablets, he said. ‘Therefore the Government cannot claim they are saving taxpayers’ money an this becomes a fruitless exercise that shows the lack of thought and in-depth study.” Chemists were only too pleased to co-operate in the reduction of medication costs to the taxpayer, but the increase in time, effort, and inconvenience to those who suffered by that type of legislation was unassessable, said Mr Mclntosh. “Also we cannot accept this, especially when it penalises a section of our community who already have problems difficult enough to face, and chemists have great concern- on their behalf.” Mr Mclntosh said strong representations would be made by the Chemists’ Guild to ensure the situation did not reoccur. CHANGES POSTPONED A spokesman for the Health Department in Christchurch said a delay with the Government Printer in Wellington had meant a hold-up in the printing of the clinical services letter which contains details of the partcharges. It was now in the mail to chemists, doctors, and psychiatrists. In Wellington, the deputy director of the Health Department’s Clinical Services Division (Dr A. G. Scott) said that departmental procedure was geared to let doctors know of part-changes before they came in, but this time things had gone out of their hands “and they were as sorry as anybody.” Doctor Scott said the imposition of the part-charges had already been postponed since January 1, and was not something “out of the blue.” It had gone through the normal processes.

The decision to peg free pharmaceutical benefits at set levels for certain antidepressant drugs is the result of studies which have taken several years.

■ The work has been done I by the Pharmacology and Therapeutics Advisory Commitee, which includes doctors, and which advises the Minister of Health (Mr Gill) on pricing within similar groups of drugs. It advises the Minister on how the S9SM annual expenditure on pharmaceutical benefits can be reduced without upsetting health standards.

The resulting list of free and part-charge drugs is very complex. Most medicines are still free, but where the committee considers one of a group of identical medicines too expensive in comparison with the others, it will set a level above which the free benefit does not apply. Where there are two brands of what is the same medicine, the Health Department will only pay up to the full price of the cheaper. Anything above this is charged to the patient. Drug companies and doctors get a chance to comment on the proposals before they are introduced, but from that point the amount of the partcharge is set by the Department of Trade and Industry in consultation with the Chemists’ Guild.

Dr Scott said no patient was permitted to suffer because of the part-charges. “If a part-charged medicine was, in ‘ the opinion of the doctor administering it, the only useful treatment for a patient, then an approach should be made to the Health Department which would make a exception. In this way the full benefit could be paid,” he said.