Researchers used records from 526 GP practices across regional and metropolitan Victoria, representing almost half of that state’s residents, to analyse opioid prescribing rates between 2017 and 2022.

Two newly published peer-reviewed papers based on that data provide a comprehensive view of where the most opioids are being prescribed and give insight into the impact of recent PBS measures designed to reduce rising opioid-related harms, including overdose.

One study, published in the International Journal of Clinical Pharmacy, found a general decrease in opioid prescribing by general practitioners, but identified a 69% increase in new opioid prescription rates for Victorians aged between 15 and 24.

The research also found that while prescription rates decreased for most opioids, the number of prescriptions for tapentadol surged by 263%.

Another recent paper, published in Pain Medicine, found a decline in the number of people being prescribed opioids for extended periods of time.

The paper found most people were prescribed opioids in the short term, with the proportion still being prescribed opioids three months after their initial prescription falling from 5.4% in 2018 to 3.6% in 2022.

Researchers also compared how gender, socio-economic status and geographical region impacted opioid prescribing rates, finding disparities between male and female patients, disadvantaged patients, as well as those in regional and remote areas.

The study found that while women are getting more opioid prescriptions overall (53%), men are more likely to start new prescriptions. It also revealed that the most disadvantaged groups saw a decrease (12%) in opioid prescriptions, while the least disadvantaged saw an increase (6%).

Regional and remote areas had the highest rates of opioid prescribing and new prescription rates, although these rates decreased significantly over the study period.

Deputy Director of Monash Addiction Research Centre, Professor Suzanne Nielsen, says there is a need for targeted interventions to ensure opioids are available when clinically needed, and equitably across all groups and geographical regions, while minimising the risk of harm.

“We know some regions have access to pain management services, which can drive increased opioid use,” she says. “Although overall reductions are positive, we want to see equitable access for pain management, and access to opioids where they are clinically appropriate.”

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Reflecting on the APP2025 theme “Unlock Your Opportunities”, APP Chairman Kos Sclavos AM shares his top program highlights for the upcoming event – a challenging task given the calibre of sessions and speakers at APP2025.

Mr Sclavos’ top 20 sessions for this year (in conference date and time order) are:

Full Scope of Practice Workshop
Wednesday afternoon

Opening Plenary and Pharmacy of The Year winners
Thursday morning

The world community pharmacy scene: why are some global giants failing – what is the key to success?
Thursday morning

How community pharmacy can strengthen their primary care role through precision health
Thursday morning

Alan Russell Oration | Pharmacist full scope of practice
Thursday afternoon

Digital Health: The next 5 years for pharmacy
Thursday afternoon

Unlocking Opportunities: Is ‘Full Scope of Practice’ a viable service offering for community pharmacy?
Thursday afternoon

Guild member (Proprietor) only breakfast: Industry update
Friday morning

The Panel: State of the Industry
Friday morning

The Patient Doctor
Friday morning

Ann Dalton Address | Fearless: finding the power to thrive
Friday morning

Harm minimisation stream
Friday afternoon

Pharmacy lessons from the USA
Saturday morning

Inspiring lifesaving communities: Greg Page’s story
Saturday morning

Finding power when you feel flat, tired and uninspired
Saturday morning

Pharmacy market insights and a financial update in the light of 60DD and 8CPA: A deep dive into the economics and business perspectives of pharmacy professional services
Saturday afternoon

People, prosperity, and the planet: The power of superannuation
Saturday afternoon

Practical guide to diabetes-specific nutritional formulas: Implementation strategies for Pharmacy Practice
Saturday afternoon

Top 10 tips from PDL
Saturday afternoon

Finding success with QCPP
Saturday afternoon

Details and information about these sessions can be found in the full APP2025 program.

Register today at appconference.com.au.

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To combat rising cost of living pressures, Diabetes Australia has announced it will provide free support to all Australians living with diabetes across the country, in a major push to see people with diabetes better supported.

Cost of living concerns

Data released by Diabetes Australia on World Diabetes Day (14 November) reveals more than 90 per cent of people living with diabetes are anxious about the rising cost of living, and 75 per cent are worried that managing their diabetes will become unaffordable in the future.

Worryingly, half of survey respondents said cost of living pressures were negatively impacting their ability to manage their diabetes – which includes attending GP appointments, undertaking pathology tests and purchasing syringes to administer insulin.

The research reveals:

• 66% reported spending more on diabetes management now than five years ago
• 61% described the cost of accessing diabetes medicines and technology as their greatest challenge
• 33% have been forced to cut costs related to their diabetes management
• 44% are turning to cheaper, less healthy food options.

Carers are also spending more, with 82% reporting an increase in their financial contributions to managing diabetes over the past five years.

Risk of complications

Diabetes Australia Group CEO Justine Cain said if people living with diabetes can’t afford regular access to health care and medication to manage their condition, the risk of diabetes-related complications increases dramatically. This also places significant burden on our health care system, as more people are hospitalised with life-threatening complications.

“Diabetes is a condition that needs to be actively managed. People are being forced to make impossible choices between health care and everyday living, and ultimately that can have devastating consequences,” Ms Cain said.

“Diabetes costs the health care system around $3.4 billion every year and that cost is only going to increase if people can’t afford proper management which can lead to complications like kidney disease, heart attack and stroke.”

Free support

With the rising cost of living impacting the ability of people to access or afford primary care and GP services, causing them to disengage from health care, Diabetes Australia is introducing a free support program.

Diabetes YOUnited is a free national membership program offering access to up-to-date information and education tools, personalised support, regular news and updates with expert insights and resources, as well as better connection to, and support from, Australia’s largest diabetes community.

“Overwhelmingly, Australians living with diabetes have also told us that they want better access to trusted information and support. They’re looking for better connection to community and support services that will help them live well,” said Ms Cain.

“Cost shouldn’t be a barrier to that support.”

There’s also an option for people who choose to, and can afford it, to upgrade to receive additional services through Diabetes YOUnited Plus. People who are already members of Diabetes Australia will automatically receive the upgrade to the paid option, which includes a range of new services and supports in addition to existing benefits.

“It doesn’t matter where you live, from Bendigo or Broome; Bundaberg to Burnie and anywhere in between – Diabetes YOUnited is available for all Australians,” said Ms Cain.

To learn more about YOUnited and how you can support people living with diabetes, visit the Diabetes Australia Membership site.

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Through Bupa’s digital health platform, Blua, eligible Bupa health insurance members will pay zero out of pocket costs for three telehealth bookings per person, per year, as part of their policy. They will have 24/7 access to doctors for consultations that may include general medical advice, repeat prescriptions or referrals.

Results from a ten month-long trial of Blua online doctors revealed most calls occurred outside business hours with 72% resolved on the initial call, 15% were recommended to visit a GP in person and only 1% advised to go to a hospital emergency department.

Bupa Clinical Director Dr Simon Benson said demand for telehealth services remained popular with patients due to its accessibility and convenience.

“This is about making medical care accessible and affordable 24/7 while taking some of the pressure off hospital emergency departments in the afterhours period,” he said.

“Blua telehealth can also play an important role in assisting where patient demand is high and where there are long wait times to see a local GP.”

Dr Benson said 91% of telehealth consultations were delivered via video consultations, as many patients still wanted face to face connection with their doctor, while the remainder were telephone consults.

Data from the online doctor trial revealed consultations for cough, fever, cold and headache were most common, followed by prescriptions or medical certificates.

As part of Blua, many of Bupa’s 4.4 million customers also have access to an online door-to-door chemist delivery service. Since launching earlier this year, most of the orders have been for e-scripts which have free delivery.

Dr Benson said Blua online doctors and chemist delivery were about simple, person-centred care.

“The pandemic has changed how people want to access their healthcare and we are making sure it fits in with their changing health and wellbeing needs,” he said.

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Awarded a $5 million National Health and Medical Research Council (NHMRC) grant, the major project will focus on synergising existing efforts to prevent chronic disease in Australia – and in doing so seek to overcome the average 15 to 17-year lag it takes for health systems to adopt proven chronic disease interventions.

Lead investigator, University of Newcastle and Hunter New England Local Health District behavioural scientist Professor Luke Wolfenden, of HMRI’s Population Health Research program, said few health crises had been as predictable as the crippling burden of chronic disease on health systems and communities.

“Chronic disease is the major contributor to health system costs. It’s what filling up our hospitals and to address this issue we need to effectively implement programs that prevent the onset of chronic disease,” he said.

Based on a two-decade strong working model in the Hunter New England region of NSW, the program will inform the integration of research into prevention services across Australia. It will focus on preventing chronic disease by addressing two major chronic disease risk factors – nutrition and physical activity – within non-clinical settings including schools, childcare centres, sporting clubs and workplaces.

“Past research investments have done an incredible job of finding solutions capable of reducing much of the chronic disease burden. However, the health system is often unable to adopt those solutions in a timely way,” Professor Wolfenden noting only about 14 per cent of effective health programs or policies ever reached implementation.

The national project aims to identify the barriers that exist to implementing the vast array of evidence-based health prevention programs, policies or procedures.

“We’re not very good at prioritising which health interventions should be implemented or replacing interventions that no longer work, where more effective ones exist,” Professor Wolfenden said. “In addition, prevention agencies often don’t work synergistically.”

For example, many schools implement a ‘no hat, no play’ policy to prevent children from sun exposure, which is a great cancer prevention initiative. But students without a hat for the day may be prevented from playing and accruing physical activity – another risk factor for cancer.

“So, often agencies are unconnected and the system is working in a very uncoordinated way,” Professor Wolfenden said.

“One of the things we’re looking to achieve is to support greater coordination of prevention activity across Australia to make sure that we’re working together to help people live better healthier lives.”

Professor Wolfenden said the national project had the potential to greatly enhance the impact of health promotion services.

“The dream would be that this project transforms the prevention system in Australia so that it’s more effective, more efficient and more equitable. And ultimately that leads to substantive reductions in chronic disease amongst the community and alleviates the burden of chronic disease for the health system and society.”

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The ACCC published a statement of issues in June 2024 which identified a range of preliminary competition concerns with the proposed acquisition, including at the retail level and the impact of the proposed integration that would result across the wholesale and retail level.

These concerns included the potential harm to pharmacies currently supplied by Sigma and the potential for Chemist Warehouse to access these pharmacies’ data in ways that damage competition.

In response to these preliminary concerns, Sigma has offered a court-enforceable undertaking that would require Sigma to:

not prevent or hinder franchisees who entered into their franchising arrangements prior to 1 January 2024 from terminating their franchise agreements with Sigma, for a period of three years. Sigma will waive its right to recover contributions Sigma has made under its franchise agreements and future fees payable to Sigma if these franchisees choose to terminate their agreements.

place restrictions on the collection, use and disclosure of confidential data and information from Sigma wholesale customers and franchisees for a period of three years.

remain a participating pharmaceutical wholesaler under the Commonwealth Government’s Community Service Obligation (CSO) arrangements for at least five years. The CSO arrangements contain service standards and compliance requirements for wholesaling of prescription medicines to all pharmacies.

“We are now seeking feedback from stakeholders on whether the draft undertaking offered by Sigma may be capable of addressing the competition concerns arising from its proposed acquisition of Chemist Warehouse,” ACCC Chair Gina Cass-Gottlieb said.

The ACCC is continuing to investigate the impact of the proposed acquisition.

“While the ACCC is publicly consulting on this undertaking, this should not be interpreted to mean that this or any other form of undertaking will ultimately be accepted by the ACCC,” Ms Cass-Gottlieb said.
The ACCC invites submissions on the proposed undertaking by 14 October 2024. Parties can contact the ACCC via SigmaCWG@accc.gov.au.

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The petition calls for a 10-year National Rural Health Strategy which ensures federal and state governments and territories make an agreement to ensure rural Australia receives better healthcare access. Currently, rural people receive less access to health care and spend less on their health care per person than those who live in the cities.

“Nearly 7 million Australians living and working outside of cities are being denied the basic human right to health care and wellbeing and are dying 12 to 16 years younger than their urban counterparts,” said Alliance Chief Executive Susi Tegen.

“This petition underscores that rural health has been neglected in policy, budgets and priority settings for too long and that Commonwealth and State investments and policies are neither coordinated nor sustained.

“Rural Australians make up 30% of the Australian population, bring in two-thirds of Australia’s export earnings, 50% of tourism income and produce over 90% of Australia’s food. Yet, governments spend $848 less per person, per year, on the health of a person living rurally than someone who lives in the city,” Ms Tegen added.

The Alliance’s three-point plan for building a healthier future for rural Australia includes:

• A National Rural Health Strategy under the National Health Reform Agreement to coordinate Commonwealth, State and Territory investment, policy and service delivery for rural Australia.
• A $1billion National Rural Health Fund for blended health delivery payments and infrastructure for rural communities where they have difficulty attracting and retaining the health workforce they need and where costs are higher for rural businesses.
• Long-term funding of the National Rural Health Alliance to work as the enabler and conduit between communities, grassroots clinicians, entities and Governments and specific funding for a Rural Health Innovation and Evidence Hub, hosted by the Alliance to learn and share the lessons from rural innovation across Australia.

To sign the petition, click here. Signatures can be collected until 10 October 2024.

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Private Healthcare Australia’s (PHA) analysis of billing records for 193,666 hospital admissions in 2022-23 reveals at least 36% of ‘private patients’ treated in NSW public hospitals received a bill for out-of-pocket charges.

The figures reveal hundreds of patients paid more than $1000 and some charges exceeded $10,000.

Most out-of-pocket bills were for medical services provided by doctors. When someone opts to use their health insurance in a public hospital, NSW promises not to charge for ‘staff specialists’, however doctors can legally charge as a private specialist, so many do.

Patients can be charged for diagnostic services by doctors they have never seen, never met and did not choose. A small number of patients were charged an out-of-pocket cost for their hospital accommodation, a violation of NSW Health policy.

PHA CEO Dr Rachel David said patients often receive the same services they would as a public patient without health insurance but find themselves thousands of dollars out-of-pocket because they ticked a box to use their health insurance. Sometimes these patients are signing documents when they’re very ill, raising ethical concerns about their ability to consent.

“It’s concerning that more than a third of NSW private patients in public hospitals are paying out-of-pocket costs. The process used by NSW Health to provide informed financial consent is fundamentally flawed, at the very least confusing and potentially misleading,” she said.

Australian Institute of Health and Welfare data shows NSW is filling its public hospitals with more private patients than any other state, despite having the longest elective surgery waiting times for public patients in Australia.

Dr David said this equates to one in five public hospital beds in NSW being occupied by people with health insurance, or nearly 4000 public hospital beds – the combined capacity of the state’s four largest hospitals: Royal Prince Alfred, Westmead, Liverpool and John Hunter hospitals.

She said the NSW Government’s plan to charge more than the Commonwealth rate for ‘private patients’ in public hospitals would likely increase this figure even more, amounting to privatisation of the NSW public hospital system by stealth.

“Our health system was built on the principles of universal, free access to healthcare for all, and this includes treatment in public hospitals. We all pay taxes for this,” she said.

“Everyone should be treated equally in a public hospital. Charging private patients out-of-pocket fees for the same services provided to public patients is unfair and should not be happening.”

PHA is calling on NSW Health to immediately update its admission information provided to patients to ensure it is clear and accurate. It says proper informed financial consent should give patients one of three options to consider when making their choice to become a private patient:

• They will not be charged any out-of-pocket costs.
• The hospital cannot guarantee they will not be charged out of pocket costs.
• They will be charged out of pocket costs, and the full amount of those costs.

If NSW Health fails to provide proper and accurate informed financial consent for patients, says PHA, health funds may require NSW hospitals to adopt their own, simpler, conditions for recognising private patient elections before providing rebates.

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The report finds the traditional medicine industry contributes between $304.4 million and $328.7 million annually to Australia’s economy, driven largely by acupuncture and herbal treatments.

AACMA President Waveny Holland says the growing demand for traditional therapies reflects a shift towards more holistic approaches to healthcare.

“This report highlights how valuable our industry is, not only in improving health outcomes but also in contributing to Australia’s broader economy,” she said.

There are 4,823 registered practitioners licensed through the Chinese Medicine Board of Australia These practitioners provide a wide range of treatments across the country, ensuring widespread access to natural therapies.

The report finds acupuncture and herbal medicine contribute $740 million in combined social benefits, enhancing individual health and reducing strain on the healthcare system by providing effective complementary care options.

In FY23, Australians spent approximately $703 million on natural therapies, including acupuncture, through both government and private health insurance plans. This reflects the growing recognition of traditional therapies as an integral part of mainstream healthcare.

An estimated 8.2 million acupuncture and natural therapy services were accessed through private health insurance last year, demonstrating these treatments’ widespread use and popularity nationwide.

Ms Holland says the future of traditional medicine in Australia is bright.

“As we continue to develop research, enhance practitioner skills, and better integrate with conventional healthcare, we see vast potential for growth in the years ahead,” she said.

The AACMA is Australia’s leading professional organisation dedicated to Chinese medicine practitioners, including acupuncturists, Chinese herbalists, Chinese herbal dispensers, and traditional remedial massage practitioners.

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An evolution of PSA’s vision for the future of the pharmacy profession, and the steps that need to be taken to get there, Pharmacists in 2030 maintains focus on medicine safety, expanding scope of practice and integration of pharmacists into collaborative care teams. It also has an increased focus on equity, medicines stewardship and pharmacist wellbeing.

PSA National President Associate Professor Fei Sim FPS said the launch built on the growing momentum behind the profession.

“Our profession has evolved significantly, and continues to evolve, to meet the increasingly complex health needs of Australians, our aging population and overstretched health system,” she said. “Our communities need us to continue down this path, they need all pharmacists doing more to support safe use of medicines and greater access to care when and where they need it.”

Future of pharmacists

The vision is a culmination of deep consultation with pharmacists, consumers and other health stakeholders. Informed by consumers across 14 in-depth focus groups, Pharmacists in 2030 describes how the care pharmacists provide will change over the next 6 years through the lens of both pharmacists and patients.

There are six key actions to realise this vision:

• Medicine safety – empowering and supporting pharmacists to reduce risks and minimise harm by advancing medicine safety in practice.
• Medicines stewardship – supporting pharmacists to actively lead and influence effective and judicious medicine use.
• Access to care – providing all consumers greater access to care by increasing and leveraging the accessibility of pharmacists to address unmet health needs.
• Equity – supporting pharmacists to meet the unique needs of vulnerable individuals and priority populations to address the disparity of health status through the provision of appropriate and responsive care.
• Workforce development – equipping and growing the pharmacist workforce to address existing and emerging health challenges.
• Sustainability – driving practice changes that increase the sustainability of the pharmacist workforce, increase social contribution and limit environmental impact.

These actions empower pharmacists to embrace their full potential to not only meet Australia’s surging health needs over the next six years, but also to build capacity to address health challenges beyond 2030, says Associate Professor Sim.

“Pharmacists in 2030 challenges the entire health ecosystem to collaboratively drive pharmacy practice to the next level, including policymakers, patients and consumers,” she said.

“We know that regulatory change alone is not enough. We need to address the cultural and system factors which hold our profession back and importantly, we cannot continue expecting pharmacists to do more with less.”

Realising the vision

Associate Professor Sim says the goal is getting to a point where practice is more efficient, relieving unnecessary administrative burden so that pharmacists can focus on delivering the care that patients need.

“Each one of us, in all areas of practice and specialisations have a role to play in realising this vision by 2030,” she said.

“The daily practice of pharmacists in direct patient-care roles will see the most evolution in their daily roles, enabled by pharmacists practising in non-patient facing roles, including academia, management and leadership.”

Pharmacists in 2030 is available to view at psa.org.au/pharmacists_in_2030.

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