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Many Australians are struggling to afford the medicines they need due to cost barriers, with women, young people, and those in poorer health particularly affected.
The 2022–23 Patient Experience Survey, released in November 2023 by the Australian Bureau of Statistics (ABS), revealed the extent to which Australians are struggling to afford essential health care.
In a perspective published in the Medical Journal of Australia, Dr Narcyz Ghinea, a research fellow from Macquarie University, discusses what the survey reveals about cost barriers to medication access in Australia.
“This latest release shows that many Australians struggle to afford the medicines they need and that cost barriers to access have increased compared with the previous year,” Dr Ghinea wrote.
Vulnerable groups affected
The data showed that 9.4% of women reported cost-related non-adherence (CRNA) to medication (ie, delaying or not filling prescriptions due to cost) in the previous 12 months, compared to 5.5% of men.
The rates increased for younger women, with 14.7% of 15–24-year-olds and 13% of 25–34-year-olds reporting medication-CRNA.
Younger Australians in general are experiencing cost barriers to care at greater rates than older Australians.
“A 25–34-year-old is 2.7 times more likely to experience medication-CRNA than a 75–84-year-old, 3.1 times more likely to delay visiting or not visit a general practitioner due to cost, and 3.8 times more likely to delay visiting or not visit a specialist due to cost,” Dr Ghinea wrote.
People in fair or poor health are also significantly affected, with 15% reporting medication-CRNA and 11.8% reporting delaying or not visiting a general practitioner due to cost.
ABS data are not the whole story
Dr Ghinea argues that the true rates of medication-CRNA are higher than described in the ABS data, as these data only relate to medicines prescribed by general practitioners and not specialists.
It also fails to capture the number of Australians who miss out on prescribed medications altogether due to lack of access to general practitioners or specialists.
Dr Ghinea notes a separate survey published in 2023, which found that 21.9% of Australians 45 years and older had experienced medication-CRNA in the previous 12 months.
“There are important data that the ABS survey does not collect and are essential to understand,” Dr Ghinea wrote.
“The experience of patients who can only afford their medications by making budget sacrifices that substantially affect their lifestyle is not captured.”
“The fact patients do find ways to pay for medicines does not mean they are affordable.”
Better data and better prices
Dr Ghinea argues that more extensive data need to be captured to understand the true extent of medication-CRNA across all medical services.
In particular, there needs to be more data on how many people are prescribed medications that are not on the Pharmaceutical Benefits Scheme (PBS), which accounts for a third of out-of-pocket health care spending for patients and contributes greatly to cost barriers.
“Addressing the affordability of medications is critical for reigning in out-of-pocket spending overall and improving access to medical treatment,” Dr Ghinea wrote.
There is also no data for people who are prescribed less effective medications, or no medication at all, because they are unable to afford the newer medications.
“Since there is no script, written data on this cost-motivated inferior treatment are never captured but are of great importance in an era when medicine prices for the newest drugs continue to rise and break new records, becoming further out of reach for patients,” Dr Ghinea concluded.
Read the perspective in the Medical Journal of Australia.
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Whilst interesting read there is lack of substance. What are people missing out on – essential medications or nice to have. In my experience people often quote cost as a barrier when they are really stating it is not offering enough benefit. We are over medicating lots of people – are they essential medications.
Also in Australia we have access to good medications which have been fully assessed by TGA and then decisions are made by PBS re the health economics – if they are life saving or likely to have an important effect on longevity and QOL then in most instances they will be subsidised. Devil is in the detail!!!