Life-saving medicines unaffordable as PBS co-pay heads to $50 script

Life-saving medicines used for diabetes, asthma, heart failure or anaphylaxis are unaffordable to many Australians as the rising cost of living collides with the rising cost of prescription medicines.

Many commonly used medicines on the Pharmaceutical Benefits Scheme (PBS) now cost patients $42.50 per prescription after the maximum co-payment went up again on 1 January 2022, putting scripts on track to cost patients up to $50 per prescription by the end of the decade. The co-payment for general patients has doubled since 2000 and according to ABS figures, more than 900,000 Australians delayed or didn’t get a script filled in 2019-20 due to cost.

PBS medicines which are becoming unaffordable are being used for conditions such as:

  • diabetes e.g. insulins, glucagon, Trulicity®, Byetta®, Januvia®, Trajenta®
  • asthma or chronic obstructive pulmonary disease (COPD) e.g. Symbicort®, Seretide®, Breo Ellipta®, Spiolto®
  • stroke/thrombosis prevention e.g. Xarelto®, Eliquis®, Pradaxa®, Clexane®
  • heart failure e.g. nebivolol, Coralan®, Entresto®
  • inflammatory bowel diseases such as ulcerative colitis or Crohn’s Disease e.g. Pentasa®, Salofalk®, Salazopyrin®
  • smoking cessation e.g. nicotine replacement therapies, Champix®
  • ADHD e.g. Ritalin® LA, Concerta®, Vyvanse®
  • severe cystic acne e.g. Roacutane®
  • schizophrenia e.g. clozapine
  • long-acting contraception e.g. Implanon®, Mirena®, Kyleena®
  • Parkinson’s Disease e.g. Sinemet® CR, Neupro®, Cabaser®
  • Rheumatoid Arthritis e.g. Humira®, Enbrel®
  • epilepsy e.g. Zarontin®, Trileptal®, Vimpat®, Briviact®
  • anaphylaxis e.g. Epipen®, Anapen®

Research conducted by independent research firm Insightfully on behalf of the Pharmacy Guild of Australia – community pharmacy’s peak body – has found that nearly a third (31 per cent) of middle-income households ($60,000 to $100,000) without a concession card have found it difficult to afford medications on the PBS.

In the marginal electorates surveyed, 13 per cent have gone without prescribed medicines because they could not afford them.

UTS modelling has found that hospitalisations and loss of productivity due to a failure to take medicines as instructed by medical professionals could cost the federal budget $10.4 billion in a year for hypertension, dyslipidemia and depression conditions alone.

The National President of the Pharmacy Guild of Australia, Professor Trent Twomey, said that patients were increasingly asking pharmacists which of the medicines prescribed by their GP could be skipped to save money.

“This is a dangerous trend, as prescribed medications are designed to work together to preserve the health and ultimately save the lives of the patients who need them,” Professor Twomey said.

“Pharmacists are worried that there will be more preventable ill-health and even deaths as people are increasingly finding themselves having to choose between buying the medicines they need and other essential items like rent, groceries and petrol.”

“As community pharmacists, we are raising the alarm. When medicines become unaffordable, it means that there is no real universal access to the PBS which is the foundation of our health system.”

The research will be made available on request.

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