CANCER patients could be forced to pay thousands of dollars for chemotherapy if the government does not provide more funding to dispense the commonly used drugs, doctors say.
The funding issue may also cause some private hospitals to close cancer services from next month, forcing patients to travel longer distances for treatment or move onto public hospital waiting lists.
The issue stems from federal government changes to the Pharmaceutical Benefits Scheme in recent years to make sure pharmacists are not getting a windfall from the $9 billion system, which covers the cost of most chemotherapy drugs.
But private hospitals and community pharmacists say tightening of the system has made it increasingly difficult for them to cover the costs of delivering the chemotherapy drugs and that, as of next month, they will start making a loss.
A statement by concerned organisations, including Cancer Council Australia and the Australian Private Hospitals Association, says if the government does not resolve the funding shortfall, some services may pass this cost on to patients.
''If the government does not urgently intervene, patients risk facing up to an additional $100 per infusion, having access to chemotherapy services restricted, being forced to travel further for their treatments and/or being forced onto potentially long waiting lists in the public system,'' the statement says.
It says more than 13,000 infusions are prepared and dispensed by community and private hospital pharmacies for Australian cancer patients each week and calls for the government to resolve the issue with a new funding model by the end of the month.
At the moment, most chemotherapy drugs are on the PBS, meaning patients face a small out-of-pocket cost for their medicine.
Dr John Bashford, a cancer specialist and immediate past president of Private Cancer Physicians of Australia, said given that about 60 per cent of chemotherapy was done in private hospitals, the impact of the price rises could be huge.
''For a lady with breast cancer, for example, it could mean an extra $2000 to $3000. These are significant gaps for people who are generally quite vulnerable because they have to stop work to have their treatment,'' he said.
Dr Bashford said he was concerned the change would exacerbate a shift by private hospitals away from cancer services because they were not economically sustainable.
''It's an area where margins are very, very small, so this impost can change the balance. If anyone is wondering whether they should continue cancer services, this will push them into deciding they should not,'' he said.
Dr Bashford has a less-than-1 per cent shareholding in a company that runs private day chemotherapy clinics, Integrated Clinical Oncology Network (ICON). However, he said he was not motivated by a financial interest.
Cancer Council of Australia head Professor Ian Olver said he was concerned about price rises for patients and feared the issue would make it difficult for some private services, especially rural chemotherapy day centres, to continue operating.
''We want to make sure those two unintended consequences of the changes in reimbursement will not occur,'' he said.
Professor Olver said he had discussed the matter with federal government representatives who assured him they were looking at the potential consequences.
A spokeswoman for federal Health Minister Tanya Plibersek said that while the government was aware of the concerns, hospitals and pharmacists could not charge patients extra for PBS medicines. She said the Pharmacy Guild of Australia had been asked to provide specific examples of where the fee structure was not meeting the cost of services so the government could examine the problem.
''Without this information the government cannot be drawn on whether pharmacists or hospitals are appropriately funding the services provided to cancer patients,'' the spokeswoman said.
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