Economic study finds holes in PBS safety net

Mar 4 2013

Associate Professor Andrew Searles

The Australian National Medicines Policy aims to facilitate access to prescription medicines at a cost that is affordable to individuals and the community, however a new study led by HMRI health economist Associate Professor Andrew Searles has found that some consumers are struggling to afford the out-of-pocket costs required for their medication needs.

In a media release issued by the Australian Healthcare and Hospitals Association, Associate Professor Searles says: “The PBS safety-net and co-payment thresholds are supposed to protect consumers with high medication expenses. However, many people still report problems accessing medicines because of the cost.”

The study aimed to create and report indicators of the affordability of prescription medicines for patients in Australia and was based on telephone interviews with 1502 randomly selected participants in the Hunter Region of NSW.

Nine per cent of consumers reported extreme to heavy financial burdens associated with the cost of their prescription medicines.  A further 19.5 per cent reported a moderate level of burden.

This means that the current co-payment and safety net thresholds are not protecting nearly one-third of Australian patients from financial burden.
Low burden was recorded for participants who said that their prescription medicines presented either a slight burden (29 per cent) or were no burden at all (42.6 per cent).

“Cost can be a barrier to accessing medicines and a lack of access can result in adverse health outcomes for patients. Ultimately the costs to consumers and the health system can be higher if health conditions become more serious and require more intensive and expensive treatment such as hospital admission,” Associate Professor Searles says.

“The indicators developed in this project now need to be used to build a comprehensive tool to evaluate the affordability of prescription medicines for patients. Ongoing evaluation of the impact on patients from the co-payment and safety net thresholds is needed to ensure the National Medicines Policy’s principle of equitable and affordable access to medicines is upheld and that the cost of healthcare, as an essential service, remains affordable for all Australians.”