Pharmaceutical Benefits Scheme Supplied Medications

Key findings about health and population characteristics from the National Health Survey (NHS) and the Pharmaceutical Benefits Scheme (PBS).

Released
30/08/2022

Key statistics

  • Two in three (63.4%) people were supplied with at least one PBS medication in the 6 months before or after NHS interview
  • Almost all (97.0%) people aged 75 years and over were supplied with a PBS medication
  • 80.4% of people with one or more selected chronic conditions were supplied PBS medications

This article includes findings about Pharmaceutical Benefits Scheme (PBS) medications supplied to National Health Survey (NHS) 2020-21 survey participants in the 6 months before and after their NHS interview. The linked PBS and NHS 2020-21 data provides information on PBS medications supplied in the context of demographics, health risk factors, and selected chronic conditions. PBS statistics includes both PBS and Repatriation Pharmaceutical Benefits Scheme (RPBS) items.

Pharmaceutical Benefits Scheme (PBS) medications

The Australian Government subsidises the cost of many medicines for Australians through the Pharmaceutical Benefits Scheme (PBS). The PBS is regarded as a key component of the National Medicines Policy (NMP) which aims to improve positive health outcomes for all Australians through their access to and wise use of medicines[1].

The PBS does not include over-the-counter medications, private prescriptions, dietary supplements, or medications supplied to most public hospital in-patients. It should be noted that PBS data tells us when a medication is supplied but not whether the person took the medication.

Definitions

PBS medications are categorised according to the World Health Organization Anatomical Therapeutic Chemical (ATC) Classification System. The ATC is a system that classifies the active ingredients of medications according to the organ or system on which they act and their therapeutic, pharmacological and chemical properties[2]. For more information see Methodology.

The ATC system includes 14 main anatomical or pharmacological groups. The list below includes examples of common uses and treatments:

   A. Alimentary tract and metabolism – reflux, ulcer, anti-nausea and diabetic medications

   B. Blood and blood forming organs – blood thinners, vitamin K, anti-anemic preparations (e.g. iron, B12, folic acid)

   C. Cardiovascular system – cholesterol-lowering, blood pressure and heart failure medication

   D. Dermatologicals – topical corticosteroids for skin conditions (e.g. dermatitis, eczema)

   G. Genito urinary system and sex hormones – contraceptives, menopausal and gynaecological medications

   H. Systemic hormonal preparations, excluding sex hormones and insulins – anti-inflammatory medications for autoimmune disorders (e.g. rheumatoid arthritis) and thyroid issues

   J. Antiinfectives for systemic use – bacterial antibiotics and antivirals

   L. Antineoplastic and immunomodulating agents – immunosuppressants and anti-cancer medications

   M. Musculo-skeletal system – non-steroid based anti-inflammatory medications

   N. Nervous system – pain relief and medications used for mental health

   P. Antiparasitic products, insecticides and repellents – medications used for infestations, parasitic worms and insect pests

   R. Respiratory system – asthma and Chronic Obstructive Pulmonary Disease (COPD) medications

   S. Sensory organs – anti-inflammatory and antibiotic medications used for the ear and eyes

   V. Various – nutrients, treatment for high potassium/phosphate and other therapeutic medications

People with supplied medications

In the 6 months before or after their NHS interview, nearly two in three (63.4%) people were supplied with at least one PBS medication. In 2020-21:

  • Females were more likely to be supplied with medications than males (70.0% compared to 56.6%)
  • The supply of medication increased with age, from 43.0% of children aged 0-17 years to 97.0% of people aged 75 years and over
  • People with a disability were more likely to be supplied a medication than those with no disability (81.1% compared to 56.3%)
  • On average, adults aged 18 years and over had more types of medications supplied than children (4.2 compared to 1.9).
  1. Total includes 2.3% of NHS respondents who were not linked to a PBS record.

  2. Includes NHS respondents who were linked to a PBS record but who did not have a PBS medication supplied in the 6 months before and after the NHS interview.

The proportion of people who were not supplied with a medication declined sharply with age, from 54.1% of children aged 0-17 years to 7.6% of people aged 65-74 years and then 2.0% of people aged 75 years and over.

People with multiple supplied medications

Of those who were supplied with PBS medications, an average of 3.9 different medication types were supplied. In 2020-21:

  • Almost one in five (18.9%) people were supplied with five or more different medication types
  • Seven in ten (72.1%) people aged 75 years and over were supplied with five or more different medication types and on average were supplied with almost eight.
  1. Average was calculated using only those people who were supplied with a PBS medication.

In 2020-21, the characteristics of people who were supplied with multiple PBS medications were as follows:

  • One quarter (24.5%) of people living in inner regional Australia were supplied with five or more medication types, compared to 17.4% living in major cities
  • People living in areas of most disadvantage were more likely to be supplied with five or more medication types than people living in areas of least disadvantage (24.1% compared to 14.0%)
  • Adults who experienced bodily pain in the last four weeks had a higher average number of medication types than those who did not experience bodily pain (4.6 compared to 3.1).

Medication types being supplied

Almost a third (30.6%) of people were supplied with Antiinfectives for systemic use medication, making it the most common type supplied. Other commonly supplied medication types included:

  • Nervous system – 23.7%
  • Cardiovascular system – 22.7%
  • Alimentary tract and metabolism – 18.8%.

Females were six times more likely than males to be supplied with a Genito urinary system and sex hormones medication (15.0% compared to 2.5%), and more likely than males to be supplied with a Nervous system medication (28.2% compared to 19.2%).

Three quarters (74.7%) of people aged 65 years and over were supplied with a Cardiovascular system medication, compared to 6.2% of people aged 18-44 years.

Medications supplied for people with chronic conditions

Long-term health conditions are conditions which were current at the time of the survey interview and had lasted, or were expected to last, 6 months or more. Selected chronic conditions are a subset of long-term health conditions that are common, pose significant health problems, and have been a focus of ongoing public health surveillance[3].

In 2020-21, nearly half (46.6%) of people had one or more selected chronic conditions[4]. These people were more likely than those without a chronic condition to be supplied with a PBS medication (80.4% compared to 48.6%). The supply of medication to people with a chronic condition varied by condition type:

  • Heart, stroke and vascular disease – 97.2%
  • Osteoporosis – 96.1%
  • Kidney disease – 95.3%
  • Diabetes mellitus – 94.9%
  • Chronic obstructive pulmonary disease (COPD) – 93.9%
  • Cancer – 93.5%
  • Arthritis – 90.1%
  • Asthma – 83.8%
  • Mental and behavioural conditions – 79.6%
  • Back problems – 77.5%.

The prevalence of selected chronic conditions was more common with age[4]. Many people with chronic conditions had more than one at the same time (multimorbidity)[5]:

  • Nine in ten (90.5%) people with two or more chronic conditions had a PBS medication and on average were supplied with 6.4 medication types
  • More than half (54.2%) of people with two or more chronic conditions were supplied with a Cardiovascular system type medication compared to 24.7% with one chronic condition.

As people age, they are more likely to have more than one condition at the same time and take multiple medications[6]. Although there is no standard definition, polypharmacy is often defined as the routine use of five or more medications at the same time[6]. It should be noted that PBS data cannot tell us whether multiple medications were routinely used or taken at the same time.

In 2020-21, seven in ten (69.7%) people with three or more selected chronic conditions were supplied with five or more medication types, compared to 42.5% of people with two chronic conditions and 20.4% of people with one. The supply of five or more medication types also varied by condition type – from 28.6% of people with Mental and behavioural conditions to 74.1% of those with Heart, stroke and vascular disease.

  1. This proportion has a high margin of error and should be used with caution.

People with Safety Net medications

The PBS Safety Net scheme aims to protect patients needing a large number of medicines in one year from excessive out of pocket costs[1]. In 2021, the Safety net threshold was $316.80 for Concession Card holders and $1,497.20 for General patients. Once these amounts are reached, Concession Card holders are provided subsequent PBS medications at no cost and General patients pay a concessional rate of up to $6.60 for PBS medications for the remainder of that calendar year[7].

One in seven (13.5%) people who were supplied with PBS medications used the Safety Net subsidy at least once. Of those people:

  • More adults (15.4%) used the Safety Net than children aged 0-17 years (2.8%)
  • Males and females had similar rates of Safety Net use (14.0% and 13.1%)
  • Use of the Safety Net increased with age – from 2.7% for those aged 18-24 years, to 31.3% of people aged 65-74 years, to 54.9% of people aged 75 years and over.

Almost one in ten (9.5%) people with one selected chronic condition used the Safety Net subsidy at least once, this increased to 22.2% for people with two selected chronic conditions and reached 46.3% for those with three or more selected chronic conditions.

The highest proportions of Safety Net subsidy use were for people with:

  • Heart, stroke and vascular disease – 49.9%
  • Kidney disease – 45.4%
  • Diabetes – 43.1%.

The characteristics of people who were most likely to use the Safety Net subsidy included:

  • People living in areas of greater disadvantage were twice as likely to use it as those from the least disadvantaged areas (20.0% compared to 9.5%)
  • People with a disability were more than three times as likely to use it as those with no disability (24.7% compared to 7.0%)
  • Adults who experienced bodily pain in the last four weeks were twice as likely as those who did not experience pain (17.3% compared to 8.7%).

Data downloads

Pharmaceutical Benefits Scheme Supplied Medications

Footnotes

  1. Australian Parliament House, ‘The Pharmaceutical Benefits Scheme: a quick guide’; accessed 03/08/2022.
  2. Department of Health and Aged Care, ‘PBS Browse by Body System’; accessed 03/08/2022.
  3. Australian Institute of Health and Welfare, ‘Australia’s health 2020 data insights’; accessed 03/08/2022.
  4. Australian Bureau of Statistics, ’Health conditions prevalence’; accessed 03/08/2022.
  5. Australian Institute of Health and Welfare, ‘Chronic conditions and multimorbidity’; accessed 03/08/2022.
  6. World Health Organization, ‘Medication safety in polypharmacy: technical report’; accessed 03/08/2022.
  7. Department of Health and Aged Care, ‘PBS Expenditure and Prescriptions Report 1 July 2020 to 30 June 2021’; accessed 03/08/2022.
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