The Pharmaceutical Benefits Scheme: Providing Access To Affordable Medicine In Australia

History of the Pharmaceutical Benefits Scheme

Discuss about the Australian Health Scheme for Pharmaceutical Benefits Scheme.

The pharmaceutical benefits scheme is an initiative by the government of Australia that makes the prescription medication accessible and cost-effective to the general public. The pharmaceutical benefits scheme manages to make the medicine available to the people by providing them at a subsidized prize.The thought of having a body that would regulate the kind of medicine entering Australia and control their prices was first initiated in 1944. Some people were against the idea; therefore, it was rejected by the law court. In 1948 PBS began it’s under many limitations. It restricted to ensuring the provision of free medication to the pensioners (Robertson, Walkom, Bevan, & Newby (2013). Lifesaving medicines and approximately one hundred and thirty-nine synthetic substitute drugs were made available to the general public. The scheme got very strong in1953 when it was for the first time allowed to be under the national health act. Until today the pharmaceutical benefits scheme is among the main components of national medicine policy. In 1960 PBS restriction to some extent got withdrawn. It became an all-encompassing scheme which was obligated to assess and allow different types of medication gain access to Australian citizens. Two hundred and eleven million and above prescription had been registered to the pharmaceutical benefits scheme for subsidizing by 2014. More than nine billion dollars is the approximate total amount of money the medication cost the government of Australia. The amount is averagely twenty-one percent of the total expenditure on health issues.

The government also established an advisory committee that is not part of pharmaceutical benefits scheme which is has a responsibility of assess all the drugs and make their recommendation on which qualifies to be listed by the PBS (Janamian, Crossland, & Wells, (2016).  In addition, the committee recommends the drugs that are supposed to be withdrawn from the list of PBS because of the public safety.

The Australian therapeutic good register must have listed the medication so that they are allowed for listing in the pharmaceutical benefits scheme. The companies that produce different types of medicine have to apply for them to be listed with the therapeutic goods administration.  A medical trial evidence from registered clinics are essential, therefore they must be provided as a means of ensuring the health safety of the patient who is likely to use the drugs. The set quality standards must be met by the medication. The drugs must also reduce the amount of money spent by the government to buy other medicine of the same condition provided in the market.

Role of the PBS in regulating medication in Australia

The national health act states that pharmacist has to be approved for them to dispense drugs from specific pharmacies. The government caters for a certain percentage of the cost while the patients pay for the remaining amount. The amount of money paid by the patient for the medication are decided and set by the PBS to protect the public.  A maximum of 37.70 dollars was paid in 2015 by the pensioners for the PBS drugs, while 6.10dollars were paid by the cohesion patients for each prescription.

Though Australia’s life expectancy is among the best in the world, the cases of death causing diseases are very high. diseases like coronary heart diseases, kidney problems, diabetes, dementia and stroke are among the main causes of deaths to both men and women. NHS report in 2014 showed that 1.2 million people were diagnosed with diabetes, over11 million people had chronic diseases like cardiovascular diseases, cancer and arthritis. Eleven million people were obese which is estimated to be sixty-three percent of the adult population.

The table below shows the top leading causes of death by sex in Australia between 2014 and 2015.

Disease	Men	Women
Coronary heart disease	11016	8750
Dementia and Alzheimer disease	3656	7277
Cerebrovascular diseases	4181	6368
Lung cancer	4995	3222
Chronic obstructive pulmonary disease	3572	2890

A safety net scheme was also established by the government of Australia to make sure the people with high medications needs feel safe and protected. If a patient had spent around 1453.90 dollars in 2015 on the PBS prescription, the government intervened to ensure for the best part of the year the patient paid only 6.10 per prescription. A medication policy set by the Australian government has a responsibility of formulating a suitable framework which should facilitate the improvement of health throughout the country (Cashin, (2014).  The outcomes of health should be improved through making sure that the Australians get access to the best quality medications for different health challenges. The main objective of the policy is to improve health care services for better life for all the people in Australia.

The roles and responsibilities of the health care system in Australia are shared by the national government and the local territory and state government. The national government runs and also funds all the public hospitals while the private health centers are owned and run by the private sectors. These private hospitals are regulated by government health policies. In 2013 -2014, the health budget of Australia was 9.8% of the gross domestic income which was $155billion compared to the 2012- 2013budget that was equivalent to$150. The health expenses of the Australian healthcare on hospital infrastructure and services delivery remained at 40% consistency over the decade. 

Benefits of the Pharmaceutical Benefits Scheme

According to the 2013- 2014 health budget, the pharmaceutical cost through Pharmaceutical Benefits Scheme (PBS) was contributed by primary and community care group. The Australian government of Australia contributed a huge portion in the medical care system (Mellish. (2015). $105 billion came from the central government which is around 68% of the Australian budget of 2013- 2012. State and territory government of Australia support the primary health care with the huge portion of funds to carry out their activities, which is approximately $6.2 billion. In 2013 the non-governmental sector total contribution was approximately $50 billion that is equal to 18% of the total health expenditure. The funds raised for non- subsidized medications for example under co-payment medicines, those offered through the counter and for private patient prescription resulted from individuals and it ranged $9.0 billion. According to the report from the department of health of 2015 the rate of health expenses increased by 1.7%.

The introduction of the new generic medicines affected the negotiable pharmaceutical drug prices was due to the significant increase in the expenditure rate. These new medicines lead to fluctuations of prices in the pharmaceutical market (Cashin, Stasa, Dunn, Pont, & Buckley (2014). The situation of inadequate health services was not as a result of the increase in the subsidized medicines cost due to a wide distribution of generic drugs at this period from 2008 million in 2012 to 223 million in 2013. The reduction scheme policy is responsible for any changes that occur in the private sector insurance fund regulation tax as authorized by the Australian government.  The policy applied in the 2012 to 2013 period where the private sector insurance cover altered from 7.4% to 8.3%.

For the private patients who wish to cover the cost of hospital bills or for covering other subordinate healthcare services, they are provided with private health insurance. 11.3 Australian people who make up the 47% of the total population were issued with private insurance cover and 13.3 Australian people which are 56% had applied for general treatment cover in 2015 (Lingam (2013). The government also intervened the private health patient by assisting in reducing the burden in some severe diseases. The national government paid for a certain percentage of the private patient hospital bills. The key reason for the standardization of healthcare in Australia is enhanced by the government through interventions in hospital bills of both private and general patient. Through healthcare infrastructure improvement by both the territory and central government has led to the ease of people of Australia in assessing the medical services. The Australian healthcare sector which is referred to as the Health Council plays the role of providing a forum of service delivery and regulation on both primary and secondary health issues also considering the cost issues (Whitty, & Littlejohns, (2015). The drug usage in Australia can be used as a measure of the regulatory intervention and in providing pharmaceutical analysis guideline.

The healthcare system in Australia

The distribution of medicine and prescription is controlled by the government subsidization schemes such Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Scheme (RPBS) (Johnston, & Bruzsa, (2013), March). The Australian medication has been divided into two forms; prescribed and non- prescribed form. The prescribed forms involve the medical officer or the professional instructions and advice for their usage. Some examples of the prescribed medication include pain relievers, blood pressure and heart problem medications. The non- prescribed form of medication in Australia are the ones that do not require proceedings from any professional pieces of advice and they include; minerals, vitamins and herbal medications (Lowe Plummer& Boyd. 2013).  According to the rules of the Therapeutic Goods Act 1989, when the new medicine is discovered, it is the responsibility of the manufacturing company to ensure that the new drug registered and approved before it is availed to the market. The company then is free to list the new medicine to the PBS for proper supply and marketing. Examples of the most commonly used medicine in Australia are; Amoxicillin, Esomeprazole, Pantoprazole, (Paracetamol, Atorvastatin and, perindopril MacLellan (Higgins, & Levett?Jones,2015). 

Conclusion

The government support and intervention in the health sector of Australia have led the sprouting of good reliable healthcare services to the people. There is a need of improving on cost and production of quality medicine by ensuring the effective laws of price and product regulation to the manufactures. The level of cost standardization is low and should be implemented with immediate effect. The PBS faces challenges as some of their products are restricted and require preauthorization from Medicare registration center. Another problem arises in the field of prices where there is disagreement among the producing institution. There is the weakness in terms of efficiency in the post-market surveillance and a lot is to be done to alter this. Problems that arise when there are weaknesses in incentives in the manufacturer’s line of pricing agreement this may result in the production of low-quality medicines (Vitry, Shin, & Vitre, (2013). Discovery of new generic medicines to the market do influences prices of the medicines and unless a rule is set this will be a usual challenge Equity has to be ensured as co-payment brings about an inequality challenge in the PBS products. There is a need for standardization of cost-effectiveness according to the government regulation policy on PBS. Some studies sectors that are sponsored by some pharmaceutical producers may exaggerate the result by favoring the sponsoring organizations.  (Sedal, Wilson, & McDonald, (2014)

References

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Cashin, A., Stasa, H., Dunn, S. V., Pont, L., & Buckley, T. (2014). Nurse practitioner prescribing practice in Australia: Confidence in aspects of medication management. International journal of nursing practice, 20(1), 1-7.

Janamian, T., Crossland, L., & Wells, L. (2016). On the road to value co-creation in health care: the role of consumers in defining the destination, planning the journey and sharing the drive. The Medical Journal of Australia, 204(7), 12.

Johnston, M., & Bruzsa, L. (2013, March). Development of an innovative steerable double extendable trailer under performance based standards (PBS). In International Conference on Heavy Vehicles HVParis 2008 (pp. 97-108). John Wiley & Sons, Inc.

Lingam, V. (2013). Community pharmacy reforms in A ustralia. International Journal of Pharmacy Practice, 21(4), 273-274.

 Lowe, G., Plummer, V., & Boyd, L. (2013). Nurse practitioner roles in Australian healthcare settings. Nursing Management (through 2013), 20(2), 28.

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.

MacLellan, L., Higgins, I., & Levett?Jones, T. (2015). Medical acceptance of the nurse practitioner role in Australia: a decade on. Journal of the American Association of Nurse Practitioners, 27(3), 152-159.

Robertson, J., Walkom, E. J., Bevan, M. D., & Newby, D. A. (2013). Medicines and the media: news reports of medicines recommended for government reimbursement in Australia. BMC public health, 13(1), 489.

Sedal, L., Wilson, I. B., & McDonald, E. A. (2014). Current management of relapsing?remitting multiple sclerosis. Internal medicine journal, 44(10), 950-957.

Vitry, A. I., Shin, N. H., & Vitre, P. (2013). Assessment of the therapeutic value of new medicines marketed in Australia. Journal of pharmaceutical policy and practice, 6(1), 2.

Whitty, J. A., & Littlejohns, P. (2015). Social values and health priority setting in Australia: an analysis applied to the context of health technology assessment. Health Policy, 119(2), 127-136.