1 / 27

Australia’s National Medicines Policy

Australia’s National Medicines Policy. Libby Roughead University of South Australia. Health expenditure as a proportion of GDP. Per capita health expenditure 2001. Healthy life expectancy at birth: 2002. Pharmaceutical expenditure as a proportion of health expenditure.

Download Presentation

Australia’s National Medicines Policy

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Australia’s National Medicines Policy Libby Roughead University of South Australia

  2. Health expenditure as a proportion of GDP

  3. Per capita health expenditure 2001

  4. Healthy life expectancy at birth: 2002

  5. Pharmaceutical expenditure as a proportion of health expenditure

  6. Costs of providing medicines are increasing

  7. Medicines are consuming a larger part of the health budget 1984-85 2002/03

  8. Australia’s National Medicines Policy • Endorsed by parliament in 2000 Goal: • To meet medication and related service needs, so that both optimal health outcomes and economic objectives are achieved http://www.health.gov.au/haf/nmp/objectives/policy.htm

  9. Equitable access to necessary medicines Quality use of medicines Medicines of high quality safety and efficacy A viable & responsible local pharmaceutical industry

  10. Medicines meeting appropriate standards of quality, safety and efficacy • Achieved via the Therapeutic Goods Administration (est 1958) • Approves for marketing • Prescription medicines • Over-the-counter medicines • Complementary therapies • Current policy development, harmonisation of regulatory arrangements with New Zealand

  11. Maintaining a responsible and viable pharmaceutical industry • Australia has had an industry development program since 1988 • In 2004, Pharmaceuticals Partnerships Program (P3) was launched • Provides $150 million over the five years to support R&D in Australia • Pharmaceuticals are Australia’s third largest manufactured export after automobiles and wine

  12. Timely access to the medicines that Australians need, at a cost the individual and the community can afford • Australia’s Pharmaceutical Benefits Scheme • Universal access to necessary medicines • Initiated in 1950, with 139 life saving and disease preventing medications available free • Today, 593 drugs (1451 forms, 2558 products) • Restrictions apply to 778 of the items, 288 of which require prior authorisation

  13. Pharmaceutical Benefits Scheme • Accounts for over 90% of all community medicine use in Australia • Consumers pay a proportion of total costs • $4.60 for concession card holders • $28.60 for general beneficiaries • Safety net system • Maximum concession card holders annual costs $239.20, then supplied free. • Maximum costs of $874.90 per annum for general beneficiaries

  14. Assessment of medicines for subsidy • Pharmaceutical Benefits Advisory Committee (PBAC) • Statutory committee established under the National Health Act • Health minister cannot list a medicine under the scheme without a positive recommendation from the PBAC

  15. Assessment of medicines for subsidy In assessing medicines for listing, the committee is required by legislation to consider: • Comparative efficacy • Comparative safety • Cost-effectiveness • Cost-minimisation assessment or cost-effectiveness assessment • Cost-effectiveness has been mandatory since 1993

  16. USA-Australian Free Trade Agreement Current policy developments due to the agreement • An independent review process of PBAC decisions • where the PBAC decided not to list a medicine • PBAC is still the final arbiter of the decision • Hearings before the PBAC; limited in scope & to specific issues • Improved transparency of PBAC decisions with publication of public summary documents; previously all material was commercial in confidence

  17. Quality Use of Medicines • National Strategy for Quality Use of Medicines • Established 1992 • In response to strong consumer lobby http://www.health.gov.au/haf/nmp/quality.htm

  18. The Original Vision for QUM (1992) National Facilitation & Co-ordination Australian National Formulary Consumer education for self-reliance Awareness Motivation Confidence Stimulate teamwork General awareness Objective Information Education & Training Consumer Services Provider Services Campaigns School kits & adult learning Academic detailing National Therapeutic Guidelines Medication records Elderly Core curricula for providers Models of practice Asthma Medication review Australian Prescriber Analgesics Undergraduate, postgraduate & continuing ed’n Audit & feedback Compliance aids Consumer Medicines Information Out-of-date medication Disposal of unwanted medicines Critical appraisal of promotion Multidisciplinary team approach Ethical promotion Targeted Grants for Further Development

  19. The Original Vision for QUM (1992) Objective Information Education & Training Consumer Services Provider Services Campaigns National Facilitation & Co-ordination Australian National Formulary Consumer education for self-reliance Awareness Motivation Confidence Stimulate teamwork General awareness School kits & adult learning Academic detailing National Therapeutic Guidelines Medication records Elderly Core curricula for providers Models of practice Asthma Medication review Australian Prescriber Analgesics Undergraduate, postgraduate & continuing ed’n Audit & feedback Compliance aids Consumer Medicines Information Out-of-date medication Disposal of unwanted medicines Critical appraisal of promotion Multidisciplinary team approach Ethical promotion Targeted Grants for Further Development

  20. QUM services and resources (2005) Objective Information Education & Training Consumer Services Provider Services Campaigns National Facilitation & Co-ordination Australian National Formulary Consumer education for self-reliance Awareness Motivation Confidence Stimulate teamwork General awareness Academic detailing School kits & adult learning National Therapeutic Guidelines E-medication record developing Elderly Core curricula for providers Models of practice Antibiotics Medication review Australian Prescriber Analgesics Undergraduate, postgraduate & continuing ed’n Audit & feedback Compliance aids Consumer Medicines Information Out-of-date medication Disposal of unwanted medicines Critical appraisal of promotion Multidisciplinary team approach Ethical promotion Targeted Grants for Further Development

  21. Ensuring quality use of medicines • Over $100 million committed over next four years

  22. The challenge • Is the policy framework holding the tensions?

  23. Cost-effectiveness assessments and impact on pricing • Costs of selected new medicines: Australia and USA • Etanercept • Aus PBS price 4x25mg = $US 734; • US FSS price $US 360 DrugStore.com $US600 • Imatinib 400mg 30 • Aus PBS price $US 2934; • US FSS price $US 2413 DrugStore.com $US2440

  24. Cost-effectiveness assessments and impact on pricing

  25. Cost-effectiveness assessments and impact on uptake of new molecular entities

  26. Conclusions • Australia’s national medicines policy aims to hold the tensions between the major objectives of the policy at the macro and micro levels • Macro level tensions, such as industry development versus access and affordability • Tensions also need to be acknowledged and held at the local level • eg hospital needs versus community needspharmacy needs versus medicines needsconsumer needs versus health professional needs

  27. Conclusions • Lack of comprehensive linked data sets in Australia limit conclusions, about how well the Australian framework balances the competing tensions. • However, currently the policy appears to be meeting its major objectives as measured by the national indicators. The real test will be if the policy framework achieves these objectives in 2020

More Related