GPs told to cut down on prescribing

A letter pleading with GPs in Otago and Southland to curb their prescribing habits has upset both pharmacists and prescribers in the region.

The letter, written by Paul Menzies, Southland DHB chair and Errol Millar, Otago DHB chair, says the Otago and Southland DHBs are under tremendous financial pressure.

“One of the areas of health that has shown levels of spending consistently above our funding share levels is community pharmaceuticals,” the letter says, and goes on to say the DHBs “simply cannot afford our current and projected pharmaceutical costs”.

According to a table included in the letter, the Southland and Otago DHBs are spending $7.24 more per patient than the national average.

Because of this, the letter pleads with prescribers to exercise restraint where possible.

Gore pharmacist Bernie McKone has seen the letter and says the figures are incorrect.

Mr McKone says papers were released about three months ago by both the Otago and Southland DHBs showing separate figures for each region.

“Under separate data for Southland the spend was lower than the national average, and in the Otago region it was considerably higher. They’ve now just simply merged all the data to get a new average.”

Mr McKone says higher spending in the Otago region is appropriate because of the number of specialists based in the Dunedin area, and because Dunedin hospital is located in the region.

“To say now that we’re all above the national average is actually very misleading, and very disappointing be-cau-se it misses the point that what we should be doing with medicines is targeting the medicines to the patient need and optimising it.”

Otago and Southland DHB chief executive Brian Rousseau says he is satisfied the analysis of figures included in the letter is correct, and not a simple average of the two regions individual spends.

Although, Mr Rousseau does admit Southland DHB region’s spend is slightly below its population-based funding share, and Otago DHB’s spend is significantly higher.

GP “put out”
GP Hans Raetz from the Queenstown Medical Centre prides himself on being a relatively low prescriber.

Dr Raetz also accuses the letter of being misleading and says prescribing above the national average never really crossed his mind.

He says reports from BPAC show his prescribing habits are about 20% below the national average.

“I was surprised and quite frankly a bit put out by the whole thing.”

Dr Raetz says the figures are misleading because the pharmaceutical budget includes more than GPs’ prescribing. It includes all the cancer drugs, and other high cost items prescribed by consultants.

He says he will not pay much attention to the letter.

“I don’t give a toss about health board communication these days. There’s not a heck of a lot that I can change to bring these numbers down.”

Agreement breached
Pharmacy Guild chief executive Annabel Young says pharmacists in the Otago Southland DHB region agreed to accept no increase in the $5.30 dispensing fee on the condition the board would not intervene to lower forecast growth rates in dispensing volumes.

Ms Young accused this letter of “flying in the face” of that agreement.

Mr Rousseau says it is not the intention to reduce national pharmaceutical usage, but rather to bring to the attention of local prescribers that, collectively, the Otago Southland region is a higher than average user of pharmaceuticals.

“We want to ensure our pharmaceutical usage does not exceed our forecast usage and to ask GPs to assist us in managing a scarce resource in the best possible way in the interests of our community.” RN

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