4364.0.55.015 - National Health Survey: Persons accessing Pharmaceutical Benefits Scheme subsidised prescriptions, 2014-15  
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Interpretation of results

There are a number of factors that should be considered when interpreting information presented in this research paper.

2014-15 National Health Survey (NHS)

Self-reported medication use was collected in the medications questionnaire module of the 2014-15 NHS and it is important to note the following:

    • All medication use is captured in a face-to-face interview and represent medications used in the two weeks prior to interview.
    • Medication use was self-reported by respondents, which may have implications for the extent to which certain types of medication were reported.
    • Whilst respondents were encouraged to collect their medications to assist in recall, this did not always occur, which may have led to some medications not being reported, or being reported incorrectly.
    • Some respondents may have provided responses that they felt were expected, rather than those that accurately reflected their own situation. Every effort has been made to minimise such bias through the development and use of appropriate survey methodology.
    • Interviewers recorded the Australian Register of Therapeutic Goods Administration (TGA) identification number of each medication taken by the respondent. These were either:
        • AUST R medicines - which include all prescription medications and many over-the-counter products such as those used for pain relief, coughs and colds and antiseptic creams; or
        • AUST L medicines - which are generally lower risk self-medication products which include vitamins, minerals, and herbal and homoeopathic products.
    • A small number of medications presented by respondents were not able to be coded to the World Health Organisation Anatomical Therapeutic Chemical (ATC) classification system[1], and were not included in output data. For example, for medications containing multiple active ingredients, or medications containing ingredients used for more than one therapeutic application. This is expected to have negligible effect on the accuracy of results.
    • Information on what the medication was being taken for or prescribed for is not captured.
    • For further information on the 2014-15 NHS, refer to the Explanatory Notes and User Guide.
    Pharmaceutical Benefits Scheme (PBS)

    For PBS subsidised prescriptions represented in the MADIP asset, it is important to note the following:
      • The Scheme is available to all Australian residents who hold a current Medicare card. For certain countries, the Australian Government’s Reciprocal Health Care Agreement (RHCA) allows international visitors to access PBS subsidised prescriptions.
      • The subsidy of some prescriptions is restricted to particular population or clinical subgroups which may impact on the representation of the data available.
      • There are programs operating under Section 100 of the National Health Act 1953 particularly in remote and very remote areas, such as the Aboriginal Medical Services, which receive access to free and subsidised medicines, at times on a bulk supply basis, that are not captured through the PBS data when distributed to patients[2].
      • PBS subsidised prescriptions can be identified based on timeframes using the prescription supply date.
      • PBS subsidised prescriptions do not include over-the-counter, private prescriptions, dietary supplements or medications supplied to public hospital in-patients.
      • Some prescription medications are not captured through PBS data, these are referred to as non-PBS prescriptions. Examples include prescription medicines that are not listed on the PBS and medications that are being used outside of its PBS manner of administration (such as PBS eye ointment for topical non-ophthalmic use)[3].
      • PBS subsidised prescriptions tell us when a prescription is filled but not whether the patients took the medication.
      • The ABS update the MADIP asset on an annual basis with data on the PBS received from Services Australia. The MADIP asset (at the time of this research) contained PBS subsidised prescriptions from 2011 to 2016.
    For more information on the MADIP asset, refer to the ABS MADIP webpages.
      Self-reported medication use in the 2014-15 NHS and PBS subsidised prescriptions have the following in common:
        • A person’s use of medication(s) does not imply a diagnosis of a condition.
        • It is not known whether people actually used the medications they self-reported in the 2014-15 NHS or the medications for which subsidised prescriptions were filled in the PBS.

      Types of medications in Australia

      There are three types of medications available in Australia[4]. These are:
        • Complementary: non-prescription medicines available predominantly over the counter from health food shops, supermarkets and pharmacies.
        • Over-the-counter: non-prescription medicines available over the counter or accessible from a pharmacist after a consultation. These medicines are available in pharmacies with selected products also available in supermarkets, health food stores and other retailers. Such medicines are typically used for mild health problems.
        • Prescription: medicines that can only be accessed via written instruction of an authorised health professional, for example a General Practitioner. These medicines are only available for purchase from a pharmacy.

      All medicines in Australia must be either registered or listed with the Australian Register of Therapeutic Goods (ARTG). All prescription medicines in Australia are registered as they carry higher risks when consumed, thus requiring a valid prescription from a health professional to gain access. The Australian Government subsidises the access to prescription medication through the PBS and RPBS, and it is such medicines that are represented in the MADIP asset.

      Over-the-counter and Complementary medications are either register or listed, but can be accessed off the shelf (some requiring a discussion with a Pharmacist) as they carry lower risk upon consumption. When purchased off the shelf without a prescription these medicines are not subsidised through the PBS or RPBS and are not represented in the MADIP asset.

      Endnotes
      1. World Health Organisation (WHO) Collaborating Centre for Drug Statistics Methodology <www.whocc.no/atc_ddd_index/> last accessed 12/03/2020.
      2. The Department of Health. Aboriginal Health Services and the Pharmaceutical Benefits Scheme (PBS) < https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pbs-indigenous > last accessed 19/05/2020.
      3. Services Australia. Education guide - Writing PBS and RPBS prescriptions < https://www.servicesaustralia.gov.au/organisations/health-professionals/services/medicare/highly-specialised-drugs/resources/education-guide-writing-pbs-and-rpbs-prescriptions#a6 > last accessed 19/05/2020.
      4. Therapeutic Goods Administration, The Department of Health. How we regulate medicine <https://www.tga.gov.au/how-we-regulate-medicines > last accessed 15/05/2020.


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