While health policy experts have blamed ‘inertia,’ suggesting GPs won’t override their practice software’s default settings, our survey of more than 2000 GPs highlights deeper concerns about quality of care…

Launched in 2023, 60-day prescribing has failed to meet the Government’s projections, with just 30% of eligible medicines dispensed from a 60-day script by November last year.

That means savings to consumers and the Government fell far short of expectations, a report from the Grattan Institute has found.

The Department of Health and Aged Care had predicted uptake would reach 45% by 2023-2024, but uptake has been “painfully slow” and the policy “isn’t living up to its promise,” according to two co-authors of the Grattan Institute report.

In fact DoHAC had expected 58% uptake in 2024-2025, but Grattan’s analysis showed that overall uptake is actually even lower when you include stages two and three of implementation, as just 21% of medicines dispensed were from a 60-day script.

So why aren’t GPs writing more 60-day scripts?

Grattan report co-authors Peter Breadon and Wendy Hu have blamed the GP practice software that defaults to 30-day prescriptions.

“Risks for patients aren’t the problem. While 60-day prescribing won’t be right for all patients, experts selected the eligible drugs because prescribing them for 60 days is usually appropriate and safe,” Mr Breadon and Ms Hu said.

“The culprit is probably inertia,” they wrote.

“GP practice software generates default prescriptions when a patient has had a drug before. With most people still getting 30-day prescriptions, that will be the default for most repeat scripts. And many patients might not be aware the new 60-day option is available.”

Their hypothesis has been repeated by the medical press (here and here), but is the reason GPs haven’t swarmed to 60-day prescribing really that simple?

Results from Healthed’s latest survey of more than 2000 GPs suggest otherwise.

Need for review, patient safety and preventive care are the real motivators

When asked their main reasons for not changing to 60-day scripts for eligible medicines, the most common reason was the need for more frequent review, cited by nearly half of GPs, followed by patient safety, which was chosen by more than one-third. Practice software defaults was actually the least common reason from the list of options, with just 10% of GPs saying it impacted their choice.

Several GPs commented that 60-day scripts are really only appropriate for patients with stable, well-controlled conditions.

“Depends on patients health and age. I prefer to see patients with high risk factors for diseases more frequently,” one GP explained.

“It reduces regular GP monitoring of chronic diseases,” another said.

So while it’s unclear what, if any, evidence is underpinning the Grattan Institute experts’ theory, it seems most GPs beg to differ.

What your colleagues are saying

“I’m happy to offer my patients 60-day prescribing although I do worry about opportunities to practice preventative care.”

“I feel it is a false economy. If a medication or dose needs changing, it negates any saving.”

“Currently causing more admin time, as pharmacists request a script change (e.g. for Webster packs), and patients come back and ask for another script.”

“I think that patients need less barriers to taking their medication, so I believe 60-day prescribing is a good thing for my patients generally when appropriate.”

“Some patients taking multiple medications find it confusing if half their meds are still 30-day prescribing and have asked me to change back!”

“Doctors need to ensure they still review the patient frequently for optimal care, consider prescribing less repeats.”

“I use 60-day prescribing so that patients don’t have to come in so often. However, I often find that the scripts get lost or on occasion (more than one) the pharmacy has only dispensed 30-day scripts.”