If levels of growth for Australia's Pharmaceutical Benefits Scheme (PBS) get much lower, "there would be grounds for concern that the government was not investing enough in patient access to medicines," says an industry leader.
Dr Brendan Shaw, chief executive of industry group Medicines Australia, was commenting on new government figures showing that the PBS grew just 5.2% in 2010-11, or 1.6% in real terms, and also on the forecasts of the Mid-Year Economic and Fiscal Outlook (MYEFO) that PBS spending to 2020 will be A$1.8 billion lower than expected.
"These latest figures convey a very clear message - PBS spending is under control and is not presenting the government with any fiscal challenge," said Dr Shaw, adding: "if anything, there is probably a good case for increasing investment in the PBS."
Alongside the MYEFO's expectations, the Department of Health's expenditure report also points to a sustainable PBS with extremely modest spending growth that is not much above inflation, while the medicines deferred by the Cabinet in February had had "next to no impact on these numbers, given the small costs involved," said Dr Shaw, who has called on the government to "stop and look at this data carefully as it frames the 2012 federal budget."
Government spending on the PBS for the year ended June 30 totaled A$8.87 billion, compared to A$8.39 billion the previous year, the Department reports. Total PBS prescription volumes rose 2.3% to 188.1 million, it notes, adding: "the growth in government expenditure compare with a smaller rise in prescription volume reflects the continuing trend of doctors prescribing newer and more expensive drugs, particularly strong growth in highly-specialised drugs."
Government expenditure amounted to 83.7% of the total cost of PBS prescriptions, the rest being accounted for by patient contributions, which rose to A$1.42 billion from A$1.38 billion the previous year.
The three drugs with the highest cost to government during the year were atorvastatin (A$597.8 million), rosuvastatin (A$312.6 million and ranibizumab (A$247.6 million). The PBS drug most frequently dispensed was atorvastatin, followed by esomeprazole magnesium trihydrate and rosuvastatin.
Meantime, Dr Shaw has also warned against calls for Australia's management of the PBS to be guided by the New Zealand model, following a recent report that New Zealanders have access to less than half the number of prescription drugs available to Australians.
The study, published in The New Zealand Journal of Medicine, also shows that new medicines gain regulatory approval on average nine months sooner in Australia than in New Zealand, and are listed for government subsidy almost three years earlier.
"The evidence highlights the fact that there are simply no subsidised medicines available at all in a number of therapeutic areas, and a disturbing lack of treatment option in many areas. That's what happens when you don't invest in healthcare and your primary focus is on cost-cutting," said Dr Shaw, who described New Zealand as "a basket case when it comes to access to medicines."