The impact of co-payment increases on dispensings of government-subsidised medicines in Australia
The impact of co-payment increases on dispensings of government-subsidised medicines in Australia
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DOI：
10.1002/pds.1670
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发表时间：
2008-11-01
影响因子：
2.6
通讯作者：
Semmens, James
中科院分区：
文献类型：
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作者：
Hynd, Anna;Roughead, Elizabeth E.;Semmens, James
目的2005年1月，根据澳大利亚药品福利计划(PBS)资助的药品患者自付费用增加了24%。我们调查了这一增长和两个相关的共同支付变化是否与澳大利亚选定的补贴药物的配药变化有关。方法我们分析了17种药物类别的全国月度处方配药总数，这些药物被选为代表一系列治疗方法(例如，糖尿病、心血管疾病、痛风)。结果随着2005年1月PBS自付金额的增加，17种处方中有12种(3.2%~10.9%)的处方数量显著减少，分别是抗癫痫药、抗帕金森病药物、哮喘联合用药、滴眼液、青光眼药物、HmgCoA还原酶抑制剂、胰岛素、肌肉松弛药、非阿司匹林抗血小板药、骨质疏松治疗药、质子泵抑制剂(PPIs)和甲状腺素。降幅最大的是用于治疗无症状疾病或使用非处方药(OTC)替代品的药物。自自付费用变化后，对社会保障受益人的分配的减少始终大于对一般受益人的分配(范围：增加1.8-9.4%，p=0.028)。结论研究结果表明，最近澳大利亚公共部门自付的增加对处方药的分配有显著的影响。结果表明，自付费用的大幅增加影响了患者支付基本药物的能力。令人主要关注的是，尽管澳大利亚系统为社会保障受益人提供特别补贴，但最近共同支付的增加对这一群体的使用产生了特别影响。版权所有(C)2008 John Wiley&Sons，Ltd.
Purpose Patient co-payments for medicines subsidised under the Australian Pharmaceutical Benefits Scheme (PBS) increased by 24% in January 2005. We investigated whether this increase and two related co-payrnent changes were associated with changes in dispensings of selected subsidised medicines in Australia.Method We analysed national aggregate monthly prescription dispensings for 17 medicine categories, selected to represent a range of treatments (e.g. for diabetes, cardiovascular diseases, gout). Trends in medication dispensings from January 2000 to December 2004 were compared with those from January 2005 to September 2007 using segmented regression analysis.Results Following the January 2005 increase in PBS co-payments, significant decrease in dispensing volumes were observed in 12 of the 17 rnedicine categories (range: 3.2-10.9%), namely anti-epileptics, anti-Parkinson's treatments, combination asthma medicines, eye-drops, glaucoma treatments, HmgCoA reductase inhibitors, insulin, muscle relaxants, non-aspirin antiplatelets, osteoporosis treatments, proton-pump inhibitors (PPIs) and thyroxine. The largest decrease was observed for medicines used in treating asymptomatic conditions or those with over-the-counter (OTC) substitutes. Decrease in dispensings to social security beneficiaries was consistently greater than for general beneficiaries following the co-payment changes (range: 1.8-9.4% greater, p = 0.028).Conclusions The study findings suggest that recent increase in Australian PBS co-payments have had a significant effect on dispensings of prescription medicines. The results suggest large increase in co-payments impact on patients' ability to afford essential medicines. Of major concern is that, despite special subsidies for social security beneficiaries in the Australian system, the recent co-payrnent increase has particularly impacted on utilisation for this group. Copyright (c) 2008 John Wiley & Sons, Ltd.