400845 The Pharmaceutical Benefit Scheme

400845 The Pharmaceutical Benefit Scheme

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400845 The Pharmaceutical Benefit Scheme

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400845 The Pharmaceutical Benefit Scheme

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Course Code: 400845
University: Western Sydney University

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Country: Australia

Question
The Australian Pharmaceutical Benefits Scheme and the consumption of medicines in Australia
Within the report, students must address the following areas:
The report should utilize appropriate data from the Pharmaceutical Benefits Scheme (PBS) as well as other relevant health and pharmaceutical-related data available in the public domain. Students should reference academic literature and analysis of the PBS to construct their response to the areas above. When appropriate, data should be expressed using charts and tables to illustrate comparisons, trends or other analysis. Students should present a clear understanding of the PBS and its financial implications for the health sector and for consumers and provide recommendations on how the scheme could be made more efficient and provide positive impacts on costs and consumption.
Answer

Pharmaceutical Benefit Scheme 
Introduction
Pharmaceuticals Benefits Scheme (PBS) was developed by the Australian government to subsidize the medical costs. The initial attempt was to provide free medications to the Australians. This includes antibiotics and emergency medicines. The Australian government submitted this proposal in 1944. However, later the proposal was dismissed in Australian High court and a regulation was released in 1948. The regulation states that the free medications would be provided for the pensioners and most of the medicine would be common life-saving medicines (Currow & Sansom, 2014). At the early of 1960, more medicines were included in the free medications for the pensioners. Presently PBS is one of the important parts of the National Medicines policy of Australia under the regulation National Health Act (1953). As per a recent report, the subsidy provided by the Australian government to the PBS is around $9.1billion which is 21% of overall Australian health expense. Moreover, the number of prescription gathered by the government is 211million. However, the number of medicines are including gradually within the PBS scheme along with the invested amount.  This study will aim to explore the issues that the Australian government is facing regarding the PBS scheme and the number of risk factors will be identified (Faunce, 2015). In addition, the betterment procedures of the organization will be analyzed properly. The interventions for the overuse or mal-use of this scheme will be analyzed followed by a conclusion outlining the key factors of the study by outlining an overall solution. The ultimate exploration of the study will pay attention to the disclosures of the ultimate prices under this policy and effect of PBS on the pricing of the medicines.
General discussion of the issue
The PBS scheme has been enforced by the government of Australia to mitigate the health issues around Australia. It would affect the healthcare practices for the old ages around the country. Presently, the Australian government has included around 793 types of medicines within this scheme and 2066 forms of medical dosages of these medicines. In addition, 5300 brands would sponsor those 793 types of medicines. Recently, PBS has applied a new scheme; PBS Safety Net that would protect the cost of the patients from buying costly medicines in a whole year (Goddard, 2014). This policy of this scheme state medicine facility would be free for those persons and families who would avail the medicines to the equal amount of threshold from Safety net. This facility would be beneficial for the patients to reduce their medical costs for the rest of the year. In addition, the amount of threshold does not equal the amount of medical price for the whole year, the patient would only have to pay only $6.20. For the amount of threshold worth $372, the patients would get a large concession of the medicine price up to $1457. Thus, these cost-benefit techniques are used to increase the financial capability of the common people by reducing the price of the medicine and medical treatment (Graham, 2017). The scheme has segregated medicines into five categories; general medicines, veterans medicines, medicines with special arrangements, statistical PBS medicine, and the lifesaving medicines.
General medicines:  The general medicines imply the medicines that are dispensed by the community medicines. This type of medicine falls under the General Schedule of National Health Act (1951) under the Section 85.
Veterans’ medicines: These are the subsidized medicines that are provided for the pensioners and the veterans which is regulated by the departments of Veterans Affairs.  The veterans medicines are generally provided under the Veterans Entitlements Act (1986).
Medicine with special arrangements: the medicines with special arrangements are the necessary medicines that are not generally provided to the community pharmacies. It requires special storage and special arrangement due to its sensitivity which is not available in the community pharmacies (Groenewold & Paterson, 2013). These types of medicines are provided under the Section100. The special arrangements include special drug programs and efficient findings. Moreover, the scheme subsidies in the toxin medicines, growth medicines and fertilization medicines are depicted to be increasing.
Statistical PBS medicines: The statistical PBS medicines include the PBS statistics regarding the expenditure of the PBS through prescriptions. The prescriptions are generally not cost beneficial an. Thus, the ultimate focus of the business is to provide a report based on the general medicines and PBS reports that are intended in the official websites of the Human Service department.
Lifesaving medicines: A large number of subsidy is provided by the Australian government on the lifesaving medicines. The subsidies are provided under the campaign of Lifesaving Drug program. So far, 278 families around Australia were helpful with this facility (Hassali, Shafie, Babar & Khan, 2012).
Issues explored
Issues on PBS
Several issues have been identified regarding the PBS. The issues are :

Unethical advantageIssue: Unethical advantage is one of the key issues that can be stated on PBS scheme. This scheme was generally enforced for the people who are not financially capable enough to buy costly and lifesaving medicines. However, some people were taking unethical advantages of this scheme and use to avail the threshold to reduce the normal prices of the medicines. Indirectly, this affects the financial efficiency of Australia. In addition, the needy people sometimes become unable to avail this opportunity of subsidy (Knott, Clarke, Heeley & Chalmers, 2015).
The diversity in the clinical settings, disease and pharma and non-pharmacological treatments in Australia can be a hindrance to the effective utilization of PBS. Hence, it is impossible to measure the improvement of a cancer patient having two months of progression level. An equalized cost of the medicine is genuinely required to clarify the statistics. Further, the issue got complicated while defining the distinction between treatment and the available resources for the treatment (Lofgren, 2009).
Application issue: Delay in the application is one of the key issues as the government of a normal price of the medicines can be differentiated into high price medicine, increase in the cost of the medicine and delay in the market accession. Thus, it creates complication while implicating the PBS evaluation.

Further improvement
There must be given sufficient time to evaluate the PBS scheme. The evaluation of the PBS scheme would be helpful to identify the ultimate costs and the available schemes for that person. Moreover, the government must enforce a quick initiative to mitigate the delay issue by enforcing several crucial norms. In addition, if a medicine is not properly applicable to the norms mentioned in PBC regulations, the sponsors of PBC should prepare and resubmit the listing of PBC (Löfgren, 2009).  
A recent statistics has signified that high-level rigor must be applied to detect the differences in treatment. Moreover, it can be applied to identify the types of and resources of differences. Thus, it has clinically different from the clinical outcomes.
Effect on overuse
The misuse of pharmaceutical drugs is increasing over the years. An evidence-based survey has disclosed the overuse of drugs a concerning on the drug treatment data. The application of PBS technique is not harmful at all but the overuse is associated with the poisoning, injection-related problems and unethical selling of pharmaceutical equipment’s (Robertson, Walkom & Henry, 2009). The key factors that can affect misuse or overuse of medicines are

Availability multiple opioids
The clinical advice from the medical institutions that have invoked the use of medicine even after discharge from the medical institutions
Difficulty in pain management
Unavailability of non-opioid treatment
The intimidation would lead the patient to inappropriate prescription

The demographical changes would impact on the population of aging and increase demand for an opioid. However, the non-opioid is unavailable is correlated with the overuse of drugs. The application of the PBS scheme is capable of mitigating the opioid issue (Salkeld, 2011).
Conclusions
The study has focused on several aspects of PBS scheme which was specially developed to mitigate the high-cost issues on buying the important medicines. It has been a cost-benefit scheme on the part of the Australian government and under the section 85 of legislation National Health Act (1951). Around 273 families were beneficial out of this scheme and most of them got free medicines. The people got $372 threshold got the medicines within $6.20. There are 793 types of medicines have been labeled under this category and the types of medicines attached to these categories are 2066. 5300 brands are associated with the scheme. However, there are several issues raised in this scheme regarding unethical advantage issue, methodological issue, and delay in application issue (Gowing, Hickman & Degenhardt, 2013). Sufficient time must be given to evaluating the PBS scheme and the government must be is hurriedness to mitigate the delay issues. Otherwise, the schemes can be used or overused. Thus, ethical implementation of the issue is required for the effective outcome and it is required to apply high-level rigor to decrease the issues regarding the proper implication of PBS.  
References
Currow, D., & Sansom, L. (2014). Uptake of medicines and prescribing patterns in the palliative care schedule of the Pharmaceutical Benefits Scheme. The Medical Journal Of Australia, 200(10), 560-561. doi: 10.5694/mja14.00188
Faunce, T. (2015). How the Australia-US free trade agreement compromised the pharmaceutical benefits scheme. Australian Journal Of International Affairs, 69(5), 473-478. doi: 10.1080/10357718.2015.1048785
Goddard, M. (2014). How the Pharmaceutical Benefits Scheme began. The Medical Journal Of Australia, 201(1), 23-25. doi: 10.5694/mja14.00124
Gowing, L., Hickman, M., & Degenhardt, L. (2013). Mitigating the risk of HIV infection with opioid substitution treatment. Bulletin Of The World Health Organization, 91(2), 148-149. doi: 10.2471/blt.12.109553
Graham, D. (2017). Regulation of proprietary traditional Chinese medicines in Australia. Chinese Journal Of Natural Medicines, 15(1), 12-14. doi: 10.1016/s1875-5364(17)30004-3
Groenewold, N., & Paterson, J. (2013). Stock Prices and Exchange Rates in Australia: Are Commodity Prices the Missing Link?. Australian Economic Papers, 52(3-4), 159-170. doi: 10.1111/1467-8454.12014
Hassali, M., Shafie, A., Babar, Z., & Khan, T. (2012). A study comparing the retail drug prices between Northern Malaysia and Australia. Journal Of Pharmaceutical Health Services Research, 3(2), 103-107. doi: 10.1111/j.1759-8893.2011.00080.x
Knott, R., Clarke, P., Heeley, E., & Chalmers, J. (2015). Measuring the Progressivity of the Pharmaceutical Benefits Scheme. Australian Economic Review, 48(2), 122-132. doi: 10.1111/1467-8462.12103
Lofgren, H. (2009). Generic Medicines in Australia: Business Dynamics and Recent Policy Reform. SSRN Electronic Journal. doi: 10.2139/ssrn.1471687
Löfgren, H. (2009). The economic crisis, the Pharmaceutical Benefits Scheme, and the dilemmas of medicines policy. Australian Health Review, 33(2), 171. doi: 10.1071/ah090171
Robertson, J., Walkom, E., & Henry, D. (2009). Transparency in pricing arrangements for medicines listed on the Australian Pharmaceutical Benefits Scheme. Australian Health Review, 33(2), 192. doi: 10.1071/ah090192
Salkeld, G. (2011). Pharmaceutical Benefits Scheme cost recovery. Australian Prescriber, 34, 62-63. doi: 10.18773/austprescr.2011.036

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