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|Title:||Increased patient co-payments and changes in PBS-subsidised prescription medicines dispensed in Western Australia|
|Citation:||Australian and New Zealand Journal of Public Health, 2009; 33(3):246-252|
|Publisher:||Public Health Assoc Australia Inc|
|Anna Hynd, Elizabeth E. Roughead, David B. Preen, John Glover, Max Bulsara and James Semmens|
|Abstract:||OBJECTIVE: To determine whether a 24% increase in patient co-payments in January 2005 and two related co-payment changes for medicines subsidised under the Australian Pharmaceutical Benefits Scheme (PBS) were associated with changes in dispensings in Western Australia (WA). METHOD: We analysed aggregate monthly prescription counts and defined daily dose per 1,000 population per day (DDD/1,000/day) for atypical antipsychotics, combination asthma medicines, HmgCoA reductase inhibitors (statins) and proton-pump inhibitors (PPIs). Trends pre and post the co-payment increase in January 2005 were compared. RESULTS: In three of the four categories examined, prescription counts were significantly lower following the increase in co-payment thresholds. Compared with dispensings prior to the co-payment increase, prescriptions fell by 8% for combination asthma medicines (p<0.001), 9% for PPIs (p<0.001) and 5% for statins (p<0.001). Following the rise in co-payments, DDD/1,000/day decreased for all four categories. Decreases in dispensings to concessional beneficiaries were between 4% and 5% larger than for general beneficiary patients. CONCLUSIONS AND IMPLICATIONS: The reduction in the both prescription counts and DDD/1,000/day observed for combination asthma medicines, PPIs and statins, which all remained above co-payment thresholds, suggests the increase in PBS co-payments has affected utilisation of these subsidised medicines. The results indicate that increases in patient contributions particularly impact on concessional patients' ability to afford prescription medicines.|
|Keywords:||Humans; Pharmaceutical Preparations; Cost Sharing; Financing, Government; Insurance, Pharmaceutical Services; National Health Programs; Western Australia; Databases as Topic|
|Description:||The definitive version may be found at www.wiley.com|
|Appears in Collections:||Public Health publications|
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