Consumer Co-payments For Subsidised Medicines: Impact On Access And Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$465,838.00
Summary
Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and di ....Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and discretionary medicines fell immediately after the introduction of copayments for concessional card holders in 1991(5). Subsequent analysis found that low income general beneficiaries bore the greatest burden of copayments, with PBS expenditure accounting for 7.4% of their income, compared with 2.4% for those with high incomes(6). Costs appear to be becoming a barrier to medicine use in Australia, with a 2005 survey of 702 Australian adults who required regular medications finding 22% did not fill a prescription because of cost in the last 2 years(7). Similar results were reported in 2002 for 23% of 844 sicker Australian adults(8). A regional survey of 420 households found 20% reported they did not purchase all of their prescription medicines due to costs(9). Apart from the initial analysis of medication changes in 1991 as a result of copayment introduction(5), no Australian study has assessed the impact of these on medication use, nor on the impact of any changes in medication use on health outcomes. While copayments may effectively reduce the cost burden of the PBS to government, they may have an unintended negative effect if costs are generated elsewhere in the health system through increased hospitalisations or emergency department attendances as a result of omission of medicines. This research will explore the association between increasing copayments, medication and health service utilisation, information critical for informing policy on increasing consumer copayments.Read moreRead less
Design And Analysis Of Interrupted Time Series Studies In Health Care Research: Resolution Of Methodological Issues
Funder
National Health and Medical Research Council
Funding Amount
$307,125.00
Summary
An interrupted time series (ITS) study involves a population observed on multiple occasions before and after the implementation of an intervention program. However, methods for statistical analysis and designing such studies have not been well developed and many statistical analyses of such studies are flawed. This proposal will investigate appropriate methods for design and analysis, and develop guidelines and software for its implementation by health researchers.
Economic Evaluation Of The Costs And Benefits Of Options For Publicly Funded Dental Care Provision In Australia
Funder
National Health and Medical Research Council
Funding Amount
$219,135.00
Summary
Governments and administrators of public dental services (PDS) currently address resource allocation problems with little guidance from the public. This project will provide evidence of population priorities that can underpin planning for public dental care and provide direction for priorities in PDS A cost-benefit analysis of dental care, to guide future decisions, will be conducted by comparing the community's willingness to pay for dental services and the cost of providing those services.
Climate Change And Rural Communities: Integrated Study Of Physical And Social Impacts, Health Risks And Adaptive Options
Funder
National Health and Medical Research Council
Funding Amount
$611,599.00
Summary
Rural Australia has begun to experience climate change impacts - which will increase in future. Losses in farm yields, water supplies, property, community morale and family incomes have diverse health effects. We will study the separate and joint effects of climate change and associated extreme events (e.g., bushfires) on selected health outcomes. Using integrative methods, we will clarify the main influences on health risks, their future projections, and how best to intervene to lessen risks.