“More than $1 billion could be saved”

New report reveals potential savings of over $1 billion to the Australian economy, if just a few prescription meds were switched to non-script status

The World Self-Medication Industry (WSMI) has launched a new report, accepted for publication in the Journal of Medical Economics, which quotes savings figures if a few prescription medicines were classified to non-prescription status.

In “The value of self-medication: summary of existing evidence”, Joshua Noone and Christopher Blanchette from Precision Health Economics in the US conducted a literature review of 17 articles, including 11 modelling studies and six retrospective analyses.

They reveal a range of common conditions for which non-prescription medications could be used to treat and implement self-care strategies.

In particular, specific therapy areas that best-demonstrated potential savings included:

  • Allergic rhinitis and chronic urticaria – through keeping non-sedating antihistamines on non-prescription status.
  • Migraine – if medications for migraine treatment from the triptan class (naratriptan, sumatriptan) were approved as non-prescription drugs.
  • Heartburn/non-ulcer dyspepsia – for example, if H2 receptor antagonist famotidine was switched to non-prescription status.
  • Symptom management of common cold – where cough medications containing dextromethorphan as the active ingredient remain available as non-prescription.
  • Cardiovascular disease – through use of non-prescription statins.

It found that if medicines related to the above areas became available without a prescription, there would be a significant reduction in the number of doctor visits.

The authors refer to an Australian study jointly funded by the Macquarie University Centre for the Health Economy (MUCHE) and the Australian Self-Medication industry (ASMI), which evaluated the economic value of non-prescription medication to the Australian healthcare system.

Estimated increases in cost to the Australian healthcare system, associated with eight categories of non-prescription medications being hypothetically switched to prescription-only status, were $3.8 billion in doctor’s visits, of which Medicare would pay out $2.5 billion, health insurers $360 million, and individuals $1 billion.

These costs were predicted to increase to more than $10 billion per year if the indirect costs of doctor
appointments were considered, such as time travelling to and from the clinic, and the impact that taking time off work to see a doctor would have on productivity.

A presenter at the WSMI General Assembly in Sydney last week, Dr Eric Brass, Professor of Medicine at the University of California, used the example of Proton Pump Inhibitor medicines in the US to demonstrate the potential benefit of non-prescription medicine availability.

“Before the availability of certain non-prescription drugs for gastroesophageal reflux disease (heartburn), physician visits were increasing,” said Dr Brass.

“After the introduction of non-prescription PPIs, the physician visits for GERD were halted and there was a stable visit rate.

“No evidence was found for increased visits or worsened outcomes for gastrointestinal conditions which might be masked by PPI treatment.”

Savings to the healthcare system are clear, say the authors of the literature review.

“The cost savings associated with self-care are beneficial to the patient, the healthcare system, and the broader economy,” they argue.

“Self-care allows many common conditions to be managed without time spent in a formal healthcare setting.

“Avoiding physician visits can also benefit the patient directly in terms of cost savings … time saved and improved workplace productivity.”

They add that while more evidence is “clearly needed”, through improving access to health products, people will be able to manage their own health in subsequently deliver significant savings for overstretched healthcare systems.

Journal of Medical Economics 2017; accepted author version posted online 10 Oct 2017.

Note: Funding for the paper was provided by the World Self-Medication Industry.

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  1. JimT

    Just say that Statins were non-script then you have the potential of having a lot of people taking them that may not need to via “clever marketing” and then the potential of side effects and extra doctors visits to work this out. Ton the other end you may also have a group of people that may not continue with statin therapy if it becomes non script with other dire consequences which then involves more intensive intervention. Both of these potential cases then add to the health bill. The article talks about the savings but nothing about potential extra costs.

    • Andrew

      Agreed – diabetes +++ in particular. A false economy when you prevent two heart attacks but create six diabetics.

      • JimT

        exactly…no word on the true opportunity cost ???

    • Red Pill

      It could be done. But a new schedule needs to be created separate from cold and flu, whereby said medicines should be supplied after taking a medical history and performing appropriate monitoring. Xenical could also fall under this category. Specialised Pharmacists conducting these practices should be given a provider number amd be allowed to claim a consultation fee on top of the cost of the drug. This fee should be lower than a GP and will save a significant amount of costs.

  2. Greg Kyle

    So a large part of the savings quoted are ” $3.8 billion in doctor’s visits, of which Medicare would pay out $2.5
    billion, health insurers $360 million, and individuals $1 billion”. Who will be paying the pharmacists for their expertise and involvement in the sales of the drugs mentioned? Why has this not been factored into the equation, or are WSMI expecting pharmacists to give away their expertise for nothing … again????

    • JimT

      classic case of cost shifting from the public purse to user pays……..do you see pensioners paying otc price …I don’t think so…….so if these drugs stay on NHS for consession holders (politically savy) the numbers are crap already………

    • Red Pill

      Spot on Greg. This can not roll out unless a new ‘specialised’ team of pharmacists are trained to monitor and supply these medicines. The S3 model and layout has many flaws, such as lack of privacy and record keeping as well as remuneration. These should only be downscheduled if they are supplied through a consultation in a private area with adequate record keeping and collection of medical history. We failed on codeine lets not do the same with these.

  3. PharmOwner

    Anyone see the story on 4 Corners about the NBN? $1 billion in savings is peanuts compared to the dog’s breakfast NBN rollout. Superseded third-world technology and it’s costing us MANY billions of dollars.

  4. olga

    The government saves money because a patient can get advice (a service) from a pharmacist for free on those medications mentioned above. But they have to pay to see a doctor for a quick turnaround visit. A service is a service whether it’s done by a doctor or pharmacist. Unfortunately, pharmacists have been trained not to think so. It’s time pharmacists started lobbying for a service fee when they advise patients.

  5. Paige

    If we take all medication off the PBS ad we introduce a free market on medicine and encourage competitive discounting even further we could save medicare even more!! /s

    • Jarrod McMaugh

      Kudos on the Reddit syntax.
      I wonder how many get it.

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