A Comparison of PBS Medications in Two Remote Central Australian Aboriginal Communities

Aim: To compare costs of medications related to chronic disease care supplied through the PBS S100 program in two remote Aboriginal communities, from data provided by Medicare.

Background: Special arrangements exist to provide to clients in remote communities access to medications listed in the PBS at no cost (S100).These have been in place since 1999 and approximately 170 community controlled and state/territory operated remote health services participate. There are few reports on conduct or outcomes of this program.

Methods: Data were obtained from Medicare comprising PBS numbers for,and costs of, items dispensed in two remote Northern Territory Aboriginal health services (C1, population > 600; C2, population > 4500) from October 2011 through September 2012. We determined dispensing costs per drug and for all drugs for each community. Profiles of drug issuance by drug type were developed using associated WHO‐published Anatomical Therapeutic Chemical(ATC) Classification System codes and a purpose‐oriented coding system (WH)developed in house.

Results2: In C1 and C2, total costs were $165,596.85 and$1,434,134.80, respectively, of which lipid‐lowering drugs were 21.1% and 16.9%, diabetes‐related drugs 16.7% and 22.5%, BP‐lowering drugs 14.7% and 8.8%(60% of these being ACEi or ARBs), and lung disease‐related drugs 8.3% and 7.8%respectively using WH codes. Cardiovascular System and Alimentary Tract and Metabolism drugs accounted for >50% of costs in both communities (ATC);>60% of costs were CD‐related (WH). Anti‐infection drugs represented 12–16%of costs in these communities.

Conclusions: The high proportions of dispensing costs for chronic‐disease related drugs and the relatively low proportions of anti‐infection drugs mark the transition in health status in these remote Aboriginal communities and the gratifying strengthening of systematic chronic disease services.