title: Increased patient co-payments and changes in PBS-subsidised prescription medicines dispensed in Western Australia.
abstract: OBJECTIVE
  To determine whether a 24% increase in patient co-payments in January 2005 and two related co-payment changes for medicines subsidised under the Australian Pharmaceutical Benefits Scheme (PBS) were associated with changes in dispensings in Western Australia (WA).
  
  
  METHODS
  We analysed aggregate monthly prescription counts and defined daily dose per 1,000 population per day (DDD/1,000/day) for atypical antipsychotics, combination asthma medicines, HmgCoA reductase inhibitors (statins) and proton-pump inhibitors (PPIs). Trends pre and post the co-payment increase in January 2005 were compared.
  
  
  RESULTS
  In three of the four categories examined, prescription counts were significantly lower following the increase in co-payment thresholds. Compared with dispensings prior to the co-payment increase, prescriptions fell by 8% for combination asthma medicines (p<0.001), 9% for PPIs (p<0.001) and 5% for statins (p<0.001). Following the rise in co-payments, DDD/1,000/day decreased for all four categories. Decreases in dispensings to concessional beneficiaries were between 4% and 5% larger than for general beneficiary patients.
  
  
  CONCLUSIONS
  The reduction in the both prescription counts and DDD/1,000/day observed for combination asthma medicines, PPIs and statins, which all remained above co-payment thresholds, suggests the increase in PBS co-payments has affected utilisation of these subsidised medicines. The results indicate that increases in patient contributions particularly impact on concessional patients' ability to afford prescription medicines.
authors.affiliation: School of Population Health, The University of Western Australia, New South Wales, Australia. anna.hynd@uwa.edu.au
authors.forename: Anna
authors.initials: A
authors.lastname: Hynd
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Roughead
authors.forename: David B
authors.initials: DB
authors.lastname: Preen
authors.forename: John
authors.initials: J
authors.lastname: Glover
authors.forename: Max
authors.initials: M
authors.lastname: Bulsara
authors.forename: James
authors.initials: J
authors.lastname: Semmens
mesh_terms: D017047:Cost Sharing / Q000191:economics* / Q000639:trends; D019992:Databases as Topic; D005380:Financing, Government; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D009313:National Health Programs / Q000191:economics; D004364:Pharmaceutical Preparations / Q000191:economics*; D014904:Western Australia
chemical_list: D004364:Pharmaceutical Preparations