Too much spent on non-PBS pharmacy meds: AMA


A new report on health spending has confirmed that pharmacists could play a bigger role in relieving some of the pressure on the health system, says the Guild… but the AMA queries meds costs

The Australian Institute of Health and Welfare has released its Health Expenditure Australia 2017-18 Report, which showed that more than $185 billion, or almost $7,500 per person, was spent on health goods and services in Australia during 2017–18.

“Total health spending increased by $2.2 billion in 2017–18 to $185.4 billion in constant prices. This was a 1.2% increase on 2016–17 against a backdrop of 3.9% average annual growth over the decade,” said AIHW spokesperson Dr Adrian Webster.

“The lower growth rate in 2017-18 was partly due to the previous year having included one-off capital expenditure on projects such as the new Royal Adelaide Hospital. It was also a result of a previous spike in Australian Government spending on new drugs to treat hepatitis C.

“Governments funded two-thirds ($126.7 billion) of total health spending in 2017–18, with the Australian government contributing $77.1 billion—$1.8 billion more than the previous year.”

Australia’s state and territory governments spent $49.5 billion—$1.3 billion less than the previous year.

“Health expenditure by governments represented 24.4% of tax revenue, a decline from 2016–17 where 26% of tax revenue was spent on health,” Dr Webster said.

“The decline in health expenditure as a proportion of tax revenue was primarily due to relatively rapid revenue growth when compared with previous years.”

In 2017–18, personal out-of-pocket health costs amounted to an average of $1,578 per person. There was little change in the proportion of individual net worth spent on health over the decade.

Contributions to health spending by private health insurers rose by $400 million to $16.6 billion in 2017–18.

“The decade has seen an overall increase in spending by private health insurance providers per person covered. In 2017–18, private health insurers spent an average of $1,470 per person covered, compared with $1,043 in 2007–08,” Dr Webster said.

The total number of people holding private health insurance decreased by almost 2 million over the decade.

AMA President, Dr Tony Bartone, said that the greatest contributor to patient out-of-pocket costs continues to be non-PBS medications, which includes vitamins and minerals and complementary therapies that are purchased over the counter at pharmacies.

“Medical costs make up only 13.1% of out-of-pocket expenditure for individuals,” Dr Bartone said.

“The AIHW report shows clearly that there is little change overall in national health spending.

“Medical services are not the highest or even second highest area of expenditure for an individual.

“The greatest contributor to patient out-of-pocket costs is over the counter medications, vitamins, and health-related products, many of which have no proven efficacy.”

President of the Pharmacy Guild of Australia, Victoria Branch, Anthony Tassone, said empowering pharmacists to practise to their full scope would lower healthcare costs for everyday Australians and provide better health outcomes for patients.

“The report demonstrates out-of-pocket costs for patients to access a GP could be significantly reduced by encouraging patients to see their pharmacist for common ailments,” Mr Tassone said.

Previous figures have shown more than half a million Australians have forgone seeing a doctor due to the cost, or the difficulty in getting an appointment; a number which will likely rise given the $38 million growth of GP out-of-pocket costs, he said.

“In other countries, like the UK and Canada, pharmacists are playing a greater role in their health systems helping reduce the cost for patients by up to $1 billion a year,” Mr Tassone said.

Allowing pharmacists to practise to their full scope could relieve some of the pressure on overworked GPs, freeing them to spend more time with their patients, treating more serious issues, he suggested.

“Giving pharmacists a greater role to treat common ailments, issue repeat prescriptions for stable and ongoing conditions, and administer more vaccinations, will provide better health outcomes and make accessing basic healthcare more affordable for Australian families,” Mr Tassone said.

Mr Tassone noted one of the few areas where there has been improvement in affordability for patients was in PBS-listed medication.

“Reform of the Pharmaceutical Benefits Scheme through successive Community Pharmacy Agreements with Federal Governments has helped more lifesaving treatments be listed and also reduce the amount patients are paying for medication, saving consumers $11 a year when compared to 2007-08,” he said.

“Better using pharmacists would also mean families don’t need to pay to see a doctor every time they need to top up their prescription, get their travel vaccinations or have an upset stomach, which would provide some relief to tight family budgets,” Mr Tassone said.

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