Pharmaceuticals Benefit Scheme

The Australian healthcare system is characterised by a complex arrangement that divides funding and service provision between federal and state governments, leading to issues like service gaps and inefficiency.

Only a small fraction of healthcare spending goes towards preventive measures. This is problematic given that a significant portion of chronic disease is preventable.

Recommendations include considering alternative funding models to foster more integrated, patient-centred care focusing on preventive health.

The system has not equally benefitted Indigenous and non-Indigenous Australians.

Aboriginal Community Controlled Health Organisations (ACCHOs) have been effective in delivering primary healthcare, and initiatives like the Special Pharmaceutical Benefits Scheme Agreement and Closing the Gap PBS strategy have improved medication access for Indigenous people.

Challenges with the Pharmaceutical Benefits Scheme (PBS)

Generic drugs in Australia are more expensive compared to other countries. Policies to reduce PBS costs include mandatory price reductions and establishing two drug formularies, which have achieved cost savings.

Issue of Out-of-Pocket Costs

Rising out-of-pocket costs are a major concern, with healthcare expenses increasing faster than the consumer price index. These costs, higher for people with chronic conditions and those in disadvantaged groups, often lead to deferred or forgone healthcare.

Inequity in Healthcare Access

Despite Medicare's aim of equitable healthcare access, disparities exist based on socio-economic status, geography, and in the distribution of hospital-based care. Rural and outer suburban residents face significant access challenges.