title: Cost driver analysis of statin expenditure on Australia's Pharmaceutical Benefits Scheme.
abstract: BACKGROUND
  The Australian Pharmaceutical Benefits Scheme (PBS) provides universal access to subsidized medicines. In 2013, statins as a class had the highest expenditure on the PBS.
  
  
  OBJECTIVE
  To assess the influence of policies and drivers affecting PBS statin utilization and expenditure between 1992 and 2013.
  
  
  METHODS
  Analyses conducted from 1992 to 2013 and over three distinct time periods, including monthly expenditure/prescription, annual utilization (calculated as Defined Daily Doses/1000 inhabitants/day) and statin strengths dispensed.
  
  
  RESULTS
  The major driver of increased PBS expenditure for statins was increased volumes. After adjusting for inflation, the average PBS expenditure on statin prescriptions was the major negative driver. Other influential drivers included the increased use of newer statins and increased strength of statins dispensed.
  
  
  CONCLUSIONS
  Whilst the inflation-adjusted reimbursed price of statins decreased, increased utilization, including increased use of patented statins, increased total statin expenditure. Successful measures adopted by other countries could be applied to Australia to decrease total medicines expenditure.
authors.affiliation: a Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute , University of South Australia , Adelaide , South Australia , Australia.
authors.forename: L P
authors.initials: LP
authors.lastname: Thai
authors.affiliation: b School of Public Health , University of Adelaide , Adelaide , South Australia , Australia.
authors.forename: J R
authors.initials: JR
authors.lastname: Moss
authors.affiliation: c Division of Clinical Pharmacology , Karolinska Institutet , Stockholm , Sweden.|d Strathclyde Institute of Pharmacy and Biomedical Sciences , Strathclyde University , Glasgow , Scotland.
authors.forename: B
authors.initials: B
authors.lastname: Godman
authors.affiliation: a Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute , University of South Australia , Adelaide , South Australia , Australia.
authors.forename: A I
authors.initials: AI
authors.lastname: Vitry
mesh_terms: D001315:Australia; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000191:economics; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D010818:Practice Patterns, Physicians' / Q000639:trends; D012051:Reimbursement Mechanisms / Q000191:economics; D013997:Time Factors; D019472:Universal Health Insurance / Q000191:economics
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Australia; demand-side measures; drug utilization research; generics; guidelines; pharmaceutical expenditure; prices; statins