WA News Have You Heard? August 2017
August 2017
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TGA and Pharma complaints

This issue of the magazine explores how pharmaceutical and device companies market their products to the profession (see P14 and our Transparency Doctors Drum write-up, P18). In a timely announcement, the TGA said it was “simplifying and improving” the handling of complaints regarding the advertising of medicines and medical devices to the public. The TGA will now be the only body handling advertising complaints effective from July 1, 2018 where previously the Australian National Regulatory Authority played a role. The reform is made as a part of the recommendations of the Expert Panel Review of Medicines and Medical Devices Regulation and attempts to make it easier for consumers and businesses to have their complaints dealt with more efficiently.

Pharmacy path tests sink

When it comes to hot stories, news that Amcal pharmacies would be ordering pathology tests sent temperatures soaring but a cool change quickly set in. Late in June, Amcal (with over 100 pharmacies) trumpeted that it was leading the way in preventive health by entering an agreement with Sonic to offer customers pathology-based health screening for diabetes, heart health, kidney and general health screening, as well as Vitamin D and fatigue testing. Prices would range from $25 for HbA1c testing to $219.50 for a Rolls-Royce over the pits job. Abnormal or out-of-range results would be sent back to their GP. There was no mention of Medicare rebates. The Royal College of Pathologists initially liked the idea but by July 4, no doubt suffering a hail of abuse from 80,000-odd GPs not to mention the RACGP and AMA, issued a statement: “The RCPA does not endorse or have any partnership or alliance with any programs in relation to the non-medical requesting of pathology tests…However, tests may be requested by a wide range of people who are not registered medical practitioners. These may include those who are part of current health care services such as pharmacists, dieticians, physiotherapists, podiatrists and dentists. In these circumstances the RCPA Policy requires the laboratory and the requestor understand the importance of oversight by a medical practitioner.” This is indeed the problem and put eloquently by a GP, who contacted us after consulting his medical defence insurer. GPs, the advice said, could ultimately be responsible for reviewing the results leaving GPs holding the baby while “the other parties profit”. Not long after, Sonic Healthcare and its subsidiary SmartHealth withdrew from the arrangement with Amcal. It said in its statement that the program was developed in line with the Health Department’s initiative to promote in-pharmacy health screening services. The Health Department might have to think again before the pharmacy lobby have another crack at the Medicare toffee apple.

Open wide for insurers

We were contacted by a GP who has become increasingly concerned about private health insurers (PHIs) buying up dental practices in the south-eastern suburbs of Perth. The Australian Dental Association shares her concerns on a national scale. It is urging the Senate inquiry into private health insurance to examine what it describes as anti-competitive practices. The ADA issued a statement urging investigation into “discriminatory rebate practices and the shift towards a conflicted corporatised insurer-owned dental practice model” which its President, Dr Hugo Sachs, says presents a glaring conflict of interest that will ultimately affect the continuity and quality of care. The ADA wants legislation to “outlaw such practices”.   

Sad sign of the times

Mental Health Commissioners, including WA’s Tim Marney, have released a consensus statement to identify what services will be needed to support the survivors of child sexual abuse now the Royal Commission into Institutional Responses to Child Sexual Abuse has released its report. It makes the powerful point that abuse is not a mental health disorder but a violation of human rights, which often impacts profoundly on a person’s mental health and it is this trauma that should shape service design and delivery. If the system got that right, it would help the broader population who have experienced childhood trauma. Its warning to services was to “prepare for increased demand”.

It’s all a game

Trawling, as opposed to trolling, the internet recently, we stumbled across what was at first glance a happy-go-lucky story on a diabetes app that had added ‘gamification’ to its functions. A simple monster game that hopes to, as its developer told a reporter, “make diabetes suck less”. It is part of a new wave of health ‘tool’ apps appealing to children and adolescents and it makes a lot of sense: fun + info = what’s your HbA1c score? It also represents the next big marketing strategy for Big Pharma. This small German developer has just been acquired by Roche, which will probably mean better games for the kids but, more pertinently for Roche, a new generation of customers. The developer told the news site that his tech company was its own legal entity and would continue to work with other companies. Welcome to the future.

Flushed away

The mainstream media was quick to report the happy news that less methamphetamine was found in the Bunbury waste water in 2015-16 than the previous year. Now we can report some less racy facts, this time from AIHW’s Alcohol and other drug treatment services in Australia: state and territory summaries 2015–16 that suggests amphetamines continue to be a bigger problem in WA than alcohol with 31% of clients, and 35% of episodes, seeking help for their ice drug problem. This compares with alcohol, 30%, cannabis, 23% and heroin, 6%. Closed treatment episodes for amphetamine use in WA was higher than the national average – 35% compared with 23%. Counselling was the most common type of treatment (74% of clients) with withdrawal management and pharmacotherapy both 8%. No surprise that 61% of all treatment agencies in WA was located in major cities with 94% of these agencies non-government.

The Knowledge

Whatever we might think of the name Health and Knowledge Precinct we got to hand it to Landcorp, they’re working hard to make it happen. Last month it announced that Fini Group had won the tender to develop the $200m first stage of the Murdoch precinct. It would be building 175 apartments and a community hub of shops and restaurants. Fini has also signed up with Aegis Aged Care Group to build a 150-bed aged care facility and the Labor Government’s first 60-bed medihotel to accommodate patients from FSH and SJG Murdoch.

By the Numbers: Public Health

$2066 million

The total government spending (Commonwealth and State) on public health across Australia, 2013-14

This is equivalent to $89 per person or 1.34% of all health care expenditure.

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  • In 2003-04, total public health expenditure was $1200 million (constant price based on 2013-14 was $1616). This was equivalent to $82 per person and 1.63% of all health care expenditure
  • In 2013-14, the total public health expenditure in WA was 0.13% of GDP; in 2003-04 it was 0.14% of GDP
  • Per capita expenditure on public health in WA in 2013-14 was $102 compared with a high of $119 in ACT and a low of $72 in Queensland
  • Internationally Australia was ranked 16th for public health expenditure among OECD countries. Canada spent most with $US 256.50 per capita (Australia spent $US 68.42) and Latvia spent the least, $US 8.05 per capital

Source: Preventive Health: How Much Does Australia Spend, and is it Enough?:  Hannah Jackson and Alan Shiell, Department of Public Health, La Trobe University, and the Australian Prevention Partnership Centre