Impact of increasing the re‐supply interval on the seasonality of subsidised prescription use in Australia

Abstract

Objective:To evaluate the impact of increasing the minimum re‐supply period for prescriptions on the Pharmaceutical Benefits Scheme (PBS) in November 1994. The intervention was designed to reduce the stockpiling of medicines used for chronic medical conditions under the PBS safety net. Methods:Interrupted times series regression analyses were performed on 114 months of PBS drug utilisation data from January 1991 to June 2000. These analyses assessed whether there had been a significant interaction between the onset of the intervention in November 1994 and the extreme levels of drug utilisation in the months of December (peak utilisation) and January (lowest utilisation) respectively. Both serial and 12‐month lag autocorrelations were controlled for. Results:The onset of the intervention was associated with a significant reduction in the December peak in drug utilisation; after the introduction of the policy there were 1,150,196 fewer prescriptions on average for that month (95%Cl 708,333–1,592,059). There was, however, no significant change in the low level of utilisation in January. The effect of the policy appears to be decreasing across successive post‐intervention years, though the odds of a prescription being dispensed in December remained significantly lower in 1999 compared to each of the pre‐intervention years (11% vs. 14%) Conclusion:Analysis of the impact of increasing the re‐supply period for PBS prescriptions showed that the magnitude of peak utilisation in December had been markedly reduced by the policy, though this effect appears to be decreasing over time. Continued monitoring and policy review is warranted in order to ensure that the initial effect of the intervention be maintained.

A Comparison of Benzodiazepine and Related Drug Use in Nova Scotia and Australia

“…19 All this exists despite numerous initiatives to improve rational prescription including the use of clinical practice guidelines, electronic decision support tools, formularies, copayments, therapeutic and generic substitution policies, and education of doctors and pharmacists. 24,[34][35][36][37] Of particular concern is the continuing use of long-acting benzodiazepines that are contraindicated in the elderly. 8,9 Our results from Australia and Canada confirm findings from the United States that benzodiazepines with longer half-lives such as diazepam and nitrazepam are some of the most common compounds prescribed.…”

Assessing overall duration of cardiovascular medicines in veterans with established cardiovascular disease

“…The system results in a phenomenon described as 'stockpiling', where increased dispensings are observed in November and December each year with a subsequent decrease in January and February [13]. For all new subsidized medicines, pack sizes are generally sufficient for a duration of 1 month.…”

Patterns of medication use in Queensland Australia and the impact of a large copayment increase: an exploratory study

“…As discussed earlier in this chapter, regulatory changes introduced into the PBS to counter this behaviour contributed to a decline in the December peak in dispensed PBS medications (Donnelly et al, 2000).…”

“…As discussed in the previous chapter, patient copayments are subject to a safety net threshold which allows for a reduction in the copayment once the total cost incurred by the patient during the calendar year exceeds the amount set as the safety net threshold for that year. Therefore, once a general patient reaches the safety net threshold for general patients the copayment becomes the same as that for a concessional patient for the rest of the year (See for example, Donnelly, McManus, Dudley & Hall, 2000;McManus, 1993).…”

“…In response to this, legislation was introduced in 1994 which increased the minimum resupply interval for a repeat dispensing for chronic disease medications from three to 20 days, and medications for acute conditions from three to four days. This measure was associated with a significant decline in the December peak in PBS medicine supply (Donnelly et al, 2000). However, Donnelly and colleagues also found that the initial impact of the policy in reducing stockpiling and hoarding was not sustained over time.…”