Australian Institute of Health and Welfare (2021) Heart, stroke and vascular disease—Australian facts, AIHW, Australian Government, accessed 29 May 2022.
Australian Institute of Health and Welfare. (2021). Heart, stroke and vascular disease—Australian facts. Retrieved from https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
Heart, stroke and vascular disease—Australian facts. Australian Institute of Health and Welfare, 29 September 2021, https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
Australian Institute of Health and Welfare. Heart, stroke and vascular disease—Australian facts [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2022 May. 29]. Available from: https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
Australian Institute of Health and Welfare (AIHW) 2021, Heart, stroke and vascular disease—Australian facts, viewed 29 May 2022, https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts
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Cardiovascular medicines are key elements in preventing and treating cardiovascular disease (CVD) and its risk factors. They are most commonly used to help control levels of blood pressure and blood lipids, and to regulate heartbeat.
Blood pressure lowering medicines—treat high blood pressure. They include:
Lipid-modifying medicines—control blood lipid levels. Statins, resin binders, nicotinic acid, fibrates and probucol reduce blood LDL cholesterol (‘bad’ cholesterol), possibly increase HDL cholesterol (‘good’ cholesterol), and lower blood triglycerides.
Antithrombotic medicines—prevent or dissolve blood clots, reducing the risk of heart attack, or further strokes among patients with a history of ischaemic stroke.
Cardiac therapy—includes cardiac glycosides, antiarrhythmics and cardiac stimulants. They regulate heart rhythm, and treat angina and heart failure. Also includes vasodilators which open the main blood vessels of the body, as well as other cardiac preparations.
Peripheral vasodilators—open blood vessels in outer parts of the body, such as the arms and legs, making it easier for the heart to pump blood.
Vasoprotectives—relieve or prevent conditions of the blood vessels.
A wide range of subsidised cardiovascular medicines are made available to the Australian community through the Pharmaceutical Benefits Scheme (PBS), and through other arrangements where appropriate.
Over 107 million PBS prescriptions for cardiovascular medicines were supplied to the Australian community in 2019–20. These comprised one-third (35%) of total PBS prescriptions (Department of Health 2020).
The line chart shows that between 2005 and 2015, the supply of renin-angiotensin system agents increased from 155.0 to 213.2 DDD/1,000/day, lipid-modifying agents increased from 90.7 to 150.7 DDD/1,000/day while the supply of calcium-channel blockers increased from 47.6 to 67.2 DDD/1,000/day. The supply of beta-blocking agents, antithrombotic agents and diuretics remained largely unchanged throughout the period.
Under the Remote Area Aboriginal Health Services (RAAHS) program, established under section 100 of the National Health Act 1953, any person attending an approved RAAHS can receive eligible PBS medicines without the need for a PBS prescription and without cost.
These arrangements seek to address barriers experienced by people living in remote areas of Australia, which may have limited access to a GP or a community pharmacy, in accessing essential medicines through the PBS.
More than three-quarters (79%) of the estimated 1.2 million Australian adults aged 18 and over who had heart, stroke or vascular disease in 2017–18 used a cardiovascular system medicine in the 2 weeks prior to survey (AIHW analysis of ABS 2019).
Two-thirds (66%) of a study population of PBS concessional beneficiaries aged 65 and over used more than one class of cardiovascular medicine to manage their conditions in 2014–15. One-quarter (23%) received blood pressure lowering, lipid-modifying and antithrombotic medicines (AIHW 2017).
The horizontal bar chart shows the most commonly used cardiovascular medications used by adults in the 2 weeks prior to survey in 2017–18 were lipid modifying agents (58.1%) followed by beta-blocking agents (32.7%) and ACE inhibitors, plain (20.8%).
The COVID-19 pandemic has impacted both patients and health practitioners in terms of the number of medical services, type of services and the way in which services are delivered (Sutherland et al. 2020). Medication access and supply has also been affected.
Analysis of the total volume of PBS scripts for ATC group C, Cardiovascular system dispensed during 2020 shows little change from 2019. During 2019, 97.4 million CVD scripts were dispensed, compared with 101.9 million for 2020 (AIHW 2021).
There were, however, changes in consumer behaviour. An unusually high volume of CVD scripts were dispensed in March 2020 (10.0 million), coinciding with the introduction of national restrictions, followed by a decrease in April 2020 (7.3 million).
In March 2020, the Australian Government implemented temporary changes to medicines regulation to support Australians’ continued access to PBS medicines during the COVID-19 pandemic. Some of these changes were in response to the dramatic increase in demand for medicines during early March, which resulted in pharmacies and wholesalers reporting medicine shortages.
The measures included a restriction on the quantity of medicines purchased to discourage unnecessary medicine stockpiling, continued dispensing emergency measures to allow 1 month supply of a patient’s usual medicines without a prescription, a home delivery service for eligible patients, digital image-based prescriptions to support telehealth medical services, and arrangements for medicine substitution by pharmacists without prior approval from the prescribing doctor (AIHW 2020).
ABS 2019. Microdata: National Health Survey, 2017–18. AIHW analysis of Detailed Microdata. Viewed 19 February 2021.
AIHW 2017. Medicines for cardiovascular disease. Cat. no. CVD 80. Canberra: AIHW.
AIHW 2020. Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use. Cat. no. ACM 42. Canberra: AIHW.
AIHW 2021. Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme: quarterly data. Cat. no. HPF 66. Canberra: AIHW.
Department of Health 2020. PBS expenditure and prescriptions report 1 July 2019 to 30 June 2020. Canberra: Department of Health.
Department of Health 2021. S100 Remote Area Aboriginal Health Services (RAAHS) Program Information Sheet. Viewed 8 February 2021.
Sutherland K, Chessman J, Zhao J, Sara G, Shetty A, Smith S et al. 2020. Impact of COVID-19 on healthcare activity in NSW, Australia. Public Health Research & Practice 30: e3042030.
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