Pharmacy Daily | Third COVAX dose payment confusion

PHARMACY software providers and industry leaders were caught off-guard by the Federal Government's announcement to roll out third doses of COVID-19 vaccinations for severely immunocompromised patients (PD 11 Oct).

Speaking during a webinar last week, Pharmacy Guild of Australia National President, Trent Twomey, told pharmacy owners that the announcement was an example of "where government policy got ahead of system design".

While pharmacists will be able to administer a third dose to eligible patients, Twomey noted that they will not be able to record it through GuildCare or MedAdvisor software until mid-Nov, and they will have to make claims manually through the Pharmacy Programs Administrator (PPA).

Twomey said that under the current payment structure "if patient A has never been to your pharmacy [for a COVAX shot] before, and if you satisfy all the clinical criteria and provide them with the third dose... you're going to be paid $16".

"If they've been to your pharmacy once before [for a COVAX jab], you're going to get $26, because even though this is the third dose and you can satisfy that by checking the Australian Immunisation Register (AIR), it is only the second dose that you've give from the pharmacy," he said.

"[However], if you've already given the first and second doses from your pharmacy you can't claim at all until after 14 Dec, until the PPA and the new business rules have come up [to date].

"This isn't good enough.

"It's completely confusing... the Guild is completely against the confusion that this has created.

"But we are obviously very supportive, and would encourage all of you to do the right clinical thing and provide their clinical service to anyone who is severely immunocompromised that presents to your practice."

Twomey added that he and the Guild's Vice President for Health Economics, Anthony Tassone, had been in discussions with "the highest levels of government" to push for "same job, same pay" in relation to third COVAX doses, and "to ensure that this is a subsequent dose payment, not an initial dose payment".