Analysis of secondary data

8.2.1 Clinical Interventions

All pharmacies enrolled in the MedsCheck and Diabetes MedsCheck pilot program were also enrolled to claim for Clinical Interventions performed. Chart 8.1 shows the volume of Clinical interventions documented versus the volume of MedsCheck and Diabetes MedsCheck services claimed per pharmacy.

 Between July and December 2011, 17,383 Clinical Interventions were documented by pharmacies recruited to provide MedsCheck and Diabetes MedsCheck services.

During the same period, 288 MedsCheck and Diabetes MedsCheck services were claimed.

 By December, only 49 of the 286 pharmacies had claimed for MedsCheck and Diabetes MedsChecks services yet 258 of the 286 pharmacies had claimed for Clinical Interventions.

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Chart 8.1: Volume of Clinical Interventions versus MedsCheck and Diabetes MedsCheck services, July to December 2011.

Source: Special data request from Department of Health and Ageing, received 16 February 2012.

8.2.2 HMR services

The Department was able to provide HMR data for the period 2007 to August 2011 for all pharmacies across Australia and for October 2011 to March 2012 for the MedsCheck pharmacies.

Number of HMR services provided — historical and projected

The number of HMR services provided across Australia during the last four years has increased from 15,436 in 2007-2008 or 0.3% of the population of people taking prescription medicines to 63,088 in 2010-2011 or 1.2% of people taking prescription medicines (Table 8.1).

Table 8.1: Number of HMR services provided in Australia Number of HMR

services*

Total number of people taking

prescription medicines#

Percentage of people taking medicines who received a

HMR

2007-2008 15,436 4,903,075 0.31%

2008-2009 48,344 5,043,498 0.96%

2009-2010 60,577 5,234,005 1.16%

2010-2011 63,088 5,407,800^## 1.17%

*Source: special data request from the Department of Health and Ageing, received 16 February 2012.

0 200 400 600 800 1000 1200

0 10 20 30 40 50 60

Number of Clinical interventions

Number of MedsCheck and Diabetes MedsCheck services

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#Source: special data request from the Department of Health and Ageing, received 19 December 2011 and Deloitte Access Economics internal analysis, see section 9.1.3. Relates only to medicine listed on the Pharmaceutical Benefits Scheme (PBS).

## Projected value, Deloitte Access Economics internal analysis, 2012

If the proportion of people who are taking prescription medicines and who receive a HMR remains constant at 1.17%, it is estimated that the number of HMR services provided by 2015 will reach around 72,100 (Table 8.2).

Table 8.2: Projected number of HMR services Total number of people taking prescription

medicines*#

Estimated number of people who will receive a HMR(a)

2012 5,587,400 65,400

2013 5,772,900 67,500

2014 5,964,600 69,800

2015 6,162,700 72,100

*Source: special data request received from the Department of Health and Ageing, received 19 December 2011 and Deloitte Access Economics internal analysis, see Section 9.1.3. Relates only to medicine listed on the PBS.

#Projected values, rounded to the nearest 100, Deloitte Access Economics internal analysis, 2012 (a)Rounded to the nearest 100

The impact of MedsCheck and Diabetes MedsCheck on the volume of HMR services provided

The average number of HMRs provided per pharmacy by pharmacies enrolled in the pilot per month was compared with the average number of HMRs provided by pharmacies Australia wide per month (the denominator each month was the number of pharmacies that provided HMR services that month for those enrolled in the pilot program and those across Australia respectively). Notably, August 2011 was the only month during which MedsCheck consultations were performed and for which HMR data for all pharmacies across Australia was available. Data for HMR claims for pharmacies across Australia was not available after August 2011. Using data from August alone as the basis for comparisons is problematic given so few pharmacies had commenced performing MedsChecks in August 2011, and only 10 of these claimed for HMR services.

Historically, the average number of HMRs claimed per month by pharmacies that subsequently provided MedsCheck and/or Diabetes MedsCheck services fluctuated far more than the average number of HMRs provided by all pharmacies (Chart 8.2) — reflecting the small number of MedsCheck pharmacies in the sample on which to estimate the average.

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Chart 8.2: Average number of HMRs conducted by all pharmacies and those which have performed MedsCheck and Diabetes MedsCheck services, 2007-08 to 2011-12, reported

monthly

Source: special data request from the Department of Health and Ageing, received April and June 2012...

On October 1^st 2011, the HMR program rules changed to allow HMR accredited pharmacists to claim directly from Medicare for HMR services provided, in addition to community pharmacies. Prior to this, only community pharmacies could claim Medicare payments for HMR services, and as a result, community pharmacies may have subcontracted a HMR accredited pharmacist to provide HMRs.

This program rule change confounds analysis of the impact of the MedsCheck pilot program on HMR service provision. In addition, the period available for analysis is too short to determine trends. HMR and MedsCheck/Diabetes MedsCheck services provided by pharmacies enrolled in the pilot are presented in Table 8.3. Following the HMR program rule change there were two months where no HMR services were performed by MedsCheck participating pharmacies (October and December 2011) and one month where data was not available (September 2011). In total, from October 1^st 2011 to March 2012, 1,306 claims were made for HMR services by pharmacies participating in the MedsCheck pilot program.

From the Pharmacist Survey, it does appear that less than one-fifth of pharmacists who work at pharmacies that are HMR service providers recommended that patients have a HMR and the Patient Survey revealed that just over one-fifth of patients who responded were recommended to have a HMR. These data do not confirm whether patients recommended an HMR actually received one.

0 1 2 3 4 5 6 7 8 9 10

2007-08 2008-09 2009-10 2010-11 2011-12

Average number of consultations

Financial year

All HMRs performed MedsCheck pharmacies only

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Table 8.3: MedsCheck and HMR services provided by pharmacies participating in the pilot

25thAug/Sept

Source: special data request from the Department of Health and Ageing, received April 2011 and analysis of SmartForm program data, Deloitte Access Economics, 2012

*only pharmacies that provided the specified services (MedsCheck and Diabetes MedsCheck or HMR) each month are used as the denominator.

8.2.3 Conclusions from secondary data analysis

The available data reveals that pharmacies are participating in the documentation of Clinical Interventions far more than the delivery of MedsCheck and Diabetes MedsCheck services.

Following the HMR program rule change, MedsCheck pharmacies did not perform HMR services during two out of the six months available for analysis however it is unclear whether this is attributable to the program change or the pilot or the accuracy of data collection. The time period for analysis is too short to test for a discernible change in the pattern of HMR service provision by pharmacies enrolled in the MedsCheck/Diabetes MedsCheck pilot.

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