Wednesday, July 26, 2023

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Double the trouble? Navigating professional indemnity risks & 60-day dispensing

The recent publication of the Double Dispensing Guide by the Federal Government brings us closer to the introduction of 60-day dispensing. While we acknowledge the potential financial impact, our focus is to help minimise the Professional Indemnity risks for our clients due to this regulatory change. This article unpacks a double dispensing scenario that could leave pharmacists exposed to risks if it is not managed.

Following the publication of the Double Dispensing Guide, we have been asked by pharmacy owners what would happen in the event their pharmacy has limited (or one remaining box) of a specific medication, meaning 60 days’ worth could not be dispensed. The Guide addresses this:

Pharmacists, in exercising flexibility, must not charge a patient twice if providing half of the prescribed quantity. 
If there is only one box of a medicine available and the prescription requires two boxes, pharmacists may dispense the full amount (two boxes) according to the prescription and order in a second box of medicine from the medicine wholesaler. For most medicines, wholesalers are required to deliver to any pharmacy within 24 hours. The consumer would then collect the second box of medicine without charge when the pharmacy receives it. The consumer must not pay the co-payment twice.

While relevant, charging the co-payment twice seems unlikely, given the setup of PBS rebates and the fact that the majority of pharmacists are good operators. To us, the underappreciated exposure is what precedes it within the Guide: “can prescribers still write a one-month supply prescription?”. 

Yes, prescribers will retain full clinical discretion over what quantity of medicine is dispensed for their patients.

It is not unforeseeable that a patient has a 60-day script, requesting for it to be fully dispensed immediately. For very valid reasons, the pharmacist may make the decision to dispense only half of the script. Exposure now exists in how this message is communicated to the client. It’s said unhappiness exists in the gap between expectation and reality – in this instance, it is unhappiness and a notification that reside in that gap.

Therefore, it is essential the customer understands:

  • There will be no additional co-payment (not that one could be legally made anyway)

  • They are not being denied their full script. It will be provided wholly to them, just not all in one visit

  • This measure is to manage supply for other customers in need

In a nutshell…

As pharmacists know, script fulfilment can be an emotional event for customers. The risk around the perception (especially for older clients or those whose first language is not Englis1) that the prescription isn’t being fully dispensed represents a potential flash point that will need gentle navigation and education. These are just two of the many soft skills pharmacists are already armed with, highlighting their value within the community and the key role they play in supporting the health of all Australians.

Please reach out at any time to find out how we can help you manage your pharmacy-related risks.

Nick Squillari

Client Executive

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Honan Insurance Group Pty Ltd is now fully owned by Marsh Pty Ltd. To find out more, speak to your broker or read the announcement