Negotiations on the seventh EU Pharmacy Agreement (7CPA) have begun in 2019. The government originally wanted to conclude negotiations by the end of 2019, but will continue until 2020. In addition to the Guild, the Pharmaceutical Society of Australia (which represents all pharmacists, not just pharmacy owners) will be co-signer of 7CPA for the first time. The Ministry of Health also consulted with a number of other stakeholders in the consumer, pharmacy and health sectors on the policy and funding considerations of 7CPA, although these stakeholders did not sign the agreement. In 1981, an independent pharmaceutical compensation tribunal (PBRT) was established to determine the remuneration of pharmacies for the dispensing of PBS-based drugs. In 1989, the PBRT proposed amendments to reduce the pay of pharmacy owners (p. 36). This sparked a dispute between the government and the Guild over the calculation of compensation, which was settled by the signing on December 6, 1990, of the first community pharmacy agreement between the Guild and the Minister of Age, Family and Health Services. The National Health Act of 1953 was amended in 1990 to require the PBRT to implement such an agreement between the Minister and the Guild (or another organization representing the majority of licensed pharmacists) (section 98BAA). In the absence of such an agreement, the PBRT determines the pharmacy`s remuneration for the dispensing of PBS-based drugs (subsection 98B (1)). As the sun sets on 6CPA, it is important to remember that this is a reform agreement that offers patients both benefits for patients and new stability and safety for 5,800 municipal pharmacies. The highly innovative and advantageous Management, Handling and Infrastructure Levy (AHI) has set a floor below PBS prices to ensure that the price opening procedure does not undermine the viability of the tax and threaten consumers` access to medicines.
In addition to funding, 6CPA also provided for the continuation of the pharmacy implementation code, which prevents pharmacies from opening near existing pharmacies or in supermarkets. In light of a March 2015 report by the Australian National Audit Office (ANAO), which criticised aspects of the negotiation and management of the fifth EU pharmaceutical agreement, 6CPA called for an independent review of pharmacy compensation and regulation. The review panel disagreed on whether the rebate fees paid to pharmacists should be based on the average cost of selling at a pharmacy of best practices or whether the tax should continue to be agreed between the guild and the government (p. 15-16). The government`s response to the revision appears to favour the latter option, while stressing that any agreed-upon royalties should ensure a viable community pharmaceutical sector while ensuring that PBS remains affordable (p. 20). the proposal to simultaneously authorize the supply of two months of deliveries of certain PBS-based medicines for chronic diseases. This would reduce costs for patients and the government, but would reduce pharmacists` revenues from distribution and related costs. The guild rejects the proposal and complains about the impact on pharmacy facilities and the risk that patients will not take their medications properly. The current state of the proposal in the negotiations is unclear, with the Ministry of Health noting at the end of 2019 that “the government will carefully consider the proposal and does not propose, at this stage, to change the quantities of PBS-based drugs.”