Pharmacy Daily Monday 4th February 2013 T 1300 799 220 W www.pharmacydaily.com.au page 1

Monday 4 Feb 2013

2013 Annual Therapeutic Update – March Weekend1 – 3 March 2013Crowne Plaza, Terrigal NSWwww.psa.org.au/education/conferences

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THE controversy over the HomeMedicines Review program iscontinuing this week, with theConsumers Health Forum todayreleasing a consultation paperwhich explores issues relating tothe uptake and sustainability of thescheme. The move follows last week’s callsby the Pharmacy Guild of Australiafor a suspension of the programdue to significant cost overruns. The CHF has analysed the fundingfor the HMR program, which hasbeen allocated $52.11 millionunder the Fifth CommunityPharmacy Agreeement. Looking at medication errors andthe need for HMRs, the CHF paperpoints out the significant impactthat the program can have onadverse events and hospitalisation. The CHF has staunchly rejectedthe Guild call for a moratorium,saying that it “sees no justificationfor additional criteria orrestrictions, and would considerany such measure to restrict accessto the program to be counter-productive”. Instead the Forum argues thatany changes to the program shouldaim to remove barriers to accessfor high-risk consumers who wouldbenefit from HMRs. Citing several “major pieces ofresearch” the CHF report also notesthat community pharmacyrepresentatives have previouslyacknowledged barriers to access,low levels of awareness of HMRsamong consumers, as well as lowrates of participation among certainpopulations.

The CHF report also notes the2010 Guild-commissioneddocument Increasing PatientDemand for HMR: A Marketing Planand points out that any recentincrease in uptake of the HMRprogram “is positive and consistentwith previous strategies”. According to the report theoverspend to date has amounted to$4.2 million, largely due to a recentspike in demand, and argues thatthe HMR program should beconsidered “within the broadercontext of the $15.4 billionprovided to communitypharmacists under the 5CPA.” MEANWHILE the release of thepaper this morning followsconfirmation of “urgent talks”between the Guild and the HealthDepartment (PD breaking news Fri). “The Department and the Guildagreed that they would worktogether as a matter of urgency tofind the earliest possible solutionthat puts the HMR program backon a sustainable financial footing,”the Guild said in a statement. “The Guild continues to believethat a temporary pause in the HMRprogram is the responsible courseof action to enable these solutionsto be expeditiously agreed and putin place without making the currentregrettable financial situation evenworse,” the Guild added. Other industry stakeholders havealso expressed dismay at a possiblesuspension of the program,including NAPSA and APESMA - seeother stories on this page. The CHF consultation paper canbe viewed by clicking HERE.

CHF releases HMR paper NAPSA HMR concern A MORATORIUM on the HomeMedicines Review program willimpact on future pharmacists,according to the National AustralianPharmacy Students’ Association. “Many universities haveembedded HMRs within thecurriculum and this providesstudents an insight into a potentialcareer path,” said NAPSA President,Chris Braithwaite. “If a moratorium occurs, studentscould see their aspirations put onhold,” Braithwaite added. HMRs also provide an “invaluableopportunity to work collaborativelywith other health professionals,which NAPSA sees as an importantstep to moving forward as aprofession,” added NAPSASecretary, Bronwyn Jones. NAPSA said it understood thefunding issue, but believes furtherinvestigation and review of how theservice is being delivered should beimplemented prior to its stoppage.

APESMA slams Guild THE Pharmacists’ division of theAssociation of ProfessionalEngineers, Scientists and Managers(APESMA) says that instead ofscrapping the HMR program “thePharmacy Guild should fund theHome Medicines Review fundinggap by forgoing a small amount oftheir income from the governmentfor managing the $15.4 billionCommunity Pharmacy Agreement”. APESMA has accused the Guild of“trying to exert its influence toensure that payments are onlydirected to the pharmacy ownersthey represent without anyconsideration for the impact onpatients or employee pharmacists”.

Safety update THE Therapeutic GoodsAdministration has released thelatest version of its MedicinesSafety Update, including a sectionon progressive multifocalleukoencephalopathy which hasbeen associated with the use ofimmunomodulatory medicines. There’s also advice that theProduct Information for thyroxinehas recently been updated toinclude a precaution about theincreased risk of osteoporoticfracture associated with excessivethyroxine doses. The TGA has also noted 51adverse event reports since 2002 ofserious electrolyte disturbancesassociated with oral bowelcleansing products which are partof the preparation for a range ofmedical and diagnostic procedures. The full Medicines Safety Updateis available on the TGA website attga.gov.au/hp/msu-2013-01.htm.

$10.6m for cancer HEALTH minister Tanya Plibersekon Fri announced $10.6 million innew funding for 38 researchprojects looking at cancer. Successful recipients include jointventures between Cancer Australiaand Australian Rotary Health;Cancer Council Australia; CancerCouncil NSW; Cure Cancer AustraliaFoundation; National Breast CancerFoundation; and the ProstateCancer Foundation of Australia. Plibersek noted that one in twomen and one in three women willbe diagnosed with cancer duringtheir lifetime in Australia.

Monday 4 Feb 2013

Weekly CommentWeekly CommentWeekly Comment

EDITORS Bruce Piper and Amanda Collins EMAIL info@pharmacydaily.com.au ADVERTISING Magda Herdzik EMAIL advertising@pharmacydaily.com.au page 2

VISITORS to the coastline nearNew Zealand’s Nelson region havebeen bemused to see lots of whatlook suspiciously like breastimplants washed up on the sand. They’re actually an unusual typeof jellyfish (pictured below).

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Getting to the heart of it HEART attack victims are beingfailed by Australian’s health system,according to the George Institutefor Global Health and the HeartFoundation. The comments follow a reportpublished this month in TheMedical Journal of Australia whichoutlines five key reforms needed toreduce the alarming number ofAustralians who have repeat heartattacks. The report is the result of anational summit of 30 keyorganisations from governmentagencies to health professionalsand heart attack survivors who metto address the issue of secondaryprevention in this country. Currently half of all heart attacksin Australia are not the first, withthousands of Aussies dying fromrepeat events every year. The report also found that thetotal cost of repeat heart attacksexceeds $8.4 billion annually, overhalf the total acute coronarydisease cost burden. “The health system is failing heartattack survivors even thoughsecondary prevention strategiesincluding taking medicines andleading a healthy lifestyle can reducedeath and future heart attacks,”said report co-author Julie Redfern. To remedy the problem, the reportoutlines a five point plan forreform, with the firstrecommendation being thedevelopment and implementationof a national approach tosecondary heart attack prevention,by providing a clear path for

patients as well as a structuredinitial assessment and plandevelopment following a heartattack, ongoing support formodifying risk factors and longterm follow up and reassessments. The second point calls for abridging of the gap betweenhospital and primary care byimplementing a case managementapproach that is recognised byMedicare and enables coordinationbetween specialist, GP and alliedhealth services and greatereducation on secondary prevention,behaviour change techniques andself-management strategies. The report also calls for increasedawareness and utilisation ofexisting services by patients via aweb based national inventory ofsecondary prevention services,along with the development of asystem for establishingperformance measures to facilitateclinical practice improvement. Lastly, it urges the implementationof a communication strategy tokeep key stakeholders informed.

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Welcome toPD’s weeklycommentfeature. Thisweek’scontributor isGiuliana Baggoley, ClinicalPolicy Adviser, OptometristsAssociation Australia andpresenter at PSA NSW’s AnnualTherapeutic Update.

Rheumatoid arthritiscan affect your eyes

RHEUMATOID arthritis affects1% of the Australian population. Ocular complications includescleritis, episcleritis and retinalvasculitis, while a particularconcern is dry eye which canbecome quite severe. If severe dry eye is not managedappropriately, deterioration ofvision can occur in the long term. Latest evidence suggests thatdry eye associated withrheumatoid arthritis arises fromocular surface inflammation thatcan further compromise tearsecretion and cause ocularsurface disease and symptoms. Anti-inflammatory therapy is areasonable consideration forpatients using artificial tears whohave clinically detectable ocularsurface disease, particularly ifinflammatory signs are present. Optometrists have beenprescribing topical ocularmedicines since 2000 andpractitioners registered withtherapeutic endorsement canprescribe Schedule 4 medicines. Initiating a relationship with theoptometrist means patients willlikely receive regular monitoring,and ongoing eye care thatincludes screening for otherconditions associated withrheumatoid arthritis. Pharmacists and optometristscan help each other by keepinginformed of professionaldevelopments and expertise. This, in turn, will strengthencollaborative health managementand produce optimal outcomes.

Hong Kong formula OFFICIALS in Hong Kong haveintroduced new customs measuresto manage a shortage of babyformula, due to a rush of peoplefrom the Chinese mainland stockingup on supplies in the lead-up toChinese New Year. The Hong Kong govt has cut theluggage allowance on trains to themainland, and also introduced anew hotline for Hong Kong mothersto place orders for seven brands ofinfant formula.

THERE’S an epidemic of bare babybottoms in Southern Norway,which has been hit by an influx ofvisitors from Eastern Europestocking up on disposable nappies. It’s the result of a supermarketprice war which saw people fromneighbouring companies cross theborder to buy “every last diaper”in order to resell them in placeslike Poland and Lithuania.