The Remote and Isolated Pharmacist Association Australia (RIPAA) has today warned that the sophisticated clinical models being championed by national pharmacy bodies are structurally unsuited for Australia’s most remote “thin markets.”
“While major industry organisations promote the clinical potential of Full Scope of Practice pilots, the long-standing Home Medicines Reviews (HMRs), and the Aged Care Onsite Pharmacist (ACOP) program, RIPAA argues that the funding structures behind these initiatives are built for the high-volume environment of the city. In the thin markets of Modified Monash (MM) 5–7 zones, these programs are economically unviable.
“We are seeing the development of expanded clinical pharmacy models,” said RIPAA President Fredrik Hellqvist. “However, the reality is that the current funding mechanisms underpinning these services—from prescribing models to specialised medication reviews—are not feasible in areas with extreme geographic isolation and low population density.”
The Feasibility Gap in Remote Practice RIPAA notes that even programs designed with structured support, such as ACOP, struggle to achieve viability in the bush. While the ACOP model contributes toward a pharmacist’s salary, it does not address the broader structural costs of maintaining a permanent clinical presence in a thin market. Without a stable economic foundation, these programs remain out of reach for many remote communities.
“You cannot expect a pharmacist to deliver Full Scope of Practice or consistent Aged Care services if the overarching economic model is under threat,” Mr. Hellqvist said. “When we rely on models that assume a certain volume of clinical activity, we inadvertently favour ‘fly-in-fly-out’ services over the permanent, resident care that rural patients deserve.”
A Different Vision for Rural Sustainability In response to these challenges, RIPAA has developed a specialised policy proposal tailored specifically to the unique needs of MM 5–7 practitioners. This alternative model moves away from the “one-size-fits-all” approach, focusing instead on securing the clinical residency required to make programs like ACOP, HMRs, and Full Scope viable in the long term.
“We have formally escalated our concerns regarding national program design,” Mr. Hellqvist added. “Our proposal offers a different path forward—one that ensures rural pharmacists aren’t just ‘visiting’ but are embedded in their communities.”
Stability Over Transactional Churn RIPAA highlights that the reliance on transactional activity to fund clinical care is increasingly fragile in remote settings. By focusing on sustainable, clinical-led residency, RIPAA’s vision aims to provide the stability that rural healthcare requires to prevent “clinical pharmacy deserts.”
“It is time to stop pretending that what works in a major city suburb will work in a small rural or remote town,” concluded Mr. Hellqvist.
