Changes in prescribing and changes in dispensing cannot be distinguished and the reality may be a mix of both. If accompanied by an increase in patients, differential numbers of scripts per patient for added or removed patients may affect the observed outcome. Table 106: Range of outcomes observed among all pre ICDP and post ICDP comparisons of average scripts per EverCtG patient, with potential causes. Observed outcome Potential causes A post ICDP trend increase: Existing PBS patients dispensed more scripts due to increased prescribing. an upwards trend pre ICDP with a larger, upwards trend post ICDP Existing PBS patients dispensed more scripts due to reduced financial barrier. A post ICDP upward trend: Existing PBS patients dispensed more scripts due to increased prescribing. flat pre ICDP with an upwards trend post ICDP Existing PBS patients dispensed more scripts due to reduced financial barrier. A post ICDP trend reversal: Existing PBS patients dispensed more scripts due to increased prescribing. downwards trend pre ICDP with an upwards trend post ICDP Existing PBS patients dispensed more scripts due to reduced financial barrier. A post ICDP positive levelling: Existing PBS patients were not filling some scripts pre ICDP, due to growing financial barrier and choose to have them downwards trend pre ICDP and filled post ICDP, when the financial barrier is reduced. flat post ICDP No change in pre ICDP trend: Pre ICDP trend drivers remain unchanged post ICDP. upwards trend pre ICDP continuing post ICDP No trend Patients are mainly concession card holders and most medicines are above the threshold. flat pre ICDP and continuing flat post ICDP A post ICDP negative levelling: No change in average scripts for existing patients and additional patients being dispensed scripts receive fewer upwards trend pre ICDP and flat scripts per patient. post ICDP Source: KPMG. Alimentary tract and metabolism Table 107: Summary of changes in annual trends from pre ICDP to post ICDP period, medicines from the ATC1 class of 'Alimentary tract and metabolism', by EverCtG status, age group and indicator. Age Group Indicator EverCtG NeverCtG 0 to 14 Patients dispensed at least one Post ICDP trend increase No trend script +8.8% to +21.3% Average scripts per patient No trend No trend
Changes in prescribing and changes in dispensing cannot be distinguished and the reality may be a mix of both. If accompanied by an increase in patients, differential numbers of scripts per patient for added or removed patients may affect the observed outcome. Table 106: Range of outcomes observed among all pre ICDP and post ICDP comparisons of average scripts per EverCtG patient, with potential causes. Observed outcome Potential causes A post ICDP trend increase: an upwards trend pre ICDP with a larger, upwards trend post ICDP Existing PBS patients dispensed more scripts due to increased prescribing. Existing PBS patients dispensed more scripts due to reduced financial barrier. A post ICDP upward trend: flat pre ICDP with an upwards trend post ICDP Existing PBS patients dispensed more scripts due to increased prescribing. Existing PBS patients dispensed more scripts due to reduced financial barrier. A post ICDP trend reversal: downwards trend pre ICDP with an upwards trend post ICDP Existing PBS patients dispensed more scripts due to increased prescribing. Existing PBS patients dispensed more scripts due to reduced financial barrier. A post ICDP positive levelling: downwards trend pre ICDP and flat post ICDP Existing PBS patients were not filling some scripts pre ICDP, due to growing financial barrier and choose to have them filled post ICDP, when the financial barrier is reduced. No change in pre ICDP trend: upwards trend pre ICDP continuing post ICDP Pre ICDP trend drivers remain unchanged post ICDP. No trend flat pre ICDP and continuing flat post ICDP Patients are mainly concession card holders and most medicines are above the threshold. A post ICDP negative levelling: upwards trend pre ICDP and flat post ICDP No change in average scripts for existing patients and additional patients being dispensed scripts receive fewer scripts per patient. Source: KPMG. Alimentary tract and metabolism Table 107: Summary of changes in annual trends from pre ICDP to post ICDP period, medicines from the ATC1 class of 'Alimentary tract and metabolism', by EverCtG status, age group and indicator. Age Group Indicator EverCtG NeverCtG 0 to 14 Patients dispensed at least one script Post ICDP trend increase +8.8% to +21.3% No trend Average scripts per patient No trend No trend
ICDP_appendices_vol4.docx