Analysis of the Pharmaceutical Benefits Scheme (PBS) in Australia

Desklib provides past papers and solved assignments for students. This report analyzes Australia's PBS.

Report
Student Name
Student ID
Table of Contents
Executive Summary.......................................................................................................2
Introduction....................................................................................................................4
General discussion of the issue......................................................................................4
Issues explored...............................................................................................................8
Conclusions....................................................................................................................9
REFERENCES...............................................................................................................9
1

2

Executive Summary
PBS (Pharmaceutical benefits scheme) is a major program which is launch by
government for providing health care facilities to various families who are in need. In
fact, a number of reformation has also been taken place in order to minimize the
probabilities of life risk as well as gives the best opportunities to them towards health
development. Thus, the project has been covering the necessary criterion related to the
PBS program with the help of several statistical data and information.
3

Introduction
Pharmaceutical benefits scheme is a program which is organized by Australian
governing bodies in order to offer subsidised prescription medicine to the populations
of Australia as well as to international visitors whose are covered under Reciprocal
Health care Agreement (Paige, and et. al., (2015). However, the main objective of this
government scheme is to make sure that every common people of Australia must
receive the affordable and reliable range of indispensable drugs. In fact, PBS is
considered as key component of Australian Health care. Therefore, this assignment is
going to cover issue associated with PBS by considering several related factors such
as; cost of the medicine, types of drugs consumed (prescribed and non-prescribed)
and so on. Additionally, precise understanding of PBS and its financial implications
on the health sector is also outlined in the project. Lastly, an effective suggestion will
also be added for efficient consumption of scheme by throwing lights on its positive
influence upon costs and consumption.
General discussion of the issue
Pharmaceutical Benefits Scheme is considered as key element for Australia’s health
care system because its main objective is to provide access to all the essential and
lifesaving drugs at a reasonable cost. Mainly, an existing provision which is
controlling the operational department of this scheme is embodied in Part VII of the
National Health Act 1953 as well as National Health Regulations 1960 is also made
under this Act. Basically, this benefit scheme has been introduced from more than the
last 50 years with the foremost advantage that has been made available for societal
people is in June 1948. This scheme has been engaged in supplying a minimal number
of “lifesaving” and illness protecting medicines free of cost to the common people. In
broader subsidised strategy which begins from 1st may 2002, health care sector have
to provide access to over almost 590 general medicines that are present in more than
approximately 1460 forms and further promoted over 250 distinct drug brands
(Clarke, (2012).
4

Previously, the origin of PBS is an outcome of various hard-fought battles and this
was initiated for the first time during the Second World War in to provide essential
medicines to returned servicemen. At the time of war (1939-1945), the Curtin
governing bodies have seen a requirement of offering creative lifesaving antibiotics
such as; sulphonamides, streptomycin and penicillin. Along with this, broader agenda
of Curtin Government is to create tax-funded national welfare scheme by ensuring
that war veterans and entire Australians people can easily afford antibiotics as well as
able to access more comprehensive list of indispensable drugs. Therefore, this vision
of Curtin/chiefly government enforces him to enact the Pharmaceutical Benefits Act
1944 after resolving several politic issues and opposition of general ideological
towards welfare state. Hence, as per this scheme of Curtin residents of Australia were
get eligible to access free prescribed drugs from their social pharmacies (Britt, et. al.,
2015).
Developing years of PBS: 1960-2005:- After the commencement of PBS to four
decades, this scheme has enjoyed considerable growth in terms of medicine supply
and in the expenditure of governing bodies also. In fact, data of office highlight that
during the era of 1960 to 2004 expenditure has been growing in double digit.
Although there are numerous of reasons are identified which shows the development
of PBS over this period.
5

According to above graphical representation, the annual growth rate of PBS has been
easily estimated as the demand for this scheme get increased at the fastest rate
because of several reasons such as;
 emergence of Medicare at the beginning of 1980s,
 presence of a maximum number of drugs for more or more treatments such
as; the launch of statins for controlling the blood cholesterol during the 1990s
after proving that this medicine is helping in reducing heart problems like;
attacks, pain in chest and controls deaths which incurred dur to heart
problems (Nichols, et. al., 2016).
 a step towards fresh and more complicated as well as high rate medicines,
 Maximization in proportion of common peoples who are eligible for
concession cards and ageing citizens.
By analysing the above diagrammatic representation, it has been understood that the
cost of PBS is increasing day by day as well as the requirement of health care in
Australia has also been increased because of demand upliftment. As a result,
governing bodies are trying to implement a new range of policies for ensuring
importance for money, controlling the budget and financial protection towards
deprived individuals with the minimum capability to pay for drugs. Mainly,
Australian statistics associated with Medicines is going to used which is produced by
Drug Utilization Sub-committee of Pharmaceutical Benefits consultative team.
6

However, data which is identified in ASM is representing the forecasting of aggregate
community on the use of prescription drugs in Australia. In fact, information which is
covered in 2015 Australian statistics is mainly sourced from department of human
service which registers the data related with PBS (Vitry & Roughead, 2014). Hence,
the department of health have used Anatomical Therapeutic Chemical code which is
suggested by the World Health organization in order to compare the usage of
prescribed and non-prescribed medicine. Thus, ATC code has covered almost seven
digit alphanumeric code which helps in classifying the medicines as per their site of
usage and chemical characteristics (Laver, et. al., 2016). Therefore, an appropriate
table will further explained for understanding the amount of using prescribed
medicine under PBS act with the help of ATC 14 code.
Table A (i): Subsidised prescriptions (PBS)
ATC Group 2013 2014 2015
(A) Alimentary Tract 3,02,85,538 3,11,84,729 3,17,69,327
(B) Blood and blood forming 93,15,858 96,75,843 1,00,19,801
(C) Cardiovascular system 7,03,72,716 6,81,45,369 6,66,13,110
(D) Dermatologicals 31,64,607 31,70,787 30,79,839
(G) Genitourinary system 33,81,145 35,40,065 36,01,733
(H) Hormonal preparations 33,18,623 34,69,552 35,87,541
(J) Antiinfectives 1,36,55,746 1,39,91,091 1,41,73,359
(L) Antineoplastic 31,49,116 33,58,857 35,57,383
(M) Musculo-skeletal 84,76,404 81,72,911 78,50,114
(N) Nervous system 4,74,18,280 4,94,28,420 5,09,27,262
(P) Antiparasitic products 6,11,474 6,10,344 6,04,857
(R) Respiratory system 1,16,76,550 1,18,75,303 1,20,42,449
(S) Sensory Organs 88,95,292 86,12,286 86,20,689
(V) Various 6,27,787 6,13,905 5,96,042
Other 1,71,128 1,69,507 1,76,871
Total 21,45,20,264 21,60,18,969 21,72,20,377
Table A (ii): Under co-payment
prescriptions (non-subsidised)
ATC Group 2013 2014 2015
(A) Alimentary Tract 76,31,763 81,86,957 85,66,538
(B) Blood and blood forming 10,01,367 11,48,833 11,72,887
7

(C) Cardiovascular system 1,81,62,624 2,11,19,235 2,38,20,941
(D) Dermatologicals 14,08,312 14,55,662 15,84,135
(G) Genitourinary system 31,81,543 33,31,238 32,78,334
(H) Hormonal preparations 22,15,227 23,76,895 25,15,752
(J) Antiinfectives 1,39,48,421 1,45,32,188 1,46,82,142
(L) Antineoplastic 67,966 89,334 1,56,039
(M) Musculo-skeletal 33,62,764 34,45,060 35,43,861
(N) Nervous system 1,28,78,587 1,48,99,247 1,65,90,718
(P) Antiparasitic products 6,20,536 6,29,849 6,24,767
(R) Respiratory system 11,74,757 12,27,951 13,86,652
(S) Sensory Organs 17,94,070 19,78,815 20,79,557
(V) Various 5,032 10,039 11,699
Other 49,380 47,999 46,484
Total 6,75,02,349 7,44,79,302 8,00,60,506
(Source- Australian Statistics on Medicines 2015, 2016)
According to above tabular representation, it has been understood that there is a
number of drugs have been used by common people across Australia such as; in 2015
almost 8, 00,60,506 members are using medicines under PBS (Australian Statistics on
Medicines 2015, 2016).
Issues explored
Pharmaceutical Benefits Scheme is considered as tenth largest commonwealth
government session which is now costing more than A$9 billion in a single year. In
fact, this has been seen as most indispensable aspect for health care system because
this helps common people to access necessary medicine with highest co-payment of
almost A$6.60 specially for concession card holders whereas A$36.90 for those who
are not having a card (Mellish, et. al., 2015). Recently, it has been noticed that PBS
advisory committed gives an effective suggestion on cost effectiveness related to
medicines which are listed on PBS but ultimately minister of health and governing
bodies provided a list of drug. Moreover, there is an absence of regular procedure of
active management of PBS budget. As a result, this can create major issues such as;
cost exceeded over $30 extra in a month for combining aspirin with other medicines.
8

However, PBS is encountering challenges and opportunities both. Therefore, the
committee of this program identifies the expense appropriateness of fresh medicines
and suggested that whether they are listed under this scheme or not. (Dobbin, 2014).
Consequently, government bodies have reformed their current policies for resolving
the problems such as; cost issues and issue regarding the usage of the medicine.
 Introduction of safety net in order to support singles and family members
whosever are requiring a number of medicine have to pay an only minimal
amount in every year. Additionally, they have to pay less for every script.
 Government is also launching a new cost effectiveness criterion for making
sure the value for money (Willis, et. al., 2016).
 Base price has been set up for certain medicines.
 Executing a package of Public Hospital Pharmaceutical reforms for enhancing
the care of patients and resolve the problem of inconvenience due to the
shifting of cost in between PBS as well as hospitals which were funded under
the state.
Conclusions
From the above report, it has been summarized that PBS has been gone through
various issues and opportunities because few members have accepted this whereas
some believe that this program is consuming maximum amount of cost. In fact,
Australians members have acquired appropriate facilities for curing their various
disease which is life taking. For example; the government have launched this program
for providing necessary drugs to needy people. Hence, main objective of this project
is to clarify the facts related with Pharmaceutical Benefits Scheme
REFERENCES Australian Statistics on Medicines (2015), [Online]. Available through<
http://www.pbs.gov.au/info/statistics/asm/asm-2015>.
 Britt, H., Miller, G. C., Henderson, J., Bayram, C., Harrison, C., Valenti, L., ...
& Charles, J. (2015). General practice activity in Australia 2014–15. Sydney
University Press.
 Clarke, P. M. (2012). Challenges and opportunities for the Pharmaceutical
Benefits Scheme. The Medical Journal of Australia, 196(3), 153-154.
9

 Dobbin, M. (2014). Pharmaceutical drug misuse in Australia. Aust
Prescr, 37(3), 79-81.
 Laver, K., Cumming, R., Dyer, S., Agar, M., Anstey, K., Beattie, E., ... &
Dietz, M. (2016). Clinical practice guidelines for dementia in Australia.
 Mellish, L., Karanges, E. A., Litchfield, M. J., Schaffer, A. L., Blanch, B.,
Daniels, B. J., ... & Pearson, S. A. (2015). The Australian Pharmaceutical
Benefits Scheme data collection: a practical guide for researchers. BMC
research notes, 8(1), 634.
 Nichols, M., Peterson, K., Herbert, J., Alston, L., & Allender, S.
(2016). Australian heart disease statistics 2015. Melbourne: National Heart
Foundation of Australia.
 Paige, E. and et. al., (2015). Using Australian Pharmaceutical Benefits Scheme
data for pharmacoepidemiological research: challenges and approaches.
 Vitry, A., & Roughead, E. (2014). Managed entry agreements for
pharmaceuticals in Australia. Health Policy, 117(3), 345-352.
 Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the
Australian health care system. Elsevier Health Sciences.
10