Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18

This section presents results for contemporary ex-serving ADF members dispensed a medication under the PBS or RPBS in 2017–18. Results are presented for all contemporary ex-serving members, as well as three cohorts within this population (see Medications dispensed to contemporary ex-serving ADF members in 2017–18).

In 2017–18, over 1 million medications were dispensed to around 70,000 contemporary ex-serving ADF members, an average of 16 dispensings per person (Table 1). Almost two thirds (64%) of all contemporary ex-serving members were dispensed at least one medication in 2017–18.

After accounting for age and sex, similar proportions of the contemporary ex-serving and Australian populations were dispensed medications in 2017–18 (72% and 71%, respectively) (Supplementary table S1).

Of all medications dispensed to contemporary ex-serving members in 2017–18, DVA cardholders were dispensed more than half (54%), general beneficiaries were dispensed a third (33%) and concession cardholders just over one in ten (12%) (Figure 3).

Figure 3: Contemporary ex-serving ADF members with a PBS/RPBS dispensing in 2017–18

Source: AIHW analysis of linked PMKeyS–PBS/RPBS data 2017–18.

DVA cardholders had an average of 27 dispensings per person, with 20 per person for concession cardholders and 9 for general beneficiaries. The rate of dispensings for DVA Gold Cardholders was an average of 43 per person (Table 1). This reflects the perceived greater need for DVA and concession cardholders and Gold cardholders in particular. This may also reflect a greater access to services DVA cards aim to facilitate. For example, recent DVA policies aim to provide greater access for eligible ex-serving members to treatment for certain conditions such as cancer and mental health.

(a) This is the average number of medications dispensed to contemporary ex-serving members with a dispensing in 2017–18. That is, ‘No. of dispensings’ divided by ‘No. members dispensed medications’ in the table above.

Notes:

1. Contemporary ex-serving member includes only ex-serving ADF members with at least one day of full-time or reserve service on or after 1 January 2001, and were discharged after this time and before 1 July 2017. The 69,177 members who received at least 1 dispensing in 2017–18 represented 64% of the total contemporary ex-serving population.
2. For 81 contemporary ex-serving members with a dispensing in 2017–18, there were 1,678 dispensings with insufficient information to assign them to an ex-serving cohort.
3. Dispensings for DVA card holders may be for either the PBS or RPBS, this is particularly relevant for DVA White card holders.

Source: AIHW analysis of linked PMKeyS–PBS/RPBS data 2017–18.

DVA cardholders and the RPBS and PBS

While an ex-serving members’ DVA card provides them with access to the RPBS, they may also have some medications dispensed under the PBS. 

For DVA White cardholders, any prescribed medications not associated with their approved condition will be dispensed under the PBS. Therefore, dispensings presented for DVA cardholders may be for medications dispensed under the RPBS or PBS.

Although DVA Gold cardholders have full access to the RPBS under their cards, there are a small number of Gold cardholders that access the PBS, and this can happen for a number of reasons. In some cases, they may not present their Gold card and accept paying the general rate. Or, they may also have access to the PBS through another concession card, or they may have received their gold card part way through 2017–18 (note, 13% of gold card holders received their card part way through 2017–18).

The results below present information on the number of medications dispensed under the PBS to the DVA cardholder cohort. 

The majority (74%) of all dispensings for DVA cardholders in 2017–18 were dispensed under the RPBS (Figure 4) and just over one quarter (26%) were dispensed under the PBS.

Figure 4: Proportion of dispensings for contemporary DVA cardholders dispensed under the RPBS and PBS, 2017–18

Source: AIHW analysis of linked PMKeyS–PBS/RPBS data 2017–18.

Nearly two-thirds (65%) of DVA cardholders who were dispensed at least one medication in 2017–18 were dispensed medications under the PBS in 2017–18 at an average of 11 dispensings per person. Just over two-thirds (68%) of DVA cardholders were dispensed medications under the RPBS at 29 per person (Figure 5 and Supplementary table S2).

Figure 5: Average number of medications dispensed to contemporary ex-serving DVA cardholders^(a) in 2017–18

(a) Average for contemporary ex-serving DVA cardholders with at least 1 dispensing in 2017–18.

Source: AIHW analysis of linked PMKeyS–PBS/RPBS data 2017–18.

Age and sex of contemporary ex-serving members dispensed a medication in 2017–18

The contemporary ex-serving population is mostly men (85%) and the majority of contemporary ex-serving members dispensed at least 1 medication in 2017–18 were also men (82%). Similarly, the majority of all dispensings for ex-serving members were for men (86%) (Supplementary table S3).

Over half (57%) of the contemporary ex-serving population are aged between 30 and 49 and, therefore, over half (54%) of contemporary ex-serving members dispensed at least 1 medication in 2017–18 were aged 30 to 49 (Figure 6). These patterns were similar in the Australian population (Supplementary table S3).

Contemporary ex-serving members in the older age-groups were dispensed more medications than younger age groups, with almost half (47%) of all medications dispensed to members aged 50 to 69, and a further 39% to members aged between 30 to 49 (Supplementary table S3), which is consistent with the development of disease with increasing age (ABS 2018). These patterns were similar in the Australian population (Supplementary table S4).

Figure 6: Contemporary ex-serving members dispensed at least 1 medication in 2017–18, by age and sex (per cent)

Source: AIHW analysis of linked PMKeyS–PBS/RPBS data 2017–18.

Consistent with the increased likelihood of developing chronic diseases with age (ABS 2018), the rate of dispensings per person increased with age (Supplementary table S3). For example, the rate of dispensings per member aged 70 and over was 35 dispensings per person, nearly twice as high as the rate for members aged 50 to 69 (19 per person) and almost ten times the rate for members aged 17 to 30 years (3 per person).

This pattern is similar in age-matched rates within the Australian population. The rate of dispensings for Australians aged 70 and over was 44 dispensings per person, just over twice as high as the rate of Australians aged 50 to 69 (20 per person) and over 10 times the rate for Australians aged 17 to 30 years (3 per person) (Supplementary table S3).

After accounting for age and sex differences, similar proportions of contemporary ex-serving men and women accessed the PBS/RPBS compared with the broader Australian population.

• 79% of ex-serving women and 76% of Australian women were dispensed at least 1 medication in 2017–18.
• 64% of ex-serving men and 64% of Australian men were dispensed at least 1 medication in 2017–18. (Supplementary table S1).

Similarly, after accounting for age and sex, the rate of dispensings per person was the same in the contemporary ex-serving and Australian populations (13 per person, respectively) (Figure 7).

Figure 7: Rate of dispensings per person, contemporary ex-serving and Australian populations (age and sex-standardised), 2017–18

Source: AIHW analysis of linked PMKeyS–PBS/RPBS data 2017–18.

References

ABS (Australian Bureau of Statistics) 2018. Chronic Conditions: National Health Survey: First Results, 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS. Viewed 27 September 2019.