COMMENT A prescription for better access to medicine

• Published date: 02 June 2023
• Author: Kathy Spencer was a deputy director-general in the Ministry of Health, a general manager in ACC, and a manager in the Treasury Kathy Spencer
• Publication title: Northern Advocate, The (Whangarei, New Zealand)

Health Minister Ayesha Verrall said the co-payment had prevented around 135,000 adults from collecting one or more prescription medicines in 2021/22. Removing the charge is definitely a step in the right direction

However, many people face other prescription costs and these can be far larger than the $5 co-payment.

Every three months, a person taking a medicine long-term has to request a “repeat prescription” from their GP and collect medicine from a pharmacy. The cost of obtaining a repeat prescription varies across GP practices but is typically around $25 per script, or $100 a year.

Hundreds of thousands of New Zealanders take medicines long-term for conditions like high cholesterol or blood pressure. Statins, for example, are taken by half a million people to reduce cholesterol and lower the risk of heart attack and stroke.

The medicines are often very cheap. Pharmac pays only $6.75 for a year’s supply of a 20mg dose of Atorvastatin — a common dose of the most widely-used statin. Barriers to accessing cheap and effective preventive medicines like statins mean that some people stop taking them, increasing the risk of serious health consequences, including hospitalisations. For many older people on multiple medications, keeping their various pills on hand can also be a significant worry.

So, are repeat prescriptions for long-term conditions really necessary and are they a good use of GP time?

Of course, repeat prescriptions have their place: mainly they provide an opportunity for the GP to check a medicine is still appropriate for the patient. Repeat prescriptions can also help prevent abuse of addictive drugs, and limit the waste that occurs if a patient doesn’t finish a bottle of pills.

In the case of statins, people stay on them long-term with minimal active monitoring; they aren’t addictive; and any savings in reduced waste are outweighed by extra dispensing fees paid to pharmacies by government.

It is never a good idea to have GPs spend time on pointless activities but particularly so when many people are experiencing long waits for appointments and others can’t find a GP practice that is enrolling new patients.

It is equally important to be sure people aren’t paying for services that have no clinical benefit. While repeat prescriptions are clearly a significant...