Pharmaceutical Benefits Scheme (PBS) Report: Issues and Solutions

This report provides an executive summary and detailed analysis of the Australian Pharmaceutical Benefits Scheme (PBS). It explores the scheme's origins, objectives, and its role in subsidizing medicine costs for Australians. The report delves into various issues, including unethical advantages, application delays, and methodological challenges. It examines the impact of the PBS on medicine pricing and the potential for overuse of pharmaceutical drugs. The study also highlights the importance of government initiatives and high-level rigor in addressing these issues. The report concludes with recommendations for improving the scheme's effectiveness, including the need for sufficient time for evaluation and swift action to mitigate delays. The report references key legislation, such as the National Health Act (1953), and provides insights into the cost-benefit aspects of the PBS, including the PBS Safety Net. This report aims to provide a comprehensive overview of the PBS, offering valuable insights into its operations and challenges.

PBS

Executive Summary
The study has highlighted various discussions regarding Pharmaceuticals benefits scheme. This
scheme is important to minimize the cause of medicines and which can be beneficial for the
common Australians to decrease the medical costs. The Australian government has enforced this
issue under the section National health Act (1953). The Australian government uses to invest
21% of their total medical allotment on pharmaceutical Benefit Scheme. The issues highlighted
are the unethical advantage issue, delay issue, and methodological issue. The issues must be
decreased with an effective initiative from the Australian government and high-level rigor.
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Table of Contents
Executive Summary.....................................................................................................................................1
Introduction.................................................................................................................................................3
General discussion of issue..........................................................................................................................3
Issues explored............................................................................................................................................5
Conclusions.................................................................................................................................................6
References...................................................................................................................................................8
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Introduction
Pharmaceuticals Benefits Scheme (PBS) was developed by the Australian government to
subsidize the medical costs. The initial attempt was to provide free medications to the
Australians. This includes antibiotics and emergency medicines. The Australian government
submitted this proposal in 1944. However, later the proposal was dismissed in Australian High
court and a regulation was released in 1948. The regulation states that the free medications
would be provided for the pensioners and most of the medicine would be common life-saving
medicines (Currow & Sansom, 2014). At the early of 1960, more medicines were included in the
free medications for the pensioners. Presently PBS is one of the important parts of the National
Medicines policy of Australia under the regulation National Health Act (1953). As per a recent
report, the subsidy provided by the Australian government to the PBS is around $9.1billion
which is 21% of overall Australian health expense. Moreover, the number of prescription
gathered by the government is 211million. However, the number of medicines are including
gradually within the PBS scheme along with the invested amount. This study will aim to explore
the issues that the Australian government is facing regarding the PBS scheme and the number of
risk factors will be identified (Faunce, 2015). In addition, the betterment procedures of the
organization will be analyzed properly. The interventions for the overuse or mal-use of this
scheme will be analyzed followed by a conclusion outlining the key factors of the study by
outlining an overall solution. The ultimate exploration of the study will pay attention to the
disclosures of the ultimate prices under this policy and effect of PBS on the pricing of the
medicines.
General discussion of the issue
The PBS scheme has been enforced by the government of Australia to mitigate the health issues
around Australia. It would affect the healthcare practices for the old ages around the country.
Presently, the Australian government has included around 793 types of medicines within this
scheme and 2066 forms of medical dosages of these medicines. In addition, 5300 brands would
sponsor those 793 types of medicines. Recently, PBS has applied a new scheme; PBS Safety Net
that would protect the cost of the patients from buying costly medicines in a whole year
(Goddard, 2014). This policy of this scheme state medicine facility would be free for those
persons and families who would avail the medicines to the equal amount of threshold from
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Safety net. This facility would be beneficial for the patients to reduce their medical costs for the
rest of the year. In addition, the amount of threshold does not equal the amount of medical price
for the whole year, the patient would only have to pay only $6.20. For the amount of threshold
worth $372, the patients would get a large concession of the medicine price up to $1457. Thus,
these cost-benefit techniques are used to increase the financial capability of the common people
by reducing the price of the medicine and medical treatment (Graham, 2017). The scheme has
segregated medicines into five categories; general medicines, veterans medicines, medicines with
special arrangements, statistical PBS medicine, and the lifesaving medicines.
General medicines: The general medicines imply the medicines that are dispensed by the
community medicines. This type of medicine falls under the General Schedule of National
Health Act (1951) under the Section 85.
Veterans' medicines: These are the subsidized medicines that are provided for the pensioners and
the veterans which is regulated by the departments of Veterans Affairs. The veterans medicines
are generally provided under the Veterans Entitlements Act (1986).
Medicine with special arrangements: the medicines with special arrangements are the necessary
medicines that are not generally provided to the community pharmacies. It requires special
storage and special arrangement due to its sensitivity which is not available in the community
pharmacies (Groenewold & Paterson, 2013). These types of medicines are provided under the
Section100. The special arrangements include special drug programs and efficient findings.
Moreover, the scheme subsidies in the toxin medicines, growth medicines and fertilization
medicines are depicted to be increasing.
Statistical PBS medicines: The statistical PBS medicines include the PBS statistics regarding the
expenditure of the PBS through prescriptions. The prescriptions are generally not cost beneficial
an. Thus, the ultimate focus of the business is to provide a report based on the general medicines
and PBS reports that are intended in the official websites of the Human Service department.
Lifesaving medicines: A large number of subsidy is provided by the Australian government on
the lifesaving medicines. The subsidies are provided under the campaign of Lifesaving Drug
program. So far, 278 families around Australia were helpful with this facility (Hassali, Shafie,
Babar & Khan, 2012).
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Issues explored
Issues on PBS
Several issues have been identified regarding the PBS. The issues are :
 Unethical advantageIssue: Unethical advantage is one of the key issues that can be
stated on PBS scheme. This scheme was generally enforced for the people who are not
financially capable enough to buy costly and lifesaving medicines. However, some
people were taking unethical advantages of this scheme and use to avail the threshold to
reduce the normal prices of the medicines. Indirectly, this affects the financial efficiency
of Australia. In addition, the needy people sometimes become unable to avail this
opportunity of subsidy (Knott, Clarke, Heeley & Chalmers, 2015).
 The diversity in the clinical settings, disease and pharma and non-pharmacological
treatments in Australia can be a hindrance to the effective utilization of PBS. Hence, it is
impossible to measure the improvement of a cancer patient having two months of
progression level. An equalized cost of the medicine is genuinely required to clarify the
statistics. Further, the issue got complicated while defining the distinction between
treatment and the available resources for the treatment (Lofgren, 2009).
 Application issue: Delay in the application is one of the key issues as the government of a
normal price of the medicines can be differentiated into high price medicine, increase in
the cost of the medicine and delay in the market accession. Thus, it creates complication
while implicating the PBS evaluation.
Further improvement
There must be given sufficient time to evaluate the PBS scheme. The evaluation of the PBS
scheme would be helpful to identify the ultimate costs and the available schemes for that person.
Moreover, the government must enforce a quick initiative to mitigate the delay issue by
enforcing several crucial norms. In addition, if a medicine is not properly applicable to the norms
mentioned in PBC regulations, the sponsors of PBC should prepare and resubmit the listing of
PBC (Löfgren, 2009).
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A recent statistics has signified that high-level rigor must be applied to detect the differences in
treatment. Moreover, it can be applied to identify the types of and resources of differences. Thus,
it has clinically different from the clinical outcomes.
Effect on overuse
The misuse of pharmaceutical drugs is increasing over the years. An evidence-based survey has
disclosed the overuse of drugs a concerning on the drug treatment data. The application of PBS
technique is not harmful at all but the overuse is associated with the poisoning, injection-related
problems and unethical selling of pharmaceutical equipment's (Robertson, Walkom & Henry,
2009). The key factors that can affect misuse or overuse of medicines are
 Availability multiple opioids
 The clinical advice from the medical institutions that have invoked the use of medicine
even after discharge from the medical institutions
 Difficulty in pain management
 Unavailability of non-opioid treatment
 The intimidation would lead the patient to inappropriate prescription
The demographical changes would impact on the population of aging and increase demand for an
opioid. However, the non-opioid is unavailable is correlated with the overuse of drugs. The
application of the PBS scheme is capable of mitigating the opioid issue (Salkeld, 2011).
Conclusions
The study has focused on several aspects of PBS scheme which was specially developed to
mitigate the high-cost issues on buying the important medicines. It has been a cost-benefit
scheme on the part of the Australian government and under the section 85 of legislation National
Health Act (1951). Around 273 families were beneficial out of this scheme and most of them got
free medicines. The people got $372 threshold got the medicines within $6.20. There are 793
types of medicines have been labeled under this category and the types of medicines attached to
these categories are 2066. 5300 brands are associated with the scheme. However, there are
several issues raised in this scheme regarding unethical advantage issue, methodological issue,
and delay in application issue (Gowing, Hickman & Degenhardt, 2013). Sufficient time must be
given to evaluating the PBS scheme and the government must be is hurriedness to mitigate the
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delay issues. Otherwise, the schemes can be used or overused. Thus, ethical implementation of
the issue is required for the effective outcome and it is required to apply high-level rigor to
decrease the issues regarding the proper implication of PBS.
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References
Currow, D., & Sansom, L. (2014). Uptake of medicines and prescribing patterns in the palliative
care schedule of the Pharmaceutical Benefits Scheme. The Medical Journal Of
Australia, 200(10), 560-561. doi: 10.5694/mja14.00188
Faunce, T. (2015). How the Australia-US free trade agreement compromised the pharmaceutical
benefits scheme. Australian Journal Of International Affairs, 69(5), 473-478. doi:
10.1080/10357718.2015.1048785
Goddard, M. (2014). How the Pharmaceutical Benefits Scheme began. The Medical Journal Of
Australia, 201(1), 23-25. doi: 10.5694/mja14.00124
Gowing, L., Hickman, M., & Degenhardt, L. (2013). Mitigating the risk of HIV infection with
opioid substitution treatment. Bulletin Of The World Health Organization, 91(2), 148-
149. doi: 10.2471/blt.12.109553
Graham, D. (2017). Regulation of proprietary traditional Chinese medicines in
Australia. Chinese Journal Of Natural Medicines, 15(1), 12-14. doi: 10.1016/s1875-
5364(17)30004-3
Groenewold, N., & Paterson, J. (2013). Stock Prices and Exchange Rates in Australia: Are
Commodity Prices the Missing Link?. Australian Economic Papers, 52(3-4), 159-170.
doi: 10.1111/1467-8454.12014
Hassali, M., Shafie, A., Babar, Z., & Khan, T. (2012). A study comparing the retail drug prices
between Northern Malaysia and Australia. Journal Of Pharmaceutical Health Services
Research, 3(2), 103-107. doi: 10.1111/j.1759-8893.2011.00080.x
Knott, R., Clarke, P., Heeley, E., & Chalmers, J. (2015). Measuring the Progressivity of the
Pharmaceutical Benefits Scheme. Australian Economic Review, 48(2), 122-132. doi:
10.1111/1467-8462.12103
Lofgren, H. (2009). Generic Medicines in Australia: Business Dynamics and Recent Policy
Reform. SSRN Electronic Journal. doi: 10.2139/ssrn.1471687
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Löfgren, H. (2009). The economic crisis, the Pharmaceutical Benefits Scheme, and the dilemmas
of medicines policy. Australian Health Review, 33(2), 171. doi: 10.1071/ah090171
Robertson, J., Walkom, E., & Henry, D. (2009). Transparency in pricing arrangements for
medicines listed on the Australian Pharmaceutical Benefits Scheme. Australian Health
Review, 33(2), 192. doi: 10.1071/ah090192
Salkeld, G. (2011). Pharmaceutical Benefits Scheme cost recovery. Australian Prescriber, 34,
62-63. doi: 10.18773/austprescr.2011.036
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