Cost driver analysis of statin expenditure on Australia’s Pharmaceutical Benefits Scheme

ABSTRACT

Introduction: The Australian Pharmaceutical Benefits Scheme (PBS) provides universal access to subsidized medicines. In 2013, statins as a class had the highest expenditure on the PBS.

Objectives: To assess the influence of policies and drivers affecting PBS statin utilization and expenditure between 1992 and 2013.

Methods: Analyses conducted from 1992 to 2013 and over three distinct time periods, including monthly expenditure/prescription, annual utilization (calculated as Defined Daily Doses/1000 inhabitants/day) and statin strengths dispensed.

Results: The major driver of increased PBS expenditure for statins was increased volumes. After adjusting for inflation, the average PBS expenditure on statin prescriptions was the major negative driver. Other influential drivers included the increased use of newer statins and increased strength of statins dispensed.

Discussion: Whilst the inflation-adjusted reimbursed price of statins decreased, increased utilization, including increased use of patented statins, increased total statin expenditure. Successful measures adopted by other countries could be applied to Australia to decrease total medicines expenditure.

KEY WORDS:

• Australia
• demand-side measures
• drug utilization research
• generics
• guidelines
• pharmaceutical expenditure
• prices
• statins

Acknowledgements

We thank Elena Lunga, Manager, Canadian National Prescription Drug Utilization Information System for her assistance in applying the cost driver analysis to the data.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Notes

1. Compound percentage formula applied across time period where where S₂₀₁₃ is the strength of statin in 2013, S_t is the strength of statin in the year of first prescription and x is the compound percentage increase.