Fees for prescriptions

Editor, – I am writing to you in response to Dr David Sharpe's question to the PBAC regarding the quantity of sumatriptan tablets supplied by pharmacists under the Pharmaceutical Benefits Scheme (PBS) (Aust Prescr 1997;20:87). As a pharmacist, I would like to bring the following points to Dr Sharpe's, as well as your other readers', attention.

It is ironic that Dr Sharpe's question should be published in an issue of Australian Prescriber accompanied by a report of 3 deaths due to myocardial infarction in patients taking sumatriptan (in one case the prescription was for 12 tablets at a time).1 These unfortunate incidents point to the critical level of care necessary in prescribing and dispensing such drugs and, at the very least, should discourage doctors from prescribing larger quantities of drugs such as sumatriptan.

At the same time however, Dr Sharpe seems to be unaware of the structure and the regulations governing supply of medicines under the PBS by pharmacists. The $5.20 per sumatriptan prescription represents the dispensing charge per PBS item of $4.34 plus a 10% mark up on cost price. This is a professional fee approved and set by the government. On the other hand, most pharmacists these days have a good idea of most of their patients' medication history and do not merely function as suppliers of medicines. The fee charged for prescriptions in many instances includes various value-added services such as provision of Consumer Medicines Information, information on drug interactions and, in the case of drugs such as sumatriptan, possible discussion with patients and their doctors regarding the latest adverse reaction reports.

I believe pharmacists are entitled to their $4.34 professional fee!

Rick Samimi
Neutral Bay, N.S.W.