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Harvey, Ken. "Australia: Pharmaceutical Benefits Scheme." Lancet 337, no. 8738 (February 1991): 418–19. http://dx.doi.org/10.1016/0140-6736(91)91181-s.
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Graham, David. "The Australian Pharmaceutical Benefits Scheme." Australian Prescriber 18, no. 2 (April 1, 1995): 42–44. http://dx.doi.org/10.18773/austprescr.1995.049http://www.australianprescriber.com/magazine/18/2/42/4.
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Turkstra, Erika, Emilie Bettington, Maria L. Donohue, and Merehau C. Mervin. "PHARMACEUTICAL BENEFITS ADVISORY COMMITTEE RECOMMENDATIONS IN AUSTRALIA." International Journal of Technology Assessment in Health Care 33, no. 4 (2017): 521–28. http://dx.doi.org/10.1017/s0266462317000617.
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Objectives: The aim of this study was to examine submissions made to the Pharmaceutical Benefits Advisory Committee (PBAC) and assess whether the predicted financial impact was associated with a recommendation. The second objective was to assess whether the financial and utilization estimates for listing the proposed medicine were reliable.Methods: Data were extracted from public summary documents of major submissions considered by the PBAC from 2012 to 2014. Information collected included whether submissions were accepted, rejected, or deferred; estimated use; and financial impact. For those submissions that were recommended in 2012 and listed on the Pharmaceutical Benefits Scheme (PBS) by January 2014, a comparison was made between predicted and actual use and cost in 2014, based on PBS utilization.Results: In 2012 to 2014, the PBAC considered 142 unique major submissions; of those, 65 were recommended for listing. A higher financial cost to the government was a statistically significant factor in predicting rejection (p = .004 for cost > AUD 30 million Australian dollars [20.7 million Euros] compared with cost-saving). Of the submissions that were recommended in 2012 and listed by 2014, the actual use was higher than predicted for 5/19 medications. The estimated cost was outside the predicted bracket of cost for 10/19 medications, with 8/19 medications having threefold underestimated expenditure, and 2/19 items having lower than predicted expenditure.Conclusions: This study highlights that the predicted financial impact of a medication to the PBS budget is associated with a PBAC recommendation and also highlights that predicted use may not reflect actual prescribing practices.
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Harvey, Ken. "Correction: Patents, pills and politics: the Australia-United States Free Trade Agreement and the Pharmaceutical Benefits Scheme." Australian Health Review 28, no. 3 (2004): 381. http://dx.doi.org/10.1071/ah040381.
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Re: ?Patents, pills and politics: the Australia? United States Free Trade Agreement and the Pharmaceutical Benefits Scheme?, by Ken Harvey, (Aust Health Rev 2004, vol. 28, no. 2, pp. 218-226). Under the heading ?A brief history of patent law relevant to pharmaceuticals?, in the second paragraph, the second sentence was: ?Before TRIPS, many developing countries provided no patent protection on pharmaceutical products, or they recognised patents on products but not process?. The corrected version should be ?. . .process but not products?.
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Harvey, Ken. "Patents, pills and politics: the Australia–United States Free Trade Agreement and the Pharmaceutical Benefits Scheme." Australian Health Review 28, no. 2 (2004): 218. http://dx.doi.org/10.1071/ah040218.
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There is tension between the need of the pharmaceutical innovator for intellectual property protection and the need of society for equitable and affordable access to innovative drugs. The recent Australia?United States Free Trade Agreement provides a nice illustration of this interplay between patents, pills and politics. This article provides a brief history of patent law as applied to pharmaceuticals, describes how the Pharmaceutical Benefits Scheme got caught up in AUSFTA negotiations, analyses the clauses that are likely to impact upon the PBS and describes the political process that reviewed and ultimately amended the AUSFTA.
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Robertson, Jane, Emily J. Walkom, and David A. Henry. "Transparency in pricing arrangements for medicines listed on the Australian Pharmaceutical Benefits Scheme." Australian Health Review 33, no. 2 (2009): 192. http://dx.doi.org/10.1071/ah090192.
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Australia?s system for assessing the cost-effectiveness of drugs for listing under the Pharmaceutical Benefits Scheme (PBS) is recognised internationally. A variety of mechanisms, such as evidencebased rules for determining eligibility for initial or continuing subsidy, price-volume agreements, rebates, and caps on government expenditure are used to contain PBS expenditures. In this paper we assess the extent of use of special pricing arrangements in Australia and how and where they are communicated to health professionals and the community. We searched publicly available documents published by the Pharmaceutical Benefits Advisory Committee (PBAC) and the Pharmaceutical Benefits Pricing Authority (PBPA). We found 73 medicines where special pricing arrangements had been applied and where prices appearing on the Schedule of Pharmaceutical Benefits might differ from those considered to be ?cost-effective? by the PBAC. Reporting of these special pricing agreements was inconsistent and generally non-transparent. In some, the lack of transparency may have reflected the desire of manufacturers to disguise the true negotiated price, lest it weaken their negotiation position in other jurisdictions.
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Faunce, Tom. "How the Australia-US free trade agreement compromised the pharmaceutical benefits scheme." Australian Journal of International Affairs 69, no. 5 (July 7, 2015): 473–78. http://dx.doi.org/10.1080/10357718.2015.1048785.
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Adams, Robert J., Sarah Appleton, David H. Wilson, Anne W. Taylor, Catherine Chittleborough, Tiffany Gill, and Richard E. Ruffin. "Cholesterol-lowering therapy and the Australian Pharmaceutical Benefits Scheme: a population study." Australian Health Review 33, no. 2 (2009): 325. http://dx.doi.org/10.1071/ah090325.
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Objective: The Australian Pharmaceutical Benefits Scheme (PBS) expanded the criteria for eligibility for subsidised lipid-lowering therapy (LLT) in 2006. The aim of this study was to determine the use of LLT in a representative Australian population in relation to cardiovascular disease (CVD) risk, and the effectiveness of the therapy in meeting target levels. Design: Cross-sectional biomedical study with telephone interviews, questionnaires, clinical measurements, and PBS dispensing data. Subjects: Representative population sample of 4060 urban adults aged 18 years attending for the biomedical examination in 2001. Results: Of the 406 who qualified for PBS-subsidised LLT at that time, only 88 (21.5%) were actually on LLT. National Heart Foundation of Australia (NHF) recommended low-density lipoprotein cholesterol (LDL-C) levels of < 2.5 mmol/L were recorded in only 13% (528) of the population, and in 46.8% of those on LLT. Of those on LLT, 76% had total cholesterol < 5.5 mmol/L, but over 80% had total cholesterol levels above NHF-recommended levels of 4.0 mmol/L. Of the 842 classified at the highest CVD risk, only 26% were using LLT. Those aged > 60 years and on low incomes were significantly more likely to use LLT. The new PBS criteria will expand eligibility to include nearly 20% of adults. Conclusions: The majority of people at high risk of CVD were not receiving LLT, and LLT is not being used to its full effectiveness. People with low incomes or on government benefits or pensions were not less likely to use LLT than others under the PBS scheme. Whether higher copayments for those on low incomes who do not qualify for concessional payments is a significant barrier to LLT use needs further research.
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Doran, Evan, Jane Robertson, and Glenn Salkeld. "Pharmaceutical Benefits Scheme cost sharing, patient cost consciousness and prescription affordability." Australian Health Review 35, no. 1 (2011): 37. http://dx.doi.org/10.1071/ah10902.
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Objective. To assess patients’ prescription medicine cost consciousness and explore the implications of further cost sharing increases for affordability. Design and participants. A telephone interview survey of 818 randomly selected prescription medicine users (408 concession card holders, 410 general beneficiaries) resident in the Hunter Valley region of New South Wales, Australia. Main outcome measures. Degree of prescription cost consciousness; attitudes towards prescription use and cost sharing; self-rated capacity to manage further co-payment increases and differences between concession card holders and general beneficiaries in these measures. Results. The majority of participants were cost conscious medicine users who act responsibly towards medicine use and believe that cost sharing is appropriate. Although there were no differences in cost consciousness scores, card holders appeared more sensitive to prescription costs and increases. Conversely, general beneficiaries were more likely to report difficulties with cost (avoiding seeing a doctor, not collecting prescription medicines, stopping or reducing the dose of a prescribed medicine). Although almost 75% of respondents reported that a co-payment increase would cause financial difficulty, only 28% indicated this would change their medicine use. Conclusions. These results suggest that most Australian patients are cost conscious but many are also close to facing difficulties with prescription costs. Further increases in PBS cost sharing could compromise prescription affordability, particularly for general beneficiaries. What is known about the topic? Increased PBS cost sharing is intended to minimise unnecessary demand for prescription medicines while maintaining affordability. The key mechanism to achieve this – ‘cost consciousness’ – has not been investigated. What does this paper add? The paper provides patient level data on cost consciousness, attitudes to cost sharing and patient capacity to manage future increases in PBS cost sharing. What are the implications for practitioners? Australians are cost conscious. Further increases in PBS cost sharing make some patients even more cost conscious but may also erode affordability, particularly for general beneficiaries. A review of cost sharing is important and long overdue.
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Harvey, Ken J., Thomas A. Faunce, Buddhima Lokuge, and Peter Drahos. "Will the Australia–United States Free Trade Agreement undermine the Pharmaceutical Benefits Scheme?" Medical Journal of Australia 181, no. 5 (September 2004): 256–59. http://dx.doi.org/10.5694/j.1326-5377.2004.tb06264.x.
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Faunce, Thomas A. "Reference pricing for pharmaceuticals: is the Australia–United States Free Trade Agreement affecting Australia's Pharmaceutical Benefits Scheme?" Medical Journal of Australia 187, no. 4 (August 2007): 240–42. http://dx.doi.org/10.5694/j.1326-5377.2007.tb01209.x.
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Kjosavik, Svein Reidar, Marianne Hansen Gillam, and Elisabeth E. Roughead. "Average duration of treatment with antidepressants among concession card holders in Australia." Australian & New Zealand Journal of Psychiatry 50, no. 12 (July 20, 2016): 1180–85. http://dx.doi.org/10.1177/0004867415621392.
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Objective: To analyse the average treatment duration with antidepressants that are reimbursed for concession card holders under the Pharmaceutical Benefits Scheme in Australia. Method: This pharmacoepidemiological study was based on a representative 10% sample of patients receiving Pharmaceutical Benefits Scheme prescriptions. Antidepressants redeemed by concession card holders in the period from 2010 to 2013 were analysed. A 5-year baseline period was used to exclude prevalent users from incident users. Estimation of treatment duration was based on the epidemiological equation: prevalence/incidence = average duration. The mean value for prevalence and incidence over the studied period was used in the equation. Results: The number of prevalent and incident users increased from 90,475 to 103,305 and from 25,006 to 26,289, respectively. The epidemiological average treatment duration in the period was about 4 years. When considered by age-bands, average treatment duration was 2 years in patients under 24 years, 3 years in patients 35 to 44 years and up to 5 years in the 55 to 64 year age group. Of new users of antidepressants reimbursed under the Pharmaceutical Benefits Scheme, 86% received their first prescription from general practitioners, 4.3% from psychiatrists and 9.7% from other physicians. Conclusion: While recommendations have underlined the importance of giving antidepressants for a sufficient period of time, the results from this study show that it is as important to remind general practitioners to review patients on antidepressant treatment regularly, and try to cease drug treatment when timely.
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Chuen Li, Shu, Fei-Li Zhao, Raj Gauba, Keri Yang, Soraya Azmi, and Constantine Si Lun Tam. "Population-wide patterns of care in chronic lymphocytic leukemia in Australia: An analysis of the pharmaceutical benefits scheme dataset." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e19518-e19518. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e19518.
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e19518 Background: The treatment landscape in patients with chronic lymphocytic leukemia (CLL) is changing with the approvals of Bruton’s tyrosine kinase inhibitors (BTKis) in Australia. We sought to understand the practice impact of the introduction of publicly funded novel agents for the treatment of CLL. The objective of this study was to describe the evolving treatment patterns of Australian patients with CLL over the last 10 years using population-wide prescription records. Methods: Patients who initiated a treatment for CLL between 01/01/2011 and 07/31/2021 were extracted from the Services Australia 10% Pharmaceuticals Benefits Scheme (PBS) dataset. This dataset includes the dispensing records for 10% of the Australian population and captures all publicly funded treatments in Australia. The index date was defined as the commencement of any drug for the treatment of CLL. First-line (1L) therapy was defined as the first treatments prescribed for CLL. A patient was defined as relapsed/refractory (R/R) if they had commenced a drug which was in a different therapeutic category, or if they re-started the same regimen after a gap of more than 180 days. Descriptive analyses were conducted to examine the use of treatment regimens for the overall 10-year population by line of therapy. Analyses by calendar year were also performed to assess changes in treatment patterns. Results: Overall, 803 patients with CLL were identified. The majority of patients were male (65%) and age > 60 years (77%), with most being aged 70-79 years (33% of total). Many patients were receiving comedications at baseline, including antihypertensives (47%), antipsychotics or antidepressants (17%), and/or anticoagulants (13%). In the overall population (2011-2021), the majority of patients had received 1L treatment with fludarabine-cyclophosphamide-rituximab (FCR, 49%), chlorambucil ± CD20 (27%), or CD20 monotherapy (17%). The most commonly used regimens in R/R patients at any subsequent episode of treatment included CD20 monotherapy (56%), BTKi (41%) or FCR (33%). A trend in adoption of novel agents was observed throughout the years following their PBS listing. Analysis by calendar year showed that from 2011 to 2020 use of FCR in 1L decreased from 78% to 10%; and use of BTKis in R/R increased from 0% to 62%. Conclusions: CLL treatment patterns have significantly changed in Australia since the introduction of the BTKis (e.g., ibrutinib, acalabrutinib). The use of FCR in 1L CLL has decreased and use of BTKis in R/R patients has increased.
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Chuen Li, Shu, Fei-Li Zhao, Raj Gauba, Keri Yang, Soraya Azmi, and Constantine Si Lun Tam. "Population-wide patterns of care in chronic lymphocytic leukemia in Australia: An analysis of the pharmaceutical benefits scheme dataset." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e19518-e19518. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e19518.
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e19518 Background: The treatment landscape in patients with chronic lymphocytic leukemia (CLL) is changing with the approvals of Bruton’s tyrosine kinase inhibitors (BTKis) in Australia. We sought to understand the practice impact of the introduction of publicly funded novel agents for the treatment of CLL. The objective of this study was to describe the evolving treatment patterns of Australian patients with CLL over the last 10 years using population-wide prescription records. Methods: Patients who initiated a treatment for CLL between 01/01/2011 and 07/31/2021 were extracted from the Services Australia 10% Pharmaceuticals Benefits Scheme (PBS) dataset. This dataset includes the dispensing records for 10% of the Australian population and captures all publicly funded treatments in Australia. The index date was defined as the commencement of any drug for the treatment of CLL. First-line (1L) therapy was defined as the first treatments prescribed for CLL. A patient was defined as relapsed/refractory (R/R) if they had commenced a drug which was in a different therapeutic category, or if they re-started the same regimen after a gap of more than 180 days. Descriptive analyses were conducted to examine the use of treatment regimens for the overall 10-year population by line of therapy. Analyses by calendar year were also performed to assess changes in treatment patterns. Results: Overall, 803 patients with CLL were identified. The majority of patients were male (65%) and age > 60 years (77%), with most being aged 70-79 years (33% of total). Many patients were receiving comedications at baseline, including antihypertensives (47%), antipsychotics or antidepressants (17%), and/or anticoagulants (13%). In the overall population (2011-2021), the majority of patients had received 1L treatment with fludarabine-cyclophosphamide-rituximab (FCR, 49%), chlorambucil ± CD20 (27%), or CD20 monotherapy (17%). The most commonly used regimens in R/R patients at any subsequent episode of treatment included CD20 monotherapy (56%), BTKi (41%) or FCR (33%). A trend in adoption of novel agents was observed throughout the years following their PBS listing. Analysis by calendar year showed that from 2011 to 2020 use of FCR in 1L decreased from 78% to 10%; and use of BTKis in R/R increased from 0% to 62%. Conclusions: CLL treatment patterns have significantly changed in Australia since the introduction of the BTKis (e.g., ibrutinib, acalabrutinib). The use of FCR in 1L CLL has decreased and use of BTKis in R/R patients has increased.
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Karnon, Jonathan, Laura Edney, and Michael Sorich. "Costs of paying higher prices for equivalent effects on the Pharmaceutical Benefits Scheme." Australian Health Review 41, no. 1 (2017): 1. http://dx.doi.org/10.1071/ah15122.
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Objective The aims of the present study were to illustrate and discuss the effects of the non-maintenance of equivalent prices when the comparators of pharmaceuticals listed on the Pharmaceutical Benefits Schedule (PBS) on a cost-minimisation basis come off-patent and are subject to statutory price reductions, as well as further potential price reductions because of the effects of price disclosure. Methods Service use, benefits paid, and price data were analysed for a selected sample of pharmaceuticals recommended for listing on a cost-minimisation basis between 2008 and 2011, and their comparators, to estimate the cost savings to the PBS of maintaining equivalent prices. Results Potential cost savings for 12 pharmaceuticals, including alternative compounds and combination products across nine therapeutic groups, ranged from A$570 000 to A$40 million to April 2015. Potential savings increased significantly following recent amendments to the price disclosure process. Conclusions Potential savings from maintaining equivalent prices for all pharmaceuticals listed on the PBS on a cost-minimisation basis could be over A$500 million per year. Actions to reduce these costs can be taken within existing policy frameworks, but legislative and political barriers may need to be addressed to minimise these costs, which are incurred by the taxpayer for no additional benefit. What is known about the topic? Pharmaceuticals listed on the PBS must provide value for money. Many pharmaceuticals achieve this by demonstrating equal effectiveness to an already listed pharmaceutical and requesting the same price as this comparator; that is, listing on a cost-minimisation basis. When the comparator moves off-patent, the price of the still-patented pharmaceutical is protected, whereas the off-patent drug is subject to price disclosure and often steep price reductions. What does this paper add? This paper adds to recent evidence on the costs to government of paying different prices for two or more pharmaceuticals that are equally effective. Between 2008 and 2011, the direct comparators for 68 pharmaceuticals listed on a cost-minimisation basis have moved onto the price disclosure list. Across 12 of these listings, the potential cost savings in the 10 months to April 2015 were A$73 million. What are the implications for practitioners? The PBS costs the Australian government over A$9 billion per year. Annual savings over A$500 million per year could be achieved by maintaining cost-minimisation across equally effective pharmaceuticals. This would improve the efficiency of the PBS at no risk to patients. Legislation is required to remove the existing F1 and F2 categorisation of listed pharmaceuticals, but the proposed changes would remove the need for therapeutic group premiums and simplify the pricing of PBS items.
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Tam, Constantine Si Lun, Fei-Li Zhao, Tom Liu, Raj Gauba, Shu Chuen Li, and Boxiong Tang. "Population-wide patterns of care in mantle cell lymphoma in Australia: An analysis of the pharmaceutical benefits scheme dataset." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e19587-e19587. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e19587.
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e19587 Background: The treatment landscape in patients with mantle cell lymphoma (MCL) is changing with the introduction of Bruton’s tyrosine kinase inhibitors (BTKis) and bendamustine in Australia. We sought to analyze the practice impact of the introduction of publicly funded novel agents in MCL. The objective of this study was to describe the evolving treatment patterns of Australian patients with MCL over the last 10 years using population-wide prescription records. Methods: Patients who initiated a treatment for MCL between 01/01/2011 and 07/31/2021 were extracted from the Services Australia 10% Pharmaceuticals Benefits Scheme (PBS) dataset, which includes the dispensing records for 10% of the Australian population. This dataset captures all publicly funded treatments in Australia. The index date was defined as the commencement of any drug for MCL. First-line (1L) therapy was defined as the first treatments prescribed for MCL. A patient was defined as relapsed/refractory (R/R) if they had commenced a drug which was in a different therapeutic category, or if they re-started the same regimen after a gap of more than 180 days. Descriptive analyses were conducted to examine the use of treatment regimens for the overall 10-year population by line of therapy. Analyses by calendar year were also performed to assess the changes in the treatment patterns. Results: Overall, 241 patients with MCL were identified over the study period. The majority of patients were male (68.4%), age > 60 years (84.9%), and most being aged 70-79 years (42.1% of total). Many patients were receiving comedications at baseline, including antihypertensives (44.1%), anticoagulants (14.5%), and/or antipsychotics or antidepressants (12.5%). In the overall population (2011-2021), the majority of patients had received 1L treatment with bendamustine-rituximab (BR, 53.9%), rituximab plus other regimens (27.6%), or rituximab monotherapy (11.2%). The most commonly used regimens in R/R patients at any subsequent episode of treatment included BTKi (66.3%), rituximab monotherapy (52.8%) or rituximab plus other regimens (31.5%). A trend in adoption of novel agents was observed throughout the years following their PBS listing. Analysis by calendar year showed that from 2011 to 2020 for 1L therapy, the use of BR increased from 0% to 50% and use of rituximab-containing regimen except BR decreased from 100% to 16.7%; use of BTKi increased in R/R patients from 0% to 74.7%. Conclusions: MCL treatment patterns have significantly changed in Australia since the introduction of BTKis and bendamustine-containing regimens. The use of rituximab-containing regimens except BR in 1L MCL has decreased and use of BTKis in R/R patients has increased.
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Lingaratnam, Senthil M., Sue W. Kirsa, James D. Mellor, John Jackson, Wallace Crellin, Michael Fitzsimons, and John R. Zalcberg. "A survey of reimbursement practices of private health insurance companies for pharmaceuticals not covered under the Pharmaceutical Benefits Scheme 2008." Australian Health Review 35, no. 2 (2011): 204. http://dx.doi.org/10.1071/ah10894.
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Objective. To describe the current practices and policy of Australian private health insurance (PHI) companies with respect to cover for pharmaceuticals not subsidised under the Pharmaceutical Benefits Scheme (PBS). Design, setting and participants. A 2008 review of web-published policy statements for top-level hospital and comprehensive general treatment insurance, and survey of reimbursement practices by way of questionnaire, of 31 Australian-registered, open-membership PHI companies. Main outcome measures(s). Description of the level of pharmaceutical cover and important considerations identified by PHI companies for funding non-PBS pharmaceuticals through benefit entitlements or ex-gratia payments. Results. Nine of thirty-one PHI companies (29%) provided responses accounting for ~60% market share of PHI. The majority of smaller PHI firms either declined participation or did not respond. The maximum limits offered for non-PBS pharmaceuticals, under comprehensive general treatment insurance, varied significantly and typically did not adequately cover high-cost pharmaceuticals. Some companies occasionally offered ex-gratia payments (or discretionary payments in excess of the policyholder’s entitlement benefits) for high cost-pharmaceuticals. Factors considered important in their decision to approve or reject ex-gratia requests were provided. All results were de-identified. Conclusions. There is little consistency across PHI companies in the manner in which they handle requests for high-cost pharmaceuticals in excess of the defined benefit limits. Such information and processes are not transparent to consumers. What is known about the topic? Pharmaceuticals that are not accessible via the Pharmaceutical Benefits Scheme (PBS) may be subsidised through private health insurance. The level of cover through general treatment insurance and hospital insurance varies according to the insurer or policy type and hospital–insurer agreement respectively. What does this paper add? An increasing proportion of lower cost, high volume pharmaceuticals that are available to consumers without any form of Commonwealth subsidy, under current arrangements, also do not attract any form of PHI cover. There is also little consistency across PHI companies in the manner in which they handle requests for high-cost pharmaceuticals in excess of the defined benefit limits and that such information and processes are not transparent to consumers. What are the implications for practitioners? PHI could be better engaged to play a more significant role in helping maintain consumer access to essential medicines.
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Lofgren, Hans. "Generic drugs: international trends and policy developments in Australia." Australian Health Review 27, no. 1 (2004): 39. http://dx.doi.org/10.1071/ah042710039.
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Public and private third-party payers in many countries encourage or mandate the use of generic drugs. This articleexamines the development of generics policy in Australia, against the background of a description of internationaltrends in this area, and related experiences of reference pricing programs. The Australian generics market remainsunderdeveloped due to a historical legacy of small Pharmaceutical Benefits Scheme price differentials betweenoriginator brands and generics. It is argued that policy measures open to the Australian government can be conceivedas clustering around two different approaches: incremental changes within the existing regulatory framework, or a shifttowards a high volume/low price role of generics which would speed up the delivery of substantial cost savings, andcould provide enhanced scope for the financing of new, patented drugs.
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Lopert, Ruth. "PBS copayments and safety nets - A commentary on Sweeny and Doran and Robertson." Australian Health Review 33, no. 2 (2009): 241. http://dx.doi.org/10.1071/ah090241.
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IN ANY DISCUSSION of key pharmaceutical policy issues, Australia?s National Medicines Policy (NMP) is an important touchstone of which Australians can be justly proud. Those familiar with the stalled evolution of the Canadian National Pharmaceuticals Strategy and the uneven provincial patchwork of pharmaceutical coverage in Canada for example, may wonder why it is that a country with longstanding universal health care has neither universal coverage of medicines nor a cohesive national policy framework like Australia?s NMP. One of the fundamental objectives of the NMP is to deliver ?timely access to the medicines that Australians need, at a cost individuals and the community can afford?. It also says that ?cost should not constitute a substantial barrier to people?s access to medicines they need? and that while ?. . . the Pharmaceutical Benefits Scheme (PBS) facilitates access to certain prescribed medicines by subsidising costs . . . (S)uch subsidies are not costless, and the community as a whole must bear them?. Importantly it also says that ?. . . access to medicines should support the rational use of those medicines?.
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Spinks, Jean, Gang Chen, and Lara Donovan. "Does generic entry lower the prices paid for pharmaceuticals in Australia? A comparison before and after the introduction of the mandatory price-reduction policy." Australian Health Review 37, no. 5 (2013): 675. http://dx.doi.org/10.1071/ah13024.
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Objective We investigated the relationship between the number of generic medicines and pharmaceutical prices over time in Australia. Methods A dataset was utilised containing 76 items for 4 years (2003–2007) on the national subsidy scheme – the Pharmaceutical Benefits Scheme (PBS) – for which a generic brand is available. The PBS price was used as the dependent variable, and the number of generics available the key explanatory variable. The ordinary least-squares estimator was adopted for estimation. In the robustness analysis, an instrumental-variables method was used to account for potential endogeneity. Results Results suggested that the effect of increased generic medicine sellers on reducing the prices paid for generics is marginal but statistically significant. Conclusions It is suggested that structural changes to the way generic prices are determined needs to be reconsidered by the Australian government if the policy aim of using increased ‘competition’ to lower prices is to be maximised. What is known about the topic? There is scant empirical evidence that supports the notion that increased generic availability for pharmaceuticals, in heavily price-regulated markets such as Australia, has a significant effect on lowering the prices paid over time. Despite this, Australia has adopted a policy that promotes increased generic ‘competition’ as a means of controlling prices, without establishing if this policy has, or is likely to be, successful in the longer term. What does this paper add? Using longitudinal data from Medicare Australia, this paper quantifies the relationship between the number of branded and generic items of a given drug molecule and formulation, and prices paid over time, controlling for other explanatory variables. What are the implications for practitioners? The results suggest that although increased generic entry may lower prices over time in the Australian context, the price reduction gained is likely to be very small. Therefore, whilst generic entry should be encouraged, it is important not to assume that this price-lowering effect is realised without question and that the magnitude of such an effect is comparable with other price-regulated countries.
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de Boer, Rebecca. "PBS reform — a missed opportunity?" Australian Health Review 33, no. 2 (2009): 176. http://dx.doi.org/10.1071/ah090176.
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The Pharmaceutical Benefits Scheme (PBS) reform package was announced in 2006 and was designed to save the government significant expenditure on the PBS through mandatory price cuts and price disclosure arrangements for multibrand products. Perhaps most significantly, the formulary was spilt in two with no linkages between the formularies on either price or therapeutic outcome. This article examines the potential impact of these changes on the PBS and pharmaceutical policy in Australia more broadly.
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Kemp, Anna, David B. Preen, John Glover, James Semmens, and Elizabeth E. Roughead. "How much do we spend on prescription medicines? Out-of-pocket costs for patients in Australia and other OECD countries." Australian Health Review 35, no. 3 (2011): 341. http://dx.doi.org/10.1071/ah10906.
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Objectives. To determine changes in out-of-pocket expenditure on prescription medicines for Australian patients, and how patient expenditure compares with other Organisation for Economic Co-operation and Development (OECD) countries. Methods. We examined out-of-pocket expenditure on prescription medicines by patients in Australia between 1970 and 2007, and between Australia and 15 other OECD countries (Canada, Czech Republic, Denmark, Finland, France, Germany, Japan, Republic of Korea (South Korea), Luxembourg, Poland, Slovak Republic, Spain, Sweden, Switzerland and the United States) in 2005. Findings. Spending on publicly subsidised medicines by Australian patients increased from $16 per person in 1971 to $62 in 2007. Patient expenditure on all prescription medicines had risen to $134 per person in 2007. Out-of-pocket expenditure for Australian patients ranked 4th of 14 OCED countries with universal pharmaceutical subsidies. Australian patients pay 28% of national pharmaceutical expenditure; more than patients in South Korea (27%), Slovak Republic (26%), Sweden (22%), France, Luxembourg, Japan and Switzerland (17%), Germany (15%), Czech Republic (11%) and Spain (6%), but less than patients in Finland (36%), Denmark (33%) and Poland (34%). Conclusions. Compared to other OECD countries, Australian out-of-pocket costs are now in the mid to upper range. Further increases have the potential to significantly affect access to care. What is known about the topic? In Australia and internationally, increases in the portion of prescription medicines paid by patients have been associated with falls in utilisation. Despite the pharmaceutical subsidies patients receive under the Australian Pharmaceutical Benefits Scheme, prescription medicine costs are a barrier to access for many low income, elderly and other vulnerable patients. What does this paper add? The findings demonstrate that the prescription medicine expenditure of Australian patients has increased substantially over recent years, and is double that indicated by benefit-paid data alone. Out-of-pocket expenditure in Australia is moderate-to-high by international standards. What are the implications for practitioners? Patient out-of-pocket expenditure for prescription medicines in Australia has increased in recent decades, accounting for higher proportions of household and national medicine expenditure. Lack of patient involvement in treatment decisions is associated with patients forgoing medicines due to costs. Practitioners are encouraged to discuss treatment decisions, cost-barriers and possible strategies to overcome cost-barriers with their patients.
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Gleeson, Deborah, Belinda Townsend, Ruth Lopert, Joel Lexchin, and Hazel Moir. "Financial costs associated with monopolies on biologic medicines in Australia." Australian Health Review 43, no. 1 (2019): 36. http://dx.doi.org/10.1071/ah17031.
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Objectives The aim of the study was to estimate the potential savings to the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS) in 2015–16 if biosimilar versions of selected biologic medicines (biologics) had been available and listed on the PBS. Methods The research involved retrospective analysis of Australian Medicare expenditure data and PBS price data from 2015–16 for biologics, for which biosimilar competition may be available in future, listed on the PBS. Results Australian Government expenditure on biologics on the PBS and RPBS was estimated at A$2.29 billion dollars in 2015–16. If biosimilar versions of these medicines had been listed on the PBS in 2015–16, at least A$367million dollars would have been saved in PBS and RPBS subsidies. Modelling based on price decreases following listing of biosimilars on the PBS suggests that annual PBS outlays on biologics could be reduced by as much as 24% through the timely introduction of biosimilars. Conclusions Biologic medicines represent a large proportion of government expenditure on pharmaceuticals. Reducing the length of monopoly protections on these medicines could generate savings of hundreds of millions of dollars per year. What is known about the topic? Biologics take up an increasing share of pharmaceutical expenditure, but no previous published studies have examined Australian Government expenditure on biologics or the potential savings from reducing the duration of monopoly protection. What does this paper add? This paper provides new evidence about Australian Government expenditure on biologics and potential savings for selected medicines that are still subject to monopoly protection and thus are not yet subject to biosimilar competition. In 2015–16 Australian Government expenditure on biologics through the PBS and RPBS was estimated at A$2.29 billion dollars. If biosimilar versions of these medicines had been listed on the PBS at that time, at least A$367million dollars would have been saved. What are the implications for practitioners? Reducing the duration of monopoly protection on biologic medicines could save hundreds of millions of dollars annually that could be redirected to other areas of the healthcare system.
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Duckett, Stephen. "Expanding the breadth of Medicare: learning from Australia." Health Economics, Policy and Law 13, no. 3-4 (January 24, 2018): 344–68. http://dx.doi.org/10.1017/s1744133117000421.
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AbstractThe design of Australia’s Medicare programme was based on the Canadian scheme, adapted somewhat to take account of differences in the constitutional division of powers in the two countries and differences in history. The key elements are very similar: access to hospital services without charge being the core similarity, universal coverage for necessary medical services, albeit with a variable co-payment in Australia, the other. But there are significant differences between the two countries in health programmes – whether or not they are labelled as ‘Medicare’. This paper discusses four areas where Canada could potentially learn from Australia in a positive way. First, Australia has had a national Pharmaceutical Benefits Scheme for almost 70 years. Second, there have been hesitant extensions to Australia’s Medicare to address the increasing prevalence of people with chronic conditions – extensions which include some payments for allied health professionals, ‘care coordination’ payments, and exploration of ‘health care homes’. Third, Australia has a much more extensive system of support for older people to live in their homes or to move into supported residential care. Fourth, Australia has gone further in driving efficiency in the hospital sector than has Canada. Finally, the paper examines aspects of the Australian health care system that Canada should avoid, including the very high level of out-of-pocket costs, and the role of private acute inpatient provision.
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Mansfield, Sarah J. "Generic drug prices and policy in Australia: room for improvement? A comparative analysis with England." Australian Health Review 38, no. 1 (2014): 6. http://dx.doi.org/10.1071/ah12009.
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Objective To assess the degree to which reimbursement prices in Australia and England differ for a range of generic drugs, and to analyse the supply- and demand-side factors that may contribute to these differences. Methods Australian and English reimbursement prices were compared for a range of generic drugs using pricing information obtained from government websites. Next, a literature review was conducted to identify supply- and demand-side factors that could affect generic prices in Australia and England. Various search topics were identified addressing potential supply-side (e.g. market approval, intellectual property protection of patented drugs, generic pricing policy, market size, generic supply chain and discounting practices) and demand-side (consumers, prescribers and pharmacists) factors. Related terms were searched in academic databases, official government websites, national statistical databases and internet search engines. Results Analysis of drug reimbursement prices for 15 generic molecules (representing 45 different drug presentations) demonstrated that Australian prices were on average over 7-fold higher than in England. Significant supply-side differences included aspects of pricing policy, the relative size of the generics markets and the use of clawback policies. Major differences in demand-side policies related to generic prescribing, pharmacist substitution and consumer incentives. Conclusions Despite recent reforms, the Australian Government continues to pay higher prices than its English counterpart for many generic medications. The results suggest that particular policy areas may benefit from review in Australia, including the length of the price-setting process, the frequency of subsequent price adjustments, the extent of price competition between originators and generics, medical professionals’ knowledge about generic medicines and incentives for generic prescribing. What is known about the topic? Prices of generic drugs have been the subject of much scrutiny over recent years. From 2005 to 2010 the Australian Government responded to observations that Pharmaceutical Benefits Scheme prices for many generics were higher than in numerous comparable countries by instituting several reforms aimed at reducing the prices of generics. Despite this, several studies have demonstrated that prices for generic statins (one class of cholesterol-lowering drug) are higher in Australia compared with England and many other developed countries, and prices of numerous other generics remain higher than in the USA and New Zealand. Recently there has been increasing interest in why these differences exist. What does this paper add? By including a much larger range of commonly used and costly generic drugs, this paper builds significantly on the limited previous investigations of generic drug prices in Australia and England. Additionally, this is the first comprehensive investigation of multiple supply- and, in particular, demand-side factors that may explain any price differences between these countries. What are the implications for practitioners? Practitioners may contribute to the higher prices of generic medications in Australia compared with England through relatively low rates of generic prescribing. There are also significant implications for health policy makers, as this paper demonstrates that if Australia achieved the same prices as England for many generic drugs there could be substantial savings for the Pharmaceutical Benefits Scheme.
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Hailey, David. "The history of health technology assessment in Australia." International Journal of Technology Assessment in Health Care 25, S1 (July 2009): 61–67. http://dx.doi.org/10.1017/s0266462309090436.
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Objectives:To describe the development and application of health technology assessment (HTA) in Australia.Methods:Review of relevant literature and other documents related to HTA in Australia.Results:Most HTA activity in Australia has been associated with provision of advice for the two national subsidy programs, Medicare, and the Pharmaceutical Benefits Scheme (PBS). National advisory bodies established by the federal government have had a prominent role. Assessments from the advisory bodies have had a major influence on decisions related to Medicare and the PBS, and in some other areas. Technologies without links to the national subsidy schemes, and those that are widely distributed, have been less well covered by HTA. To some extent these are addressed by evaluations supported by state governments, but details of approaches taken are not readily available.Conclusions:HTA in Australia now has a long history and is well established as a source of advice to health decision makers. Challenges remain in extending the scope of assessments, developing more transparent approaches in some areas, and consistently applying appropriate standards.
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Searles, Andrew. "The PBS in a globalised world: free trade and reference pricing." Australian Health Review 33, no. 2 (2009): 186. http://dx.doi.org/10.1071/ah090186.
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In January 2005 Australia implemented the Australia? United States Free Trade Agreement (AUSFTA). The agreement had placed domestic health policy and the Pharmaceutical Benefits Scheme (PBS) in particular, on the trade negotiating table. At the time Australians were told the PBS would not be undermined, but why was it included in a trade agreement? This article argues that recent reforms to the PBS partially delivered on an issue that the US has compelled its trade negotiators to ensure since 2002: the elimination of reference pricing. In Australia, reference pricing, as used by the PBS, had been credited with obtaining money when buying new medicines.
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Brown, Laurie, Annie Abello, Ben Phillips, and Ann Harding. "Moving towards an Improved Microsimulation Model of the Australian Pharmaceutical Benefits Scheme." Australian Economic Review 37, no. 1 (March 2004): 41–61. http://dx.doi.org/10.1111/j.1467-8462.2004.00307.x.
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Walker, Agnes. "Distributional impact of higher patient contributions to Australia's Pharmaceutical Benefits Scheme." Australian Health Review 23, no. 2 (2000): 32. http://dx.doi.org/10.1071/ah000032.
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This paper uses NATSEM's Pharmaceutical Benefits Model to analyse the effects of a hypothetical25 per cent rise in patient contributions to prescribed medicines under Australia's PharmaceuticalBenefits Scheme (PBS). The model, based on microsimulation techniques, is able to provide a muchbroader range of outcomes information, at a much greater level of detail, than is possible withtraditional methods.Higher patient contributions are analysed in terms of their impact on the government to patient splitin PBS costs, as well as the distribution of such costs across age groups, family incomes, family types and36 prescribed medicine types. Also considered are changes in the shares of family disposable incomesspent on prescribed drugs arising from the higher patient contributions.
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Hodge, Robert L. "How Are Drugs Made Available in Australia?" International Journal of Technology Assessment in Health Care 2, no. 4 (October 1986): 683–90. http://dx.doi.org/10.1017/s0266462300003524.
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The release of prescription drugs in Australia for use by the medical profession is complicated because in practice there is a two-tier system determining availability. The first tier, for new drugs, involves evaluation for safety and efficacy prior to marketing. The final decision is made by the Australian Drug Evaluation Committee (ADEC) serviced by the Department of Health. In the second, much more unusual step, a decision is made by a different committee on whether the now-approved drug is to be included on the government-subsidized drug list (Pharmaceutical Benefits Scheme—PBS). Because the PBS list is unusually extensive for a country without a nationalized health service (1,184 items, including all forms and strengths of over 600 drugs) and because a large proportion of prescriptions are written for drugs on the PBS, the PBS Committee making the listing decisions has a major influence on prescribing patterns. In addition, the government is able to exert considerable pressure on drug prices.
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Probyn, Andrew J. "Some drugs more equal than others: pseudo-generics and commercial practice." Australian Health Review 28, no. 2 (2004): 207. http://dx.doi.org/10.1071/ah040207.
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This article analyses the impact of the Department of Health and Ageing?s brand price premium policy for some products listed on the Pharmaceutical Benefits Scheme. The policy, introduced in 1990, allows pharmaceutical companies to charge patients an out-of-pocket expense for post-patent brands of pharmaceuticals. One of the policy?s intended goals was to increase consumer awareness of price differentials between competing brands, with a view to encouraging greater use of cheaper generic products. More than fourteen years since its introduction, it is debatable whether the policy has achieved this aim. This article looks at how the brand price premium policy can be exploited by global pharmaceutical giants to entrench bigname brands in the Australian pharmaceutical market and, in some cases, prevent ?true? competition from generic pharmaceuticals. This is being done through the establishment of ?pseudogenerics? that are sourced from the same factory floor as the original product.
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Currie, Jane, Mary Chiarella, and Thomas Buckley. "Privately practising nurse practitioners' provision of care subsidised through the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme in Australia: results from a national survey." Australian Health Review 43, no. 1 (2019): 55. http://dx.doi.org/10.1071/ah17130.
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Objective Since legislative changes in 2010, certain health care services provided by privately practising nurse practitioners (PPNPs) in Australia have been eligible for reimbursement under the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS). The aim of the present study was to describe survey results relating to the care provided by PPNPs subsidised through the MBS and PBS. Methods PPNPs in Australia were invited to complete an electronic survey exploring their practice activities. Quantitative data were analysed using descriptive statistics and 95% confidence intervals were calculated for percentages where relevant. Free text data were analysed using thematic analysis. Results Seventy-three PPNPs completed the survey. The most common form of payment reported (34%; n=25) was payment by direct fee for service (MBS rebate only, also known as bulk billing). Seventy-five per cent of participants (n=55) identified that there were aspects of care delivery not adequately described and compensated by the current nurse practitioner (NP) MBS item numbers. 87.7% (n=64) reported having a PBS prescriber authorisation number. Themes identified within the free text data that related to the constraints of the MBS and PBS included ‘duplication of services’ and ‘level of reimbursement’. Conclusion The findings of the present study suggest that PPNPs are providing subsidised care through the MBS and PBS. The PPNPs in the present study reported challenges with the current structure and breadth of the NP MBS and PBS items, which restrict them from providing complete episodes of patient care. What is known about the topic? Since the introduction of legislative changes in 2010, services provided by PPNPs in Australia have been eligible for subsidisation through the MBS and PBS. What does this paper add? This paper provides data on PPNPs’ provision of care subsidised through the MBS and PBS. What are the implications for practitioners? Eligibility to provide care subsidised through the MBS and PBS has enabled the establishment of PPNP services. The current breadth and structure of the NP MBS and PBS item numbers have restricted the capacity of PPNPs to provide complete episodes of patient care.
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Almutairi, K., J. Nossent, D. Preen, H. Keen, and C. Inderjeeth. "POS0632 THE LONGITUDINAL ASSOCIATIONS OF METHOTREXATE AND BIOLOGIC USE ON HOSPITAL ADMISSION FOR RHEUMATOID ARTHRITIS PATIENTS IN WESTERN AUSTRALIA POPULATION (1995- 2014)." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 554.1–554. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3230.
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Background:Rheumatoid arthritis (RA) carries a substantial burden for patients and society in terms of morbidity, enduring disability, and costs [1]. The Australian Pharmaceutical Benefits Scheme (PBS) has subsidised biological disease-modifying anti-rheumatic drugs (B-DMARDs) since 2003 [2].Objectives:We examined the impact of B-DMARDs availability on RA hospitalisation rate in the Western Australia (WA) population pre- and post- B-DMARDs introduction to the PBS (1995-2002 and 2003-2014).Methods:Population PBS dispensing data for WA of DMARD were obtained and converted to defined daily doses (DDD)/1000 population/day using the WA population census. RA inpatient records were extracted from the WA Hospital Morbidity Data Collection using ICD-9 codes 714 and ICD-10 codes M05.00–M06.99). Principal component analysis (PCA) was applied to determine the relationship between DMARDs use and RA hospital admission rates.Results:There was a total of 17,125 patients who had 50,353 admissions with a diagnostic code for RA during the study period. DMARD use for RA rose from 1.45 to 3.19 DDD/1000 population/day over 1995-2014 (Figure 1). In 1995-2002, the number of RA admissions fell from 7.9 to 2.6 per 1000 hospital separations, then dropped further from 2.9 to 1.9 per 1000 hospital separations in 2003-2014. Based on PCA analysis, conventional DMARDs (methotrexate) and B-DMARDs dispensing had an inverse association with hospital admissions for RA.Conclusion:The increased availability of conventional and biological DMARDs for RA was associated with a significant decline in hospital admissions for RA patients in WA.References:[1]Boonen A, Severens JL (2011) The burden of illness of rheumatoid arthritis. Clin Rheumatol 30:3-8.[2]Medicare Australia (2020) Pharmaceutical Benefits Schedule statistics. http://medicarestatistics.humanservices.gov.au/statistics/pbs_item.jsp.Figure 1.The hospital separations and total drugs use patterns of RA in 1995-2014 in Western Australia.Acknowledgements:Supported by an Australian Government Research Training Program PhD Scholarship at the University of Western Australia.Disclosure of Interests:Khalid Almutairi: None declared, Johannes Nossent Speakers bureau: Janssen, David Preen: None declared, Helen Keen Speakers bureau: Pfizer Australia, Abbvie Australia, Charles Inderjeeth Speakers bureau: bureau: Eli Lilly
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Staatz, Christine E., Alesha J. Smith, and Susan E. Tett. "A comparison of mycophenolate use in Australia and Northern Europe, and the impact on the pharmaceutical benefits scheme." Pharmacoepidemiology and Drug Safety 18, no. 5 (May 2009): 386–92. http://dx.doi.org/10.1002/pds.1726.
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Gardner, Anne, Phillip R. Della, Sandy Middleton, and Glenn E. Gardner. "The status of Australian nurse practitioners: the first national census." Australian Health Review 33, no. 4 (2009): 679. http://dx.doi.org/10.1071/ah090679.
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A five-section questionnaire was mailed to all 234 authorised Australian nurse practitioners in late 2007. An 85% response rate was achieved (202 responses). Respondents had a mean age of 47.0 years and 84.2% were women. Only 145 nurse practitioners (72% of respondents) reported being employed in Australia at the time of the census. Emergency nurse practitioners were the most commonly employed nationally (26.9%). Nearly one third of employed nurse practitioners reported that they were still awaiting approval to prescribe medications despite this being a core legislated skill. Over 70% stated that lack of Medicare provider numbers and lack of authority to prescribe through the Pharmaceutical Benefits Scheme was extremely limiting to their practice. These findings are consistent with the international literature describing establishment of reformative health care roles.
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Dalton, Andrew. "Australia's pharmaceutical benefits system: flawed but improving, and better than anywhere else." Australian Health Review 24, no. 2 (2001): 7. http://dx.doi.org/10.1071/ah010007.
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The composition and role of the Pharmaceutical Benefits Advisory Committee (PBAC) has been the subject ofacrimonious debate through the media in recent months, with accusations of government subjugation to strongindustry lobby groups at the future expense of the Australian taxpayer. An understanding of the issues at thismore political level is helped by appreciation of the rationale for the current process of listing drugs forreimbursement on the Pharmaceutical Benefits Scheme (PBS). I will try to give the non-economist reader anoverview of the system and share some perceptions of the strengths and weaknesses of what is fundamentally agood system.
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Long, R., J. Luzuriaga, C. Biondi, A. Woods, P. Jackson, C. Anderiesz, C. Giles, and H. Zorbas. "Collection and Reporting of System-Wide Cancer Treatment Activity Data As Part of the Stage, Treatment and Recurrence (STaR) Project." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 74s. http://dx.doi.org/10.1200/jgo.18.61400.
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Background: The need for high quality, comprehensive national data on the treatments applied to cancers is widely recognized within the Australian cancer control community. The analysis and reporting of cancer treatment data will greatly enhance our ability to better understand cancer care activity and outcomes - and in particular the treatments being applied across population groups. Aim: To collect and report national data on cancer treatments, as part of Cancer Australia's Stage, Treatment and Recurrence (STaR) project. The linking of this data with national data on stage at diagnosis, survival and recurrence, will help inform policy and practice and ultimately improve cancer outcomes. Methods: Cancer Australia developed a dataset of selected surgical procedures for the treatment of the top five incidence cancers (prostate, breast, colorectal, lung, and melanoma). A dataset of key selected radiotherapy, and systemic therapies for the treatment of all cancer types was also developed. Data for reporting system-wide treatment activity were extracted from existing national health administrative datasets, including: the Pharmaceutical Benefits Scheme (PBS), the Medicare Benefits Schedule (MBS) and the National Hospital Morbidity Database (NHMD). The scope of the analysis was selected surgical procedures, radiotherapy procedures, or pharmaceutical agents administered with the general intent to change the outcome of the cancer and/or provide symptom relief/ palliative care. Results: The data reported provide a high-level national system-wide overview of cancer treatments applied, including: • More than 1 million radiotherapy services were provided for all cancers combined in Australia (as indicated by MBS reimbursement claims data) for the years 2013 to 2015 inclusive; • The number of people receiving systemic anticancer therapies in Australia for all cancers combined (as indicated by PBS reimbursement claims data) increased from 198,756 in 2012 to 247,939 in 2016; and • The number of hospital separations recorded in the NHMD (i.e., episodes of admitted patient care) for patients with a principal diagnosis of cancer undergoing surgery for the treatment of the top five high incidence cancers in Australia increased from 53,516 in 2010 to 57,651 in 2015. Conclusion: National cancer treatment data were successfully collected and reported. Australia is one of very few countries in the world to collect and report national system-wide treatment data with a specific focus on cancer. These data will be linked to cancer incidence, stage at diagnosis, survival and recurrence data to help inform for population-level reporting of cancer outcomes.
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Kjosavik, Svein R., Marianne H. Gillam, and Elisabeth E. Roughead. "Average duration of treatment with antipsychotics among concession card holders in Australia." Australian & New Zealand Journal of Psychiatry 51, no. 7 (February 14, 2017): 719–26. http://dx.doi.org/10.1177/0004867417691851.
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Objective: To analyse average treatment duration with antipsychotics reimbursed for concession card holders under the Pharmaceutical Benefits Scheme; the proportion of initial prescribing by general practitioners, psychiatrists and other physician; and the trend in drug choice in Australia. Method: Based on a representative 10% sample of patients receiving Pharmaceutical Benefits Scheme prescriptions since 2005, antipsychotics redeemed by concession card holders in the period from 2010 to 2013 were analysed. A 5-year baseline period was used to exclude prevalent users from incident users. Treatment duration was estimated using the epidemiological equation: prevalence/incidence = average duration. Results: The overall average treatment duration was 3.0 years, ranging from 1.5 years in patients aged 75 years and older to more than 4 years among patients aged 25–64 years. The most commonly used antipsychotics were olanzapine, risperidone and quetiapine, with average duration of 2.9, 2.1 and 1.7 years, respectively. Amisulpride was used longest with an average duration of 3.7 years. Quetiapine is currently the most prescribed antipsychotic and the main antipsychotic prescribed by psychiatrists to new users. The increased prescribing of quetiapine among general practitioners explains the rapid increase in the overall use of quetiapine. General practitioners initiated therapy in about 70% of cases, while psychiatrists and other physicians in about 15% each. In children younger than 15 years of age, paediatricians initiated such treatment in 47%. Conclusion: General practitioners both initiate and maintain treatment with antipsychotics for most adults, while paediatricians mainly begin such treatment in children. The substantial increase in use of quetiapine among general practitioners, along with the short treatment duration for quetiapine, strengthens a concern about antipsychotics increasingly used for less severe disorders. Increased collaboration between paediatricians and psychiatrists regarding the youngest and between general practitioners and psychiatrists or geriatricians regarding adults and older patients seems required.
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Bulfone, Liliana. "High prices for generics in Australia — more competition might help." Australian Health Review 33, no. 2 (2009): 200. http://dx.doi.org/10.1071/ah090200.
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It is commonly believed that dispensed prices of medicines in Australia are substantially lower than those in other developed countries, particularly the US. This article reports the results of an analysis comparing dispensed prices for the most commonly prescribed and the highest cost items in Australia with dispensed prices in the US. Although a large majority of items are less expensive in Australia than in the US, Australian prices are higher for a substantial number of products, particularly generic drugs. This article examines various policies affecting the pricing of generics in Australia. It is postulated that the main cause for higher prices for a substantial number of generic products is the lack of price competition. This results from government policy which ensures that a price reduction by one company is communicated immediately to all competitors in that market along with an invitation to match the reduced price. The dominant strategy for all suppliers is to only reduce their price in response to a reduction in price by a competitor. The result is a lack of differentiation in pricing across brands of a medicine on the Schedule of Pharmaceutical Benefits. The government could improve the structure of the generics market and encourage greater competition by ceasing to disclose competitor firms? offers to other competitors. The government could conduct pricing reviews of each generic product relatively infrequently (eg, only once annually or every 18 months). At the time of the pricing review, the government would request confidential offers on price for a generic from all players in the market. Brands should then all be listed under the Pharmaceutical Benefits Scheme (PBS) at the offered price. Prices offered by the individual supplier would apply until the next pricing review. The PBS would continue to subsidise up to the price of the lowest priced brand, with brand premiums applying to all brands priced higher than the benchmark price. Such an approach would provide opportunity for players in the market to capture market share by being the lowest priced brand.
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Behdarvand, Behrad, Emily A. Karanges, and Lisa Bero. "Pharmaceutical industry funding of events for healthcare professionals on non-vitamin K oral anticoagulants in Australia: an observational study." BMJ Open 9, no. 8 (August 2019): e030253. http://dx.doi.org/10.1136/bmjopen-2019-030253.
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ObjectivesTo describe the nature, frequency and content of non-vitamin K oral anticoagulant (NOAC)-related events for healthcare professionals sponsored by the manufacturers of the NOACs in Australia. A secondary objective is to compare these data to the rate of dispensing of the NOACs in Australia.Design and settingThis cross-sectional study examined consolidated data from publicly available Australian pharmaceutical industry transparency reports from October 2011 to September 2015 on NOAC-related educational events. Data from April 2011 to June 2016 on NOAC dispensing, subsidised under Australia’s Pharmaceutical Benefits Scheme (PBS), were obtained from the Department of Health and the Department of Human Services.Main outcome measuresCharacteristics of NOAC-related educational events including costs (in Australian dollars, $A), numbers of events, information on healthcare professional attendees and content of events; and NOAC dispensing rates.ResultsDuring the study period, there were 2797 NOAC-related events, costing manufacturers a total of $A10 578 745. Total expenditure for meals and beverages at all events was $A4 238 962. Events were predominantly attended by general practitioners (42%, 1174/2797), cardiologists (35%, 977/2797) and haematologists (23%, 635/2797). About 48% (1347/2797) of events were held in non-clinical settings, mainly restaurants, bars and cafes. Around 55% (1551/2797) of events consisted of either conferences, meetings or seminars. The analysis of the content presented at two events detected promotion of NOACs for unapproved indications, an emphasis on a favourable benefit/harm profile, and that all speakers had close ties with the manufacturers of the NOACs. Following PBS listings relevant to each NOAC, the numbers of events related to that NOAC and the prescribing of that NOAC increased.ConclusionsOur findings suggest that the substantial investment in NOAC-related events made by four pharmaceutical companies had a promotional purpose. Healthcare professionals should seek independent information on newly subsidised medicines from, for example, government agencies or drug bulletins.
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McManus, Peter, Donald J. Birkett, John Dudley, and Alan Stevens. "Impact of the Minimum Pricing Policy and introduction of brand (generic) substitution into the Pharmaceutical Benefits Scheme in Australia." Pharmacoepidemiology and Drug Safety 10, no. 4 (2001): 295–300. http://dx.doi.org/10.1002/pds.603.
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HARDING, ANN, ANNIE ABELLO, LAURIE BROWN, and BEN PHILLIPS. "Distributional Impact of Government Outlays on the Australian Pharmaceutical Benefits Scheme in 2001-02." Economic Record 80, s1 (September 2004): S83—S96. http://dx.doi.org/10.1111/j.1475-4932.2004.00187.x.
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Wang, Yichao, Jennifer Koplin, Shaoke Lei, Rachel Peters, Simon Horne, Harriet Hiscock, and Katrina Allen. "Time Trends in Adrenaline Auto-Injector Dispensing Patterns Using Australian Pharmaceutical Benefits Scheme Data." Journal of Allergy and Clinical Immunology 143, no. 2 (February 2019): AB431. http://dx.doi.org/10.1016/j.jaci.2018.12.976.
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Thng, Caroline Chun Mei. "A Review of Sexually Transmitted Infections in Australia – Considerations in 2018." Academic Forensic Pathology 8, no. 4 (December 2018): 938–46. http://dx.doi.org/10.1177/1925362118821492.
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Sexually transmitted infections (STIs) bear a high burden of disease and, subsequently, high health costs globally. Chlamydia, gonorrhoea, syphilis, and trichomoniasis contribute to nearly one million infections every day worldwide. Sexually transmitted infections continue to be the most frequently notified condition to the Australian National Notifiable Diseases Surveillance System and the numbers continue to increase. Australia has achieved several significant successes in reducing STIs and blood-borne viruses (BBV) including the significant decrease in genital warts in those less than 30 years old since 2007 following the launch of human papillomavirus vaccines in women, the virtual elimination of mother to child transmission of HIV, and the increased uptake of successful hepatitis C treatment following the availability of direct acting antiviral treatment on the Pharmaceutical Benefits Scheme. However, several challenges remain, including the ongoing rise of chlamydia, gonorrhoea, and syphilis over the last five years; the emergence of antibiotic resistance; and the increasing disparity in the prevalence of STIs and BBV in men who have sex with men, young people, and Aboriginal and Torres Strait Islander people, and challenges in the delivery of services to rural and remote Australia. In this paper, we aim to provide a snapshot of the current landscape and challenges for chlamydia, gonorrhoea, mycoplasma, syphilis and HIV infections in Australia.
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Lindsay, Daniel, and Emily Callander. "Quantifying the Costs to Different Funders over Five-Years for Women Diagnosed with Breast Cancer in Queensland, Australia: A Data Linkage Study." International Journal of Environmental Research and Public Health 18, no. 24 (December 8, 2021): 12918. http://dx.doi.org/10.3390/ijerph182412918.
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Individuals diagnosed with breast cancer have the highest rates of survival among all cancer types. Due to high survival, the costs of breast cancer to different healthcare funders are of interest. This study aimed to describe the cost to public hospital and private health funders and individuals due to hospital and emergency department (ED) admissions, as well Medicare items and pharmaceuticals over five years for Queensland women with breast cancer. We used a linked administrative dataset, CancerCostMod, limited to Queensland female breast cancer diagnoses between July 2011 and June 2013 aged 18 years or over who survived for 5 years (n = 5383). Each record was linked to Queensland Health Admitted Patient Data Collection, Emergency Department Information Systems, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between July 2011 and June 2018. Total costs for different healthcare funders as a result of breast cancer diagnoses were reported, with high costs and service use identified in the first six months following a breast cancer diagnosis. After the first six months post-diagnosis, the financial burdens incurred by different healthcare funders for breast cancer diagnoses in Queensland remain steady over a long period. Recommendations for reducing long term costs are discussed.
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Campbell, Julie A., Steve Simpson, Hasnat Ahmad, Bruce V. Taylor, Ingrid van der Mei, and Andrew J. Palmer. "Change in multiple sclerosis prevalence over time in Australia 2010–2017 utilising disease-modifying therapy prescription data." Multiple Sclerosis Journal 26, no. 11 (July 26, 2019): 1315–28. http://dx.doi.org/10.1177/1352458519861270.
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Objective: Determine the prevalence of multiple sclerosis (MS) in Australia in 2017 using MS-specific disease-modifying therapy (DMT) prescription data and estimate the change in prevalence from 2010. Methods: DMT prescriptions were extracted from Australia’s Pharmaceutical Benefits Scheme (PBS) data for January–December 2017. Percentages of people with MS using DMTs (DMT penetrance) were calculated using data from the Australian MS Longitudinal Study. Prevalence was estimated by dividing the total number of monthly prescriptions by 12 (except alemtuzumab), adjusted for DMT penetrance and Australian population estimates. Prevalences in Australian states/territories were age-standardised to the Australian population. Comparisons with 2010 prevalence data were performed using Poisson regression. Results: Overall DMT penetrance was 64%, and the number of people with MS in Australia in 2017 was 25,607 (95% confidence interval (CI): 24,874–26,478), a significant increase of 4324 people since 2010 ( p < 0.001). The prevalence increased significantly from 95.6/100,000 (2010) to 103.7/100,000 (2017), with estimates highest in Tasmania in 2017 (138.7/100,000; 95% CI: 137.2–140.1) and lowest in Queensland (74.6/100,000; 95% CI: 73.5–75.6). From 2010 to 2017 using the median latitudes for each state/territory, the overall latitudinal variation in MS prevalence was an increase of 3.0% per degree-latitude. Conclusion: Consistent with global trends, Australia’s MS prevalence has increased; this probably reflecting decreased mortality, increased longevity and increased incidence.
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Löfgren, Hans. "The economic crisis, the Pharmaceutical Benefits Scheme, and the dilemmas of medicines policy." Australian Health Review 33, no. 2 (2009): 171. http://dx.doi.org/10.1071/ah090171.
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AS THIS SPECIAL ISSUE of Australian Health Review was finalised, the media reported daily on the global financial debacle and its deepening into a crisis in the real economy. The causes of the crisis are hazy ? but its impact, across the globe, on people?s lives is real and distressing. Many people are affected by worsening poverty and deteriorating access to health services and medicinal drugs. In the United States, unemployment often means the loss of health insurance, reinforcing risks of financial and social disaster for many families who would have previously considered themselves comfortable middle class. For those lucky enough to retain jobs, the cost of health insurance may rapidly become unaffordable; ?Healthcare a Budget-Buster for Families; Even County?s Middle Class Can?t Afford It?, ran a typical recent headline in a non-metropolitan newspaper.1 Even before the present crisis, tens of millions of Americans were excluded from health insurance. Those not excluded pay premiums to insurance companies that spend vast resources trying to insure the healthy, avoid the sick, and deny payment for claims wherever possible. Gaining power partly on a wave of resentment against the excesses of neo-liberalism, President Barak Obama has promised public health insurance for those not otherwise covered. Should this reform be successfully implemented, it will belatedly bring to US citizens a level of security approximating what Australians, and many Europeans, have had for decades.
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Vitry, Agnes, Joel Lexchin, and Peter R. Mansfield. "Is Australia's National Medicines Policy Failing? the Case of Cox-2 Inhibitors." International Journal of Health Services 37, no. 4 (October 2007): 735–44. http://dx.doi.org/10.2190/hs.37.4.i.
Full textAbstract:
Australia has a National Medicines Policy with aims that include quality use of medicines, but policy stakeholders failed to protect Australia from the COX-2 (cyclo-oxygenase-2) inhibitor disaster. Drug regulators did not warn prescribers appropriately about potential cardiovascular risks. The Pharmaceutical Benefits Scheme did not limit unjustified drug expenditures on COX-2 inhibitors. Drug companies ran intense and misleading promotional campaigns on COX-2 inhibitors without adequate controls. Independent drug information was insufficient to counter the effects of the millions of dollars spent on advertising. Core elements of the National Medicines Policy—in particular the drug approval process, the post-marketing surveillance system, the control of drug promotion, and the quality of independent drug information—require major reappraisal if we want to avoid similar disasters in the future.
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Gisev, Natasa, Sallie-Anne Pearson, Timothy Dobbins, David C. Currow, Fiona Blyth, Sarah Larney, Adrian Dunlop, Richard P. Mattick, Andrew Wilson, and Louisa Degenhardt. "Combating escalating harms associated with pharmaceutical opioid use in Australia: the POPPY II study protocol." BMJ Open 8, no. 12 (December 2018): e025840. http://dx.doi.org/10.1136/bmjopen-2018-025840.
Full textAbstract:
IntroductionOpioid prescribing has increased 15-fold in Australia in the past two decades, alongside increases in a range of opioid-related harms such as opioid dependence and overdose. However, despite concerns about increasing opioid use, extramedical use and harms, there is a lack of population-level evidence about the drivers of long-term prescribed opioid use, dependence, overdose and other harms.Methods and analysisWe will form a cohort of all adult residents in New South Wales (NSW), Australia, who initiated prescribed opioids from 2002 using Pharmaceutical Benefits Scheme dispensing records. This cohort will be linked to a wide range of other datasets containing information on sociodemographic and clinical characteristics, health service use and adverse outcomes (eg, opioid dependence and non-fatal and fatal overdose). Analyses will initially examine patterns and predictors of prescribed opioid use and then apply regression and survival analysis to quantify the risks and risk factors of adverse outcomes associated with prescribed opioid use.Ethics and disseminationThis study has received full ethical approval from the Australian Institute of Health and Welfare Ethics Committee, the NSW Population and Health Services Research Committee and the ACT Health Human Research Ethics Committee. This will be the largest postmarketing surveillance study of prescribed opioids undertaken in Australia, linking exposure and outcomes and examining risk factors for adverse outcomes of prescribed opioids. As such, this work has important translational promise, with direct relevance to regulatory authorities and agencies worldwide. Project findings will be disseminated at scientific conferences and in peer-reviewed journals. We will also conduct targeted dissemination with policy makers, professional bodies and peak bodies in the pain, medicine and addiction fields through stakeholder workshops and advisory groups. Results will be reported in accordance with the REporting of studies Conducted using Observational Routinely collected Data (RECORD) Statement.
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Seaman, Karla L., Frank M. Sanfilippo, Max K. Bulsara, Tom Brett, Anna Kemp-Casey, Elizabeth E. Roughead, Caroline Bulsara, and David B. Preen. "Frequent general practitioner visits are protective against statin discontinuation after a Pharmaceutical Benefits Scheme copayment increase." Australian Health Review 44, no. 3 (2020): 377. http://dx.doi.org/10.1071/ah19069.
Full textAbstract:
ObjectiveThis study assessed the effect of the frequency of general practitioner (GP) visitation in the 12 months before a 21% consumer copayment increase in the Pharmaceutical Benefits Scheme (PBS; January 2005) on the reduction or discontinuation of statin dispensing for tertiary prevention. MethodsThe study used routinely collected, whole-population linked PBS, Medicare, mortality and hospital data from Western Australia. From 2004 to 2005, individuals were classified as having discontinued, reduced or continued their use of statins in the first six months of 2005 following the 21% consumer copayment increase on 1 January 2005. The frequency of GP visits was calculated in 2004 from Medicare data. Multivariate logistic regression models were used to determine the association between GP visits and statin use following the copayment increase. ResultsIn December 2004, there were 22495 stable statin users for tertiary prevention of prior coronary heart disease, prior stroke or prior coronary artery revascularisation procedure. Following the copayment increase, patients either discontinued (3%), reduced (12%) or continued (85%) their statins. Individuals who visited a GP three or more times in 2004 were 47% less likely to discontinue their statins in 2005 than people attending only once. Subgroup analysis showed the effect was apparent in men, and long-term or new statin users. The frequency of GP visits did not affect the proportion of patients reducing their statin therapy. ConclusionsPatients who visited their GP at least three times per year had a lower risk of ceasing their statins in the year following the copayment increase. GPs can help patients maintain treatment following rises in medicines costs. What is known about the topic?Following the 21% increase in medication copayment in 2005, individuals discontinued or reduced their statin usage, including for tertiary prevention. What does this paper add?Patients who visited their GP at least three times per year were less likely to discontinue their statin therapy for tertiary prevention following a large copayment increase. What are the implications for practitioners?This paper identifies the important role that GPs have in maintaining the continued use of important medications following rises in medicines costs.