Magnitude of variation Interpretation In 2013–14, were 1,659,993 PBS prescriptions Potential reasons for the variation include dispensed for asthma medicines, representing differences in: 20,425 prescriptions per 100,000 people aged 20 to rates of smoking, which is a known trigger for 44 years (the Australian rate). asthma. Higher rates of smoking are evident in those from low socioeconomic groups1, and The number of PBS prescriptions dispensed for among Aboriginal and Torres Strait asthma medicines across 325* local areas (SA3s) Islander people2 ranged from 2,244 to 44,092 per 100,000 people distribution of Indigenous people, who are almost aged 20 to 44 years. The number of prescriptions twice as likely as people to was 19.6 times higher in the area with the highest report having asthma3 rate compared to the area with the lowest rate. levels of adherence to medicines poor The average number of prescriptions dispensed – adherence to preventive medicines results in varied across states and territories, from 9,521 per poor asthma control4,5 100,000 people aged 20 to 44 years in the Northern Territory, to 32,260 in Tasmania. clinicians’ prescribing preferences, including for combination products or single-agent products After excluding the highest and lowest results, the distribution of concession cardholders as current asthma medicine prescription rate across the 306 PBS arrangements result in a cost gap for buying remaining local areas was 3.4 times higher in one asthma relievers but not preventers local area compared to another. use of spirometric assessments by general practitioners to determine asthma severity Dispensing rates tended to be higher in inner and outer regional areas than in major cities and were levels of access to, and of, over-the-counter lowest in remote communities. reliever medications. There was a clear relationship with socioeconomic It is also important to note that the dispensing of status in all categories of remoteness, with medicines in remote areas by some Aboriginal dispensing rates highest in areas of low Health Services is not captured in the PBS. socioeconomic status and decreasing as the socioeconomic status increased. To explore this variation, further analysis could focus on: the variation in dispensing of relievers and preventers for asthma across states and territories the extent to which higher smoking rates are linked to locations with higher asthma medicine dispensing rates.
Magnitude of variation In 2013–14, were 1,659,993 PBS prescriptions dispensed for asthma medicines, representing 20,425 prescriptions per 100,000 people aged 20 to 44 years (the Australian rate). The number of PBS prescriptions dispensed for asthma medicines across 325* local areas (SA3s) ranged from 2,244 to 44,092 per 100,000 people aged 20 to 44 years. The number of prescriptions was 19.6 times higher in the area with the highest rate compared to the area with the lowest rate. The average number of prescriptions dispensed varied across states and territories, from 9,521 per 100,000 people aged 20 to 44 years in the Northern Territory, to 32,260 in Tasmania. After excluding the highest and lowest results, the asthma medicine prescription rate across the 306 remaining local areas was 3.4 times higher in one local area compared to another. Dispensing rates tended to be higher in inner and outer regional areas than in major cities and were lowest in remote communities. There was a clear relationship with socioeconomic status in all categories of remoteness, with dispensing rates highest in areas of low socioeconomic status and decreasing as the socioeconomic status increased. Interpretation Potential reasons for the variation include differences in: rates of smoking, which is a known trigger for asthma. Higher rates of smoking are evident in those from low socioeconomic groups1, and among Aboriginal and Torres Strait Islander people2 distribution of Indigenous people, who are almost twice as likely as people to report having asthma3 levels of adherence to medicines – poor adherence to preventive medicines results in poor asthma control4,5 clinicians’ prescribing preferences, including for combination products or single-agent products distribution of concession cardholders as current PBS arrangements result in a cost gap for buying asthma relievers but not preventers use of spirometric assessments by general practitioners to determine asthma severity levels of access to, and of, over-the-counter reliever medications. It is also important to note that the dispensing of medicines in remote areas by some Aboriginal Health Services is not captured in the PBS. To explore this variation, further analysis could focus on: the variation in dispensing of relievers and preventers for asthma across states and territories the extent to which higher smoking rates are linked to locations with higher asthma medicine dispensing rates.
Chapter-6-30-Nov-2015-WORD-VERSION.docx