Australian Institute of Health and Welfare (2019) Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18, AIHW, Australian Government, accessed 02 February 2023.
Australian Institute of Health and Welfare. (2019). Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18. Retrieved from https://www.aihw.gov.au/reports/veterans/medications-dispensed-contemporary-ex-adf
Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18. Australian Institute of Health and Welfare, 29 November 2019, https://www.aihw.gov.au/reports/veterans/medications-dispensed-contemporary-ex-adf
Australian Institute of Health and Welfare. Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18 [Internet]. Canberra: Australian Institute of Health and Welfare, 2019 [cited 2023 Feb. 2]. Available from: https://www.aihw.gov.au/reports/veterans/medications-dispensed-contemporary-ex-adf
Australian Institute of Health and Welfare (AIHW) 2019, Medications dispensed to contemporary ex-serving Australian Defence Force members, 2017–18, viewed 2 February 2023, https://www.aihw.gov.au/reports/veterans/medications-dispensed-contemporary-ex-adf
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This section provides information on the costs associated with medications dispensed to contemporary ex-serving members in 2017–18.
Averages presented in this section are for members who were dispensed at least one medication in 2017–18. Averages for different medication classes are calculated only for members who were dispensed a medication in that medicine class. Averages presented for age and sex adjusted rates are the rate per person within each population. Costs include costs associated with either the PBS and/or RPBS.
Data in this report include all valid medications dispensed under the PBS/RPBS (including medications dispensed that are under the co-payment amount, known as ‘Under co-payment data’. PBS/RPBS co-payments and Safety Net Thresholds are updated on 1 January each year. Co-payment and Safety Net Thresholds for 1 January 2018 are as follows (for full details on fees, patient contributions and thresholds for both 2017 and 2018, see the PBS website):
The following are some important notes to consider when interpreting information on costs in this report:
Given the different co-payment amounts for concessional (DVA cardholders and concession cardholders) and general beneficiaries, it is expected that a much higher proportion of general beneficiaries will be dispensed medications that are under the co-payment threshold.
As well as government contributions provided through either the PBS or RPBS, ex-serving ADF members also have access to a range of other programs through DVA. These programs provide further reimbursement of medication costs, thereby increasing the government costs. As information on these is not available, they are not included in this report.
Two programs worth noting in the context of this report are the Medical Expenses Privately Incurred (MEPI) and Veterans Pharmaceutical Reimbursement Scheme (VPRS).
Results presented in this report on costs for medications under the co-payment amount are an estimate of the price of that medication, see Technical notes for more details.
Discounts applied to medications within pharmacies are not included in these results, including any discretionary discounts of the patient co-payment by the pharmacy. Therefore, costs for under co-payment medications are most likely an over estimate—noting this will affect results for total costs only.
Some medications will incur a Brand or Therapeutic Premium, which is a cost incurred by the individual. These premiums are also not included in these results.
In 2017–18, total costs for the 1 million medications dispensed to contemporary ex-members came to just over $50 million, which was an average of $728 per person and $47 per dispensing (Table 4).
Accounting for age and sex differences, total costs for contemporary ex-serving members were $586 per person in 2017–18 and $666 per person in the Australian population (Supplementary table S1).
Half of all total costs for contemporary ex-serving members were for DVA cardholders (53%), followed by general beneficiaries (34%) and concession cardholders (13%). Reflecting the frequency of dispensings, the average total costs per person was highest for DVA cardholders ($1,223 per person) and in particular for Gold cardholders, ($2,006 per person).
DVA Gold cardholder
DVA White cardholder
All DVA cardholders
All contemporary ex-serving members
(a) This is the average total cost per person. Total cost = government costs + patient costs.
Source: AIHW analysis of linked PMKeyS–PBS/RPBS data 2017–18.
Due to the very high prices of certain medications relating to the treatment of cancer, highest total costs for medications dispensed to members in 2017–18 were for ‘antineoplastics and immunomodulating agents’. Medications within this class accounted for 32% of total PBS/RPBS costs, but represented only 1.4% of all dispensings for contemporary ex-serving members in 2017–18 (Supplementary table S5) This pattern is consistent with age-matched results in the Australian population, with these drugs accounting for 27% of total PBS/RPBS costs, but representing only 1.5% of all dispensings.
Nervous system and cardiovascular system medications, which accounted for the largest proportion of dispensings for contemporary ex-serving members, accounted for 20% and 11% of total costs, respectively.
After accounting for age and sex differences, average total costs for nervous system medications were $99 per person in the contemporary ex-serving population and $87 per person in the Australian population (Supplementary table S4), which is consistent with the rates of dispensing of nervous system medicines.
For cardiovascular system medications, total costs for the contemporary ex-serving population were $67 per person in the contemporary ex-serving population and $78 per person in the Australian population, adjusted for age and sex differences, which also reflects the rates of dispensing for these medication classes.
In 2017–18, the costs met by Government for medications dispensed to contemporary ex-serving members under the PBS/RPBS was just over $38 million. This was just over three-quarters (76%) of the total costs for all contemporary ex-serving members, and equated to an average of $550 per person for the year (Supplementary table S9).
After accounting for age and sex differences, Government costs for the contemporary ex-serving population were $447 per person for the contemporary ex-serving population and $533 per person for the Australian population (Supplementary table S4).
Government costs for different medications classes
As with total costs, government costs were highest for ‘Antineoplastics and immunomodulating agents’, accounting for 41% of all government contributions to medications dispensed to ex-serving members in 2017–18.
Nervous system and cardiovascular system medications accounted for 17% and 7% of government contributions, respectively.
As with total costs, government costs for nervous system and cardiovascular system medications reflect the rate of dispensing for these medications in the contemporary ex-serving and Australian populations. After accounting for age and sex differences, average government costs for the contemporary ex-serving population were $61 per person for nervous system medications and $30 per person for the Australian population (Supplementary table S4). Government costs per person for cardiovascular system medications were $33 per person in the ex-serving population and $37 per person in the Australian population.
As mentioned above, it is expected that DVA cardholders will have some dispensings provided under the PBS, rather than the RPBS. Government costs for dispensed medications come from both the RPBS (funded by the Australian Department of Veterans’ Affairs) and the PBS (funded by the Australian Department of Health).
The majority of costs for contemporary ex-serving members were dispensed under the RPBS (see Figure 12 below).
Another form of government available under the PBS and RPBS is safety nets for patients and families who reach certain cost thresholds within a given year. Once an individual, or family reaches the safety net threshold in the year, their medication costs are further reduced.
For concession cardholders and general beneficiaries using the PBS, these thresholds are based on cost. For concession cardholders, the safety net threshold on 1 January 2018 was $384. Once this threshold is reached, there are no further co-payment costs for concession cardholders. For general beneficiaries, the safety net threshold was $1,521.80. Once this threshold is reached, the co-payment cost per medication is $6.40 for general beneficiaries.
For RPBS users, safety net and co-payment thresholds were the same as for concession cardholders in the PBS.
In 2017–18, very small proportions of contemporary ex-serving members reached the safety net in 2017–18, less than 10% for each cohort, and less than 1% for general beneficiaries.
AIHW (Australian Institute of Health and Welfare) 2017. Medicines for cardiovascular disease. Canberra: AIHW.
DVA (Department of Veterans' Affairs) 2018. Non-Liability Health Care. Canberra: DVA. Viewed 1 July 2019.
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