PHARMACIST Chelsea Felkai is at risk of losing her home.
But for the co-owner of My Village Pharmacy Whitebridge, it's just one "soul-destroying" concern on a long list after the federal government announced it would allow patients to buy 60 days' worth of medication on a single prescription - effectively doubling their supply and slashing pharmacy profits in half.
Ms Felkai looks after seven large aged-care facilities in Newcastle, providing free, same-day delivery six days a week and palliative care medication 24/7, every day of the year.
She offers free destruction of tightly-restricted Schedule 8 medications, provides medication trolleys and packs medication in single doses to make it safer for nurses and staff to administer to elderly patients.
"There are a lot of things we do because we believe in ensuring patients have things done safely and appropriately and we absorb those costs because we are paid through providing a script," she said.
"We constantly and always have been able to provide our time, advice, knowledge and expertise and that's remunerated through supply, when you're only being paid half as much for the same amount of work it really is soul-destroying.
"We were open through COVID-19, we were there for our communities and it's not fair to feel like the community and politicians don't care - they just want to save a quick buck."
Pharmacies are paid dispensing fees from the federal government every time medication is sold.
When the changes come into play in September, they will essentially provide double the medication to patients with half of the pay.
For Ms Felkai, the projected financial hit means she could have to lose four to five staff members just to make ends meet.
Already, her and her two business partners only pay themselves three days out of the five to seven they work each week to make loan repayments to the bank.
"It's so terrifying," she said.
"I'm a pharmacist who has gone in on this business because I love my community and I'm at risk of losing our house because we might not be able to meet the bank covenants and repayments."
In response to concerns from pharmacists, Minister for Health and Aged Care Mark Butler introduced additional measures on Friday, arguing in an interview that the 60-day prescriptions would save taxpayers money and reduce pressure on GPs and emergency rooms.
He estimated it would return $1.2 billion to the budget with patients having to go to the pharmacist less often - saving on the handling fee.
"I've said over the last couple of days, every since one of those dollars that we save as a government will be plowed back into community pharmacy," he said.
"Look, there will be a hit to the bottom line of pharmacies, but I think people need to put it in context.
"It will be around 1 to 1.5 per cent of the revenue that they declare their industries earn."
He said consumers would save $1.6 billion over the next four years, and said that in late 2023 barriers and incentives for health professionals, including pharmacists, would be reviewed to optimise the use of the health workforce across a stretched primary care sector.
For community pharmacists like Pharmacy 4 Less Blacksmiths co-owner Rowen Turnbull, the reality is that he will have to choose between reducing the level of service he provides with staff cuts or start charging for services and advice he gives out for free.
"For me personally as a young, new owner who has taken on a lot of debt and made an investment in my career, my staff and my community, I will be looking at bankruptcy unless I make some pretty big changes to the way I operate," he said.
"I feel totally devalued by the federal government, especially after standing on the front lines during the pandemic providing health services - we didn't just shut our doors or work remotely.
"I can say with all honesty that I will be demoralised by this policy change and it will be an act of resilience to keep showing up every day to my pharmacy and serve my customers with a smile."
Community pharmacists in the Hunter have raised concerns with not only the financial impacts, but the lack of access and service they can provide to customers.
They're worried supply chains won't be able to keep up with 60-day prescriptions leaving some medications out of stock.
Luke Kelly is the Newcastle and Hunter Valley Pharmacist Association president, he said hospital pharmacists are also concerned about an increase in admissions due to overdoses if patients are handed more medication.
It comes at the same time as the Therapeutic Goods Administration issued an interim recommendation to limit the supply of Panadol from June 1, 2024 in an attempt to reduce intentional overdoses.
"So they're reducing the supply of Panadol to a four-day supply and yet providing a 60-day supply of potent medications," Mr Kelly said.
"We don't believe the risks have been considered.
"There are a whole host of medications where we need to track people, engage with them every month and every pharmacist I know does - there is a great risk that people will put off requests for information on a whole host of these medications."
He said the profession understands they need to keep the Pharmaceutical Benefits Scheme (PBS), which subsidises prescription medications, viable.
Instead of hitting pharmacists in the hip pocket, he said the federal government should consider reducing the co-payment on medications for patients to reduce cost-of-living pressures.
"Don't make the pharmacist give up staff members so you can get cheaper medication," he said.
"The answer is a collaborative approach, not cutting each other up. It's a rush-job and the effects are dramatic."
Mr Kelly estimated pharmacies would lose about $170,000 each year under the changes.
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