Australian Institute of Health and Welfare (2020) Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use, AIHW, Australian Government, accessed 18 August 2022.
Australian Institute of Health and Welfare. (2020). Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use. Retrieved from https://pp.aihw.gov.au/reports/health-care-quality-performance/covid-impacts-on-mbs-and-pbs
Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use. Australian Institute of Health and Welfare, 17 December 2020, https://pp.aihw.gov.au/reports/health-care-quality-performance/covid-impacts-on-mbs-and-pbs
Australian Institute of Health and Welfare. Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use [Internet]. Canberra: Australian Institute of Health and Welfare, 2020 [cited 2022 Aug. 18]. Available from: https://pp.aihw.gov.au/reports/health-care-quality-performance/covid-impacts-on-mbs-and-pbs
Australian Institute of Health and Welfare (AIHW) 2020, Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use, viewed 18 August 2022, https://pp.aihw.gov.au/reports/health-care-quality-performance/covid-impacts-on-mbs-and-pbs
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This web report looks at the influence of COVID-19 on the Pharmaceutical Benefits Scheme (PBS) (including the Repatriation Schedule of Pharmaceutical Benefits (RPBS)) over the first eight months of 2020. The analysis compares the number of prescriptions dispensed and government benefits paid with the same period in the previous year.
Across the PBS, the total volume of scripts dispensed was similar in the 2019 and 2020 periods, with an increase of 0.6% in 2020. Over the past 7 years the yearly average growth in PBS script volumes was 1.5%, with the annual percent change ranging from -1.2% to 3%. This finding suggests that, to date, the COVID-19 pandemic has had minimal influence on overall script volumes for 2020.
There were other impacts during the period with changes in consumer behaviour coinciding with the introduction and then easing of restrictions. For example, there were unusually high volumes of scripts dispensed in March 2020, coinciding with the introduction of restrictions nationally, and this was followed by a decrease in April 2020. While it is difficult to directly measure the factors influencing health service use by the population, we can see the impacts on the PBS in the service use data. More detail on these impacts are provided below.
In March 2020, the Australian Government implemented temporary changes to medicines regulation to support Australians’ continued access to PBS medicines in response to the COVID-19 pandemic. Some of these changes were in response to a dramatic increase in demand for medicines during early March, which resulted in pharmacies and wholesalers reporting medicine shortages (1).
The temporary measures included:
The following data visualisation shows the difference in the number of scripts dispensed (per cent), in January to August, 2019 and 2020, nationally:
The following data visualisation shows the total amount of government benefits paid, in January to August, 2019 and 2020 nationally through the PBS:
This line graph compares the monthly scripts dispensed and government benefits paid from January to August 2020 compared to the same period in 2019. Beyond the spike in script volume in March 2020 the monthly scripts for 2019 and 2020 followed a similar trajectory. Except for a slight drop in benefits paid in May 2020, the monthly benefits paid was higher than the same month in the previous year.
Scripts dispensed are presented using greater capital city statistical areas as defined by the Australia Bureau of Statistics. Scripts were assigned to an area based on the patient's Medicare enrolment postcode which corresponds to most people’s residential address.
The following data visualisation shows the difference in the number of scripts dispensed (per cent), in January to August, 2019 and 2020, nationally and in each state and territory. States and territories are further split by greater capital cities and rest of state/territory areas:
This visualisation presents monthly scripts dispensed graphically and as a table, in states/territories and greater capital city areas. The line graph shows that the national pattern of script volumes was generally consistent across the states/territories. The table and bar graph show the percent change comparing the same months in 2020 to 2019. Northern Territory had either the largest percent increase or the smallest percent decrease in a month
People obtain their medicines via an original (first time dispensing of a prescription) prescription or refill their medicines via a repeat (subsequent supply from an original prescription) prescription.
In response to the COVID-19 pandemic, from March 2020 the Australian Government introduced a range of temporary telehealth items in the MBS which allowed various medical practitioners to provide consultations either by telephone and/or videoconference. These changes included the introduction of digital image based prescriptions.
These temporary measures may have changed consumer behaviour. Original prescriptions may have decreased when telehealth was not feasible, and consumers may have chosen to avoid attending healthcare appointments.
The following data visualisation shows the number of scripts dispensed by original or repeat prescription, nationally and at state and territory levels from January to August, 2019 and 2020:
This visualisation presents monthly scripts dispensed from an original or a repeat prescription. The line graph shows a similar pattern over the 8 months for both types of scripts with repeat scripts (27.3%) having a greater percent increase in March 2020 from March 2019 compared to original scripts (17.4%). The bar chart shows that following the consistent spike across all variables in March 2020, the percent change for repeat scripts moved into the positive while original scripts remained in the negative. All states and territories, except the Northern Territory, experienced a percent decrease in original scripts dispensed in April to August 2020 compared to the same period in 2019. The Northern Territory had a percent decrease in April and May 2020 then returned to a percent increase in June to August.
The PBS allows for original and repeat prescriptions to be supplied at the same time, in certain circumstances, according to Regulation 49 (previously Regulation 24). A common use of this rule is for people living or travelling to very remote areas within Australia or overseas. At the early stages of the pandemic there was significant concern around medication shortages and the risk of this option being overused.
The following data visualisation shows the number of scripts dispensed concurrently, nationally and at state and territory levels from January to August, 2019 and 2020:
This visualisation presents monthly scripts dispensed where an original prescription and all repeats were dispensed all together. Comparing 2020 to 2019, all states and territories had a percent increase in March and percent decreases from April to August.
The majority of PBS medicines are prescribed by medical professionals and dispensed by community pharmacies. The PBS also provides specific schedules for other prescribers such as dentists and optometrists. There are also several programs funded under Section 100 of the National Health Act that provide alternative ways of providing medicine when the usual supply through community pharmacies is unsuitable. The largest of these are the Highly specialised drugs and Efficient funding of chemotherapy programs, both relate to medicines provided predominantly in tertiary care facilities such as hospitals, rather than in the community.
The following data visualisation shows the number of scripts dispensed by PBS programs, nationally and at state and territory levels from January to August, 2019 and 2020. Some specific effects included:
This visualisation presents monthly scripts dispensed according to PBS programs which include; general, palliative care, dental, optometrical, prescriber bag, highly specialised drugs, efficient funding of chemotherapy, in-vitro fertilisation and botulinum toxin programs. The dental schedule had a large percent decrease of 17.1% in April 2020 and 11.6% in May, compared to the same months in 2019. This was due to suspension of non-urgent health services.
The Anatomical Therapeutic Classification (ATC) groups have been used to show the impact of COVID-19 on medicine utilisation. The ATC is a classification system for medicines and is defined by the World Health Organisation.
The following data visualisation shows the number of scripts dispensed by ATC groups, nationally and at state and territory levels from January to August, 2019 and 2020:
This visualisation presents monthly scripts dispensed graphically and as a table, according to ATC groups such as cardiovascular system, nervous system, sensory organs. Among the ATC groups, respiratory system had the largest percent increase of 10.7% over the 8 months in 2020 compared to the same period in 2019. Anti-infective for systemic use had the largest percent decrease of 21.8%.
For more information on medicines in the health system, see:
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