Senate Community Affairs Legislation Committee [Part 2], , 1:31:06 to 1:39:03
The committee examines the funding of Dose Administration Aids (DAAs) and the interaction between pharmacy caps and the Support at Home program for older Australians.
Topics: Health, Social services
Speakers: Rachelle Davis, Chris Gatenby, Blair Comley, Speaker 17
>> Thank you, Chair. Um earlier today I spoke to the age care area about dose administration aids um and the interaction there with with pharmacies in the HCPA. Um under the previous home care system some age care home care clients were able to claim the cost of their dose administration aids um under that scheme. Um, a pharmacy can claim about $6 under the HCPA up to a cap. I think some are 90, some have an extended amount, maybe up to 120 or so, uh, depending on the demand uh, for the pharmacy to cover the cost of that. Um, but I believe that's only under for concessional patients, not general patients, uh, or um, yeah, clients. Um, a pharmacy I know in Tasmania exceeds the cap by about 100 DAAs a week. Um they say that the $6 that they receive per DIA to do that is about half the cost of actually preparing it. Um and then we've obviously got some age care resident or sorry home care uh people under the old home care system who now under the support at home aren't getting any support for DA. So I just wondered if um you know obviously we've got many old Australians at the moment who are uh feeling cost of pressure living pressures. We've got small businesses whichies mostly are um feeling some of those pressures. Um if a DIA can't be funded under the support home now and realize that's sounds like that's what is the new rules. Um who made that decision to change that? Um from yeah no no longer allowing it under the new support at home program.
Senator, I can answer and tell you a bit about the intersection of the dose administration aids under the 8CPA and the how that uh intersects with the eligibility under the support at home program.
>> Yeah. And I'm really just wanting to make sure those that had something that now they can't no longer get it. Um and then obviously there's clearly um it'll depend on each pharmacy, but if every week I'm you know I've got a 100 over my cap and it's costing me a money. This pharmacy for instance is losing about just under four grand a week um even after taking a co-ayment from an old resident and um more so from claiming through the CPA. So it's a significant cost if you add that up times 52.
>> So and the component I won't be able to answer is around the changes to the support at home specifically. But under the dose administration aids program under the 8CPA which as you know is designed to assist patients living at home in the community to better manage their medicines with the objective of avoiding misadventures and improving medication adherence. Um, the pharmacists identify eligible patients who live at home in the community, hold a Medicare or DVA card and a current governmentissued concession card and are either having difficulty managing medicines due to literacy, language issues, physical disability or cognitive difficulties or take five or more prescription medicines and have difficulty managing them. Where it intersects with the people receiving support at home services through age care funding is if they are living at home in a community setting, they would meet the living situation eligibility for a government funded dose administration aid service provided by a participating pharmacy. Under the 8 CPA which again commenced on 1 July 2024, the weekly base caps for funded DIA services increased from 60 to 90 services per pharmacy for the duration of the 8 CPA. That was uh an increase uh an additional commitment of 196.7 million over the 5 years of the 8 CPA to um to support that expanded DAA cap. So the DA services funded under the program are not available uh this may be something you already know so apologies if you do to impatients of public or private hospitals, day hospital facilities or transitional care facilities, residents of residential age care homes or patients in a correctional facilities. We have seen an increase uh in those services and take up if we look from 2025 26 to 26 27. So we've seen an increase sorry 2425 compared to 2526. So in 2024 25 uh we had uh sorry 2526 we had more than 19.3 million DA services that were delivered and funded and compared to and that was an increase of 700,000 services for 2425 there is acknowledging your point around there is the cap is uh a funding limit at the at the pharmacy level rather than a limit on whether an individual patient is eligible. ible for a DAA service. So acknowledge that we have seen in the most recent figures that uh from earlier around April 2026 that approximately 7% of pharmacies reach that weekly cap.
>> Only 7%.
>> Yes, that's correct.
>> That's interesting. Um so it'll really depend on really the lottery of where you live and um which pharmacy and how much they're servicing particularly probably near
>> the availability of other services in the area. um and hopefully the option of choice as well as then obviously up to the individual pharmacy around any additional fees or services that they offer um to the patient.
>> And is there any consideration under the ATHM service list or for future CPAs um about reviewing that? Obviously there's we're going to as more people are aging um it's obviously there's a huge demand for it. If one local pharmacy is doing 100 a week over its cap um it's pretty significant. especially at the moment in this financial environment that we're in. Is that something that might even be one for the minister if that's something the government's looking at or would consider in the future looking at making sure that the pharmacy but also the the older Australian isn't out of pocket any extra at the moment because things are quite tight and medication management does keep people in their home a lot
>> Um Senator Dr. and a Pete first assistant secretary health security and immunization division. Uh you would have heard from our colleagues uh in uh outcome 2 that there is a survey list out uh so we would encourage people to put in uh to that survey ideas around what services are provided at for the uh stay-at-home packages. So yes, I I consider it would be a part of that review process.
>> Okay. I mean, just to be um clear, [clears throat] we're little over two years into the 8CPA. It's a 5-year agreement, so it would probably be a little while before we'd be collecting um and putting forward in a future negotiation with the pharmacy guild. But I would be I would be surprised um knowing the pharmacy guild that they wouldn't put this on the agenda in the same way that number of pharmacists have raised with us things like the um the home medicine review um issue as well which I think you were alluding to as well
>> and is there any modeling that you'll do in anticipation of that of you know the uptake um you mentioned the 7% cap but will you model things like the cost on pharmacies and and how that may you know what what's the cost basis that you then come to the in the formation of an agreement with them. How do you do that?
>> So the elements for the modeling for any future agreements, we're not quite there yet, but of course there will be multiple elements that we will economic that we will take into account in terms of future economic modeling to inform uh strategies and priorities for future
>> No worries. I'm just going to shift now to the HTA review if I may. Um that may