Beginning a week ago today (on February 1), New Zealanders learned were eligible maybe, quite possibly, be able to get a 12-month prescription. Or not. The government claims it will save money for patients and time for GP practices, and that might be true sometimes, but for many—perhaps most—people, it's more complicated than the government makes it sound.
When the government first announced they were doing this, my first reaction was. “are they insane?!” That requires some explanation, beginning with a bit of history.
When I arrived in New Zealand in 1995, people on regular prescriptions generally got a 6-month supply. At some point after I started on regular medication that was shortened to three months because, we were told, too many people weren’t taking all their medications, and so, there was waste. I probably thought that was a bullshit excuse at the time, but the result was incredibly annoying.
I had to go to the chemist three times a year, which was annoying when the chemist was quite a drive from our house. Worse, one drug (the blood thinner) has special restrictions and I had to pick it up monthly. So, I had to go to the chemist every damn month.
Awhile back, I switched to an “online” NZ-owned pharmacy, and my prescriptions are delivered to me monthly, so I don’t have to go get them, which is so much better. They also remind me when it’s time to request a new prescription.
The medical practice I go to sent a message to patients, saying, first, that some patients “with stable, long-term health conditions” may be eligible, however, “not everyone will be clinically appropriate.” Patients who need close monitoring, for example, won’t qualify. This doesn’t fully apply to me. Also, they said, “controlled drugs”, which they said inlcudied drugs “such as morphine, ADHD medicines like methylphenidate, benzodiazepines including temazepam, and zopiclone”. This doesn’t apply to me at all.
I don’t have “regular monitoring”, as they call it (like of my blood pressure), and so, I probably qualify for 12-month prescriptions. However, there’s also not much of an incentive for me to switch.
Not many people will save a lot of money by switching to a 12-month prescription. However long the prescription is, there’s a dispensing fee of $5 per item up to a maximum per year (I’ve forgotten what the annual maximum is, but I always used to hit it). The previous Labour Government abolished the co-pay, but the current National-Act-NZ First coalition government reinstated it. Not all pharmacies charge the co-pay: Australian-owned Chemist Warehouse and the pharmacy in the Australian-owned supermarket chain Woolworths also doesn’t charge it, but smaller pharmacies often do (the pharmacy I use doesn’t charge the co-pay).
For example, suppose a patient has four drugs. Each one would carry a $5 co-pay at the time the new prescription is filled. So, right now, with 3-month prescriptions, that would be $80 for the year. Under the new system, people who qualify to use it would pay $20 for the year, but they’ll have to pick it up every 3-months, because that part hasn't changed. This means that the pharmacies that charge the co-pay will be doing more work for less income.
On top of that is the fee the medical practice charges for a prescription renewal, and that varies a lot. In my case, I pay $26 for every renewal ($104 per year for the four 3-month prescriptions). If I got a 12-month prescription, I’d pay $26 for the year (and I’d save $78 for the year).
Some people may save a bit of money, others would save very little, and some would save nothing because they’re not even eligible for 12-month prescriptions. I’d probably be in the middle category, but I don’t care about that, I just want quality healthcare. Mind you, it’s easy for me to say that when I get my prescriptions without a copay and delivered to my house for free every every month.
Healthcare is difficult enough to manage, especially with the current government chronically underfunding the healthcare system, but I still think that it would’ve been wiser—and safer—to go back to the former 6-month system than to jump to the 12-month system that the current government chose. Maybe it really will help people save some money and also reduce workload for GP practices, as the government claims, but I’m not convinced it’ll do much of that, either. It’ll take time before we can know who’s right about this.
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