Online version of the 2012-13 Department of Health and Ageing Annual Report
- Continued to give Australians affordable access to medicines by approving or listing 87 new Pharmaceutical Benefits Scheme (PBS) medicines, or extensions to existing listings, at a net cost of around $1.8 billion.
- Achieved value for Australian taxpayers by delivering further savings through the Expanded and Accelerated Price Disclosure program. Price changes in 2012-13 and beyond will reduce the forward estimates by a further $2 billion, with a total of around $4 billion in savings since these reforms began in 2010.
- Completed post market reviews of medicines used to treat Alzheimers disease and Atrial Fibrillation. This has led to improvements in the quality use of medicines, and easier access, where appropriate, for consumers and savings to the Australian community.
- Enabled people in residential aged care facilities to better manage medications through the Supply and Claiming from a Medication Chart in Residential Aged Care Facilities initiative, which by March 2013, was used in around 20 sites in the initial phase.
- Helped more than 30,000 Australians to better manage their medication through the MedsChecks and Diabetes MedsChecks programs. This, in turn, supported and improved peoples’ adherence to the quality use of medicines.
- Contesting a legal challenge to the Expanded and Accelerated Price Disclosure program.
- Ensuring a sustainable, efficient and transparent funding model for chemotherapy medicine infusions under PBS arrangements.
18.2% SUBSTANTIALLY MET
0% NOT MET
|Period||Met||Substantially met||Not met|
Programs contributing to Outcome 2
- Program 2.1: Community pharmacy and pharmaceutical awareness
- Program 2.2: Pharmaceuticals and pharmaceutical services
- Program 2.3: Targeted assistance – pharmaceuticals
- Program 2.4: Targeted assistance – aids and appliances
Figure 2.1: Government PBS expenditure and cost per capita, 2009-10 to 2012-13
Figure 2.2: Urban and Rural Pharmacies, 30 June 2009 to 30 June 2013
Note – As a result of the update of the Pharmacy Access/Remoteness Index of Australia (PhARIA) classifications, 118 pharmacies were reclassified from rural to urban.
Outcome 2 aims to provide reliable, timely and affordable access to cost-effective, sustainable and high quality pharmaceutical services and medicines. In 2012-13, the Department worked to achieve this Outcome by managing initiatives under the programs outlined below.
Program 2.1: Community pharmacy and pharmaceutical awareness
Program 2.1 aims to support timely access to medicines and pharmacy services. Support timely access to medicines and pharmacy services through the Fifth Community Pharmacy Agreement (the Fifth Agreement).
The Department continues to ensure that all eligible Australians continue to have timely access to PBS medicines and other professional services through the Fifth Agreement. The Fifth Agreement provides funding to remunerate pharmacists for dispensing PBS medicines and provides pharmacists with a range of professional programs and services which enable them to better service the community.
The medication management continuum is a key focus under the Fifth Agreement. It includes Clinical Interventions, MedsChecks and Diabetes MedsChecks, and Home Medicines Reviews. This approach allows for a graduated focus on helping people with their medication management needs.
Currently more than 80% of pharmacies participate in clinical interventions. The Fifth Agreement introduced this continuum arrangement to assist with medication management. Uptake has been higher than anticipated and the Department, in consultation with key stakeholders, is considering various approaches to ensure medication management programs are sustainable.
Deliverable: Phased rollout of measure: Electronic Recording and Reporting of Controlled Drugs Supply
2012-13 Reference Point: Measure phased in during the first half of 2012-13, including working with jurisdictions to facilitate the delivery of this measure
- First phase of implementation included the Department developing additional functionality for the existing Tasmanian Department of Health and Human Services real-time reporting and monitoring system so it could be used as the National Electronic Recording and Reporting of Controlled Drugs platform. The new system was offered to the states and territories at no charge via a Software Licence Agreement. States and territories that signed a Software Licence Agreement with the Commonwealth began evaluating the extent to which the system met their current and future needs. The Department will continue to work with states and territories in 2013-14 to implement this measure nationally.
Deliverable: Phased rollout of measure: Supply and PBS Claiming from a Medication Chart in Residential Aged Care Facilities
2012-13 Reference Point: Measure phased in during the first quarter of 2012-13, including testing the National Residential Medication Chart used in the aged care sector
- The Department, in conjunction with the Australian Commission on Safety and Quality in Health Care, began phased implementation of the National Residential Medication Chart (NRMC) in nominated residential aged care facilities and pharmacies in New Soth Wales (NSW). The initiative will directly support improved medication safety for residents and streamline access through enabling pharmacists to supply and claim PBS medicines from orders written on standardised medication charts in aged care facilities, instead of requiring an additional prescription.
The Commonwealth completed the PBS legislative changes required to allow phased implementation of the NRMC to begin from July 2012. However, state and territory enabling legislation is required to permit a medication chart to act as a prescription. In March 2013, NSW Health granted a legislative exemption to permit piloting of the NRMC. Consequently, the Department began phased implementation of the NRMC in approximately 20 selected aged care facilities in NSW from March 2013. The NSW pilot will be completed in 2013-14, and will include an evaluation to maximise medication safety and administrative efficiency.
Deliverable: Phased rollout of measure: Continued Dispensing of PBS medicines in Defined Circumstances
2012-13 Reference Point: Measure phased in during the first quarter of 2012-13, including working with jurisdictions to facilitate the delivery of this measure
Result: Substantially met
- The initiative aims to ensure that a patient’s treatment is not interrupted because they are unable to get their prescription renewed on time. Continued dispensing will complement existing state emergency supply provisions and allow pharmacists to process a PBS and Repatriation Pharmaceutical Benefits Scheme claim without the need for a follow-up prescription. The Commonwealth completed the PBS legislative changes required to allow continued dispensing to start from July 2012. Work progressed over 2012-13 with state and territories to support implementation, with national roll out commencing from 1 September 2013.
Deliverable: Number of medication management services provided under the Fifth Agreement
2012-13 Target: 63,000
2012-13 Actual: 115,894
- In 2012-13, 115,894 medication management services were funded under the the Home Medicines Review Program under the Fifth Agreement. This compares to 74,376 services provided in 2011-12 and 61,353 in 2010-11.
Traditionally, this deliverable is measured against the Home Medicines Review Program. However, it is worth noting that the Residential Medication Management Review Program and MedsCheck/Diabetes MedsCheck are also medication management services funded under the Fifth Agreement. During the year, 124,326 Residential Medication Management Reviews were undertaken as well as 43,442 MedsChecks and 9,849 Diabetes MedsChecks.
KPI: Percentage of rural community pharmacies accessing targeted rural programs to support the sustainability of community pharmacy in rural and remote Australia
2012-13 Target: 70%
2012-13 Actual: 82%
- In 2012-13, 82% of rural community pharmacies (699 of 851) accessed targeted rural programs. This compares to 89% in 2011-12 and 83% in 2010-11. The rate of pharmacy uptake of rural programs is demand-driven and therefore is subject to annual fluctuation. In addition, an update to the PhARIA classification took effect on 1 July 2012. This change impacted the total number of rural pharmacies eligible for rural programs.
KPI: Percentage of community pharmacies participating in the Pharmacy Practice Incentives Program
2012-13 Target: 45%
2012-13 Actual: 82%
- As at 1 June 2013, 4,385 (82%) of community pharmacies were participating in one or more components of the Pharmacy Practice Incentives Program. This is an increase from 75% of pharmacies that were participating in 2011-12. The components are Clinical Interventions, Dose Administration Aids, Staged Supply, Working with Others, Primary Health Care and Community Services Support.
Program 2.2: Pharmaceuticals and pharmaceutical services
Program 2.2 aims to provide access to cost-effective, innovative, clinically effective medicines to all Australians, and ensure the sustainability of the PBS.
List cost-effective, innovative, clinically effective medicines on the PBS
The PBS aims to provide Australians with timely access to a wide range of affordable and cost-effective medicines. In 2012-13, the PBS subsidised around 750 medicines available in more than 1,970 forms and marketed as more than 4,500 differently branded items.
KPI: Number of prescriptions subsidised through the PBS
2012-13 Target: 199m
2012-13 Actual: 197m
Result: Substantially met
- In 2012-13, 197 million PBS prescriptions were subsidised against an estimate of 199 million, representing approximately 8.6 prescriptions per capita. This compares with 194.9 million prescriptions in 2011-12 and 188.1 million in 2010-11.
The listing of medicines on the PBS is based on the advice of the Pharmaceutical Benefits Advisory Committee (PBAC), an independent, expert advisory body comprising doctors, other health professionals and a consumer representative.
The PBAC assesses the safety, therapeutic benefits and cost-effectiveness of a medicine and its intended use, in comparison with other available treatments.
Deliverable: The PBAC meets at least three times a year and provides recommendations to the Minister on new listings for the PBS
2012-13 Reference Point: The PBAC recommendations for listing on the PBS are based on the clinical effectiveness and cost-effectiveness of new medicines, and provided in a timely manner
- The PBAC met on six occasions during 2012-13. The PBAC recommendations were provided to product sponsors and the Minister for Health and the Minister for Medical Research, and made publicly available in timeframes consistent with long standing arrangements agreed with industry. All PBAC assessments are based on the clinical and cost-effectiveness of the medicine.
Deliverable: Percentage of the community’s (public) comments included for consideration at each PBAC meeting
2012-13 Target: 100%
2012-13 Actual: 100%
- In 2012-13, there were 792 consumer submissions on matters before the PBAC, compared with 924 received in 2011-12. Consumer comments on medicines under consideration by the PBAC are summarised, provided to the medicine’s sponsor, and taken into account by the committee in its decision making process.
In 2012-13, the Government approved or listed 87 new PBS medicines, or extensions to existing listings, at a net cost of around $1.8 billion over the forward estimates. In 2012-13, the following high-cost medicines, including the two new breakthrough and innovative medicines to treat hepatitis C, were listed.
Table 2.1: High-cost medicines listed in 2012-13
|Medicine||Indication||Listing date||Estimated number of patients per annum||Estimated expenditure – five years (fiscal)|
|Ticagrelor||Acute Coronary Syndrome||1 August 2012||60,000||$116.7m|
|Pregabalin||Chronic nerve pain||1 March 2013||270,000||$452.7m|
|Boceprevir and Telaprevir||Hepatitis C||1 April 2013||3,900||$219.3m|
PBS listing of new hepatitis C medicines
Australians infected with hepatitis C now have affordable access to two new ground breaking medicines.
On 1 April 2013, the Australian Government listed on the PBS boceprevir (Victrelis®) and telaprevir (Incivo®) – two new and innovative medicines used to treat hepatitis C.
Patients would have to pay up to $78,000 a year for these medicines without subsidised access through the PBS. The PBS listings, which will cost the Australian Government around $220 million over five years, will mean more people with the most common strain of hepatitis C can be treated.
Hepatitis C represents a significant public health problem. It was estimated in 2011 that more than 300,000 Australians had been exposed to the hepatitis C virus and at least 220,000 were living with chronic hepatitis C.41 An estimated 10,000 Australians are newly infected with hepatitis C each year. Hepatitis C is the leading cause of liver transplants in Australia.42 The symptoms of chronic hepatitis C can take years to emerge. However, if left untreated, it can lead to cirrhosis (scarring of the liver), liver cancer and liver failure.43
The Department plays a pivotal role in the PBS listing process of a medicine.
The Australian Government subsidises medicines through the PBS. The Pharmaceutical Benefits Advisory Committee (PBAC) is an independent, expert advisory body which evaluates medicines for subsidy and makes recommendations to the Australian Government. The Australian Government cannot list a medicine on the PBS unless the PBAC makes a recommendation in favour of its listing.
Following a positive recommendation from the PBAC, the Department negotiated with the relevant pharmaceutical companies to ensure that the PBS listing of the hepatitis C medicines was implemented in a timely manner.
Unlike other common types of hepatitis, there is currently no vaccine to prevent hepatitis C and medication is the only way to manage the disease.
Due to the PBS listing of boceprevir (Victrelis®) and telaprevir (Incivo®), it is estimated that there will be an approximate 75% cure rate for people with the most common and difficult to treat strain of the hepatitis C virus, genotype 1.44
Further details about the PBS listing of boceprevir (Victrelis®) and telaprevir (Incivo®), and other useful information about the PBS, can be found on the Department’s PBS website.45
On 30 June 2013, the Minister for Health and the Minister for Medical Research announced that the Australian Government had approved the PBS listing of many new medicines, including three groundbreaking medicines to treat cancer:
- Abiraterone (Zytiga®) for the treatment of prostate cancer;
- Ipilimumab (Yervoy®) for the treatment of advanced melanoma; and
- an oral form of vinorelbine (Navelbine®) for the treatment of advanced breast cancer.
The new subsidies for these three cancer medicines will cost the Australian Government more than $430 million over four years.
Deliverable: Price negotiations with sponsors and conditions for listing finalised, and quality and availability checks undertaken for new PBS listings
2012-13 Reference Point: All negotiations and listing activity completed in a timely manner
- The listing requirements for the 87 new medicines or extensions to existing PBS listed medicines announced or listed on the PBS (after consideration by the PBAC and approval by the Government, against appropriate criteria such as quality, availability and price), were completed in a timely manner, taking into account that the Department must negotiate outcomes with sponsors.
KPI: Revenue received from the cost recovery of the PBS listing process
2012-13 Target: $14.1m
2012-13 Actual: $9.2m
Result: Substantially met
- PBS cost recovery arrangements for the listing of new medicines or vaccines, or to vary the listing of existing products, were introduced from 1 January 2010. As reported in previous years, revenue from the measure continues to be well below forecast. PBS cost recovery is demand-driven. Revenue depends on factors outside the control of the Department, such as the type and number of submissions, and the number of waivers and exemptions applicable. The revenue of $9.2 million in 2012-13 compares with $6.8 million in 2011-12 and $7.8 million in 2010-11.
As required under Section 99YBC of the National Health Act 1953, an independent review into the impact of PBS Cost Recovery was undertaken with the report tabled in both Houses of Parliament on 19 September 2012.
The report contained four recommendations, ‘that the Government’:
- re-evaluate the activities subject to PBS Cost Recovery to ensure that costs for all current activities associated with the evaluation and listing process, such as the cost of maintaining risk share agreements, are updated to reflect current practice;
- consider whether total Government expenditure on a medicine also be considered in deciding whether to grant a fee exemption or waiver, even for those applications, which like the medicines on the Life-Saving Drug Program, involve small patient numbers but millions of dollars in expenditure, as blanket exclusions based solely on the number of patients likely to be treated do not always reflect the profitability of the medicine;
- develop ways in which structured consultation with consumers can be implemented to better inform PBS processes; and
- restructure the terms of reference for future reviews of the Cost Recovery program be structured to better align the terms of reference with the data sources available.
Increase the sustainability of the PBS
Reforms to the PBS, including price disclosure, are helping to ensure its ongoing sustainability into the future.
Price disclosure helps to ensure that Australian taxpayers benefit from discounts and incentives provided by manufacturers for medicines where there is more than one brand on the PBS. This reduces the price paid by Government for many medicines, which helps to ensure the sustainability of the PBS. In some cases, consumers will also pay less for each PBS prescription.
The price disclosure reforms of 2010 have resulted in further price reductions for many PBS medicines. In the first year of the 2010 reforms, $1.9 billion in savings were achieved over the forward estimates period. Price changes in 2012-13 and beyond will reduce the forward estimates by a further $2 billion, with a total of around $4 billion in savings since these reforms began in 2010.
On 6 December 2012, the Federal Court ruled in favour of a Sanofi-Aventis challenge to 1 December 2012 price disclosure reductions for risedronic acid and docetaxel, resulting in a full reversal of the 23.09% reductions for risedronic acid and a change in the docetaxel reduction from 76.83% to 76.20%. The corrected prices were included in the January 2013 Schedule of Pharmaceutical Benefits. The ruling also affected the way calculations were performed in the 2013 Main Cycle46 (for 1 April 2013). In response, the Department amended the National Health (Pharmaceutical Benefits) Regulations 1960 to reflect the decisions made by the Federal Court and has proceeded to calculate all subsequent Experienced and Accelerated Price Disclosure (EAPD) cycles using the new regulations.
KPI: Estimated savings to Government from the price disclosure program per annum
2012-13 Target: $121.0m
2012-13 Actual: Not applicable
Result: Not applicable
- This KPI has previously been reported for the 2007 price disclosure measure. From the 2012-13 financial year onwards, all price disclosure reductions occur under the EAPD measure, which was part of 2010 Further PBS Reform. The savings achieved from Further PBS Reform is reported under the “Estimated savings to Government from Further PBS Reform” KPI set out below. Price disclosure-related price reductions are an adjustment of the prices the Commonwealth pays for heavily discounted drugs, to more closely reflect the prices at which the drugs are supplied to the pharmacist. This KPI will be removed for the next reporting period.
KPI: Estimated saving to Government from Further PBS Reform47
2012-13 Target: $528.4m
2012-13 Actual: $661.3m
- Further PBS Reform saved the Government $661.3 million in 2012-13. This includes EAPD from 1 April 2012, savings from the 2% and 5% reductions on 1 February 2011 in the prices of all medicines listed on the F2A and F2(T) formularies respectively on 11 October 2010; and savings from the 1 February 2011 increase from 12.5% to 16% in the statutory price reduction applied to all medicines when their first generic competitor lists on the PBS.
National Medicines Policy
Australia’s National Medicines Policy (NMP) is the overarching framework that guides the Department in maintaining the community’s access to, and quality use of, medicines. The NMP has four central objectives: timely access to the medicines that Australians need, at a cost individuals and the community can afford; medicines meeting appropriate standards of quality, safety and efficacy; quality use of medicines; and maintaining a responsible and viable medicines industry.
The Department continues to collaborate with consumers, clinicians and all sectors of industry as part of its ongoing discussions on NMP issues. This engagement is important approaching the expiry of the Memorandum of Understanding (MOU) with Medicines Australia in June 2014.
The Department, on behalf of the Australian Health Minsters Advisory Council, oversaw the publishing of the Australian Medicines Handbook Children’s Dosing Companion in July 2013. The principal goal of the companion is to ensure health professionals have access to information on the safe delivery of commonly used medicines in Australia for children up to 18 years of age. The first edition contains information on 230 medicines. Updates to the companion will be published every six months.
The Department revised and published the Guiding Principles for Medication Management in Residential Aged Care Facilities in October 2012. This includes current evidence, policies and practices with the aim of promoting the safe and quality use of medicines in residential aged care facilities. The guidelines were distributed to pharmaceutical and aged care stakeholders.
Post Market Reviews
Post-market monitoring has been designed to improve patient safety, and quality use of medicines through a coordinated governance framework that draws on existing programs and data sets to monitor the actual use of medicines in clinical practice. This will allow the earlier identification of quality use of medicines issues including adverse events, improving prescribing and dispensing (through an enhanced ability to target education and support) and improve the sustainability of the PBS in the longer term through the integration of routine assessment of medicines use in the real world, including cost-effectiveness reviews for subsidised medicines
In 2012-13, the Department completed a number of reviews including of Anticoagulation Therapies in Atrial Fibrillation and PBS listed anti-dementia medicines for Alzheimers disease, and began two further reviews into products used in the management of diabetes and PBS medicines used to treat asthma in children.
The reviews have contributed to improved quality use of medicines for the Australian community. For example, the review of anti-dementia medicines used to treat Alzheimers disease has led to price reductions for these medicines, improving the sustainability of the PBS and resulted in changes in the assessment process required to establish patient eligibility for continued subsidisation. This ensures access to these medicines is made easier for patients benefiting from treatment. It also reduces red tape for clinicians.
The Trends in and Drivers of Pharmaceutical Benefits Scheme Expenditure Report jointly developed by the Department and Medicines Australia was released in May 2013. The report aims to inform future policy discussions between the Department and pharmaceutical industry stakeholders and provides an agreed and authoritative background to discussions on PBS expenditure and sustainability. This report demonstrates PBS growth is being driven by new medicine listings and increases in demand for existing medicines as well as an ageing population. It also confirms price disclosure and other policies are improving PBS sustainability, through growth in generic medicines.
The Department, on behalf of the Government, is seeking to recover compensation from pharmaceutical companies for losses incurred as a result of delays in the listing of generic medicines on the PBS arising out of unsuccessful legal challenges by pharmaceutical patent owners. The Department has commenced proceedings in the Federal Court in separate cases against Sanofi and Wyeth for losses arising out of delayed listing of generic versions of clopidogrel and venlafaxine, respectively.
Pharmaceutical Benefits Consolidated Information System (PharmCIS)
PharmCIS, implemented on 1 December 2012, is a submission processing information technology system that supports the processes of evaluating, pricing and listing medicines on the PBS. The new information system has modernised the PBS data infrastructure providing a consolidated view of all PBS Schedule information and delivering consistent and reliable information for improved decision making. The introduction of the new system has provided the opportunity to better structure information and data (for example PBS restrictions text) that allows downstream recipients of PBS data the capacity to more easily and automatically use the data and provides greater clarity for prescribers and dispensers.Top of Page
Program 2.3: Targeted assistance – pharmaceuticals
Program 2.3 aims to improve access to new and existing medicines for patients with life threatening conditions.
Improve access to new and existing medicines for patients with life threatening conditions
The Life Saving Drugs Program provides patients with financial assistance to access expensive and ‘life saving’ drugs not available on the PBS. In 2012-13, the Life Saving Drugs Program provided 228 eligible patients with fully subsidised access to expensive, life saving medicines for very rare life threatening conditions. During the year, 10 medicines were funded through the program for the treatment of seven separate disorders including: imiglucerase (Cerezyme®), velaglucerase (VPRIV®) and miglustat (Zavesca®) to treat Gaucher disease; agalsidase alfa
(Replagal®) and agalsidase beta (Fabrazyme®) for Fabry disease; laronidase (Aldurazyme®) for Mucopolysaccharidosis (MPS) Type I; idursulfase (Elaprase®) for MPS Type II; galsulfase (Naglazyme®) for MPS Type VI; alglucosidase alfa (Myozyme®) for infantile-onset Pompe disease; and eculizumab (Soliris®) for Paroxysmal Nocturnal Haemoglobinuria.
Each condition has separate eligibility guidelines, developed and administered with the advice of an expert disease advisory committee.
Global shortages of Fabrazyme® and Cerezyme® in 2012-13 continued to have an impact on the availability of these medicines through the Life Saving Drugs Program for treating Fabry and Gaucher diseases. The Department worked with industry and clinical advisory committees to ensure the best outcome for patients receiving treatment through the program. The supply shortages of Fabrazyme® and Cerezyme® were resolved in 2012-13, and eligible patients will continue to receive treatment through the program.
In 2013-14, the Department will continue to work with industry to finalise Deeds of Agreement for terms of supply for all medicines supplied through the Life Saving Drugs Program.
Deliverable: Review program guidelines to ensure they remain current and relevant
2012-13 Reference Point: Program guidelines reviewed within agreed timeframes
- The guidelines are used by the disease advisory committees to assess patients’ initial and ongoing eligibility. This assessment process can lead to the identification of the need for appropriate changes to guidelines.
Deliverable: Number of patients assisted through the Life Saving Drugs Program
2012-13 Target: 225
2012-13 Actual: 228
- In 2012-13, 228 patients were assisted through the Life Saving Drugs Program. All patients are reviewed every six months against the relevant eligibility criteria for the respective disease.
KPI: Eligible patients have timely access to the Life Saving Drugs Program
2012-13 Reference Point: Patient applications are processed within 30 calendar days of receipt
- All applications were processed within 30 calendar days of receipt of the complete data package to support the application.
Program 2.4: Targeted assistance – aids and appliances
Program 2.4 aims to provide support for people that require specific medical aids and appliances, for those people with diabetes, people who require a stoma and dressings for individuals with Epidermolysis Bullosa.48
Provide support for people with diabetes
The Department ensures that people with diabetes have timely, reliable and affordable access to products and services that help them effectively self-manage their condition. In 2012-13, the Department worked with Diabetes Australia to continue the effective delivery of the National Diabetes Services Scheme (NDSS). This also included work to progress three independent reviews which assess current arrangements under the scheme, to identify potential efficiencies for product supply and delivery, product listing, and registrant support services. These reviews, the final of which were completed in early 2013, will be supplemented by a consultation process that began in June 2013 and will draw together findings of the three reviews to inform future arrangements.
Deliverable: Number of people with diabetes receiving benefit from the National Diabetes Services Scheme
2012-13 Target: 1,180,000
2012-13 Actual: 1,087,000
Result: Substantially met
- As at 30 June 2013, an estimated 1,087,000 people with diabetes were registered on the NDSS. The forecast of 1,1800,00 was an estimate and it should be noted that the number of people receiving benefits under the scheme reflects the demand-driven nature of the scheme.
Deliverable: Number of people under 18 years of age with type 1 diabetes receiving a subsidised insulin pump
2012-13 Target: 62
2012-13 Actual: 76
- The number of insulin pumps subsidised under the program in 2012-13 exceeded its target due to the variable cost of pumps that are available and subsidised under the program.
KPI: Percentage of eligible people with diabetes who are able to access clinically appropriate products
2012-13 Target: 100%
2012-13 Actual: 100%
- All eligible people with diabetes have been able to access needles, test strips, syringes and insulin pump consumables through the scheme as required.
Assist people with a stoma by providing stoma related products
The Department continued to support the revised program pricing and listing framework for the Stoma Appliance Scheme, including listing 22 new products on the scheme. These new products, while being cost neutral to the scheme, have offered a wider choice of subsidised products. In addition, a review of price premiums applied to products has begun as a result of a 2012-13 Budget measure. In April 2013, price premiums were added to 22 products and removed from 23 products, following a review by the Stoma Product Assessment Panel. Further reviews will take place in 2013-14.
Deliverable: Number of people receiving stoma49 related products
2012-13 Target: 41,000
2012-13 Actual: 39,06350
- This figure represents people receiving assistance to the end of March 2013. Directly comparable data for the full financial year is not available due to a system change which has resulted in a change to the way in which individual participants are reported.
However, it is anticipated that if June 2013 figures had been available, they would have shown that the target has been met, as expenditure on the Stoma Appliance Scheme increased in line with predicted growth. In 2012-13 expenditure was 5% more than 2011-12; a 5% increase in the number of people benefiting would give a total of 42,149 at 30 June 2013.
KPI: Percentage of eligible people with stomas who are able to access clinically appropriate products
2012-13 Target: 100%
- All participants who met the eligibility criteria received products under the Stoma Appliance Scheme.
Improve the quality of life for people with Epidermolysis Bullosa
The Department has continued to provide access to clinically appropriate dressings for people with Epidermolysis Bullosa51 through the National Epidermolysis Bullosa Dressing Scheme. The scheme continues to assist people with Epidermolysis Bullosa by reducing the financial burden associated with purchasing necessary dressings.
KPI: The National Epidermolysis Bullosa Dressing Scheme is reviewed
2012-13 Reference Point: Review completed by 30 June 2013
- Following an internal review, ongoing consultation with peak groups including Dystrophic Epidermolysis Bullosa Research Association of Australia, and previous discussions with the Clinical Advisory Committee, the eligibility for the scheme was modified in October 2012 to remove all age restrictions under the scheme.
In addition, regular reports from the program administrators indicate overall satisfaction with the scheme and timely supply of clinically necessary products to ensure positive health outcomes and quality of life for these people.
Deliverable: Number of people with Epidermolysis Bullosa receiving subsidised dressings
2012-13 Target: 79
2012-13 Actual: 99
- The number of people with Epidermolysis Bullosa who are receiving subsidised dressing has significantly increased in 2012-13, as a result of the expansion of eligibility for the scheme to all age groups.
(A) Budget Estimate 2012-13
(B) Actual 2012-13
Variation (Column B minus Column A)
|Program 2.1: Community Pharmacy and Pharmaceutical Awareness|
|Ordinary Annual Services (Annual Appropriation Bill 1)||333,854||319,430||( 14,424)|
|Expenses not requiring appropriation in the current year2||157||264||107|
|Total for Program 2.1||340,795||326,590||( 14,205)|
|Program 2.2: Pharmaceuticals and Pharmaceutical Services|
|Ordinary Annual Services (Annual Appropriation Bill 1)||190,182||189,709||( 473)|
|National Health Act 1953 - Pharmaceutical Benefits||9,466,358||8,645,529||( 820,829)|
|Departmental Appropriation 1||36,521||36,300||( 221)|
|Expenses not requiring appropriation in the current year 2||1,191||2,303||1,112|
|Total for Program 2.2||9,694,252||8,873,841||( 820,411)|
|Program 2.3: Targeted Assistance - Pharmaceuticals|
|Ordinary Annual Services (Annual Appropriation Bill 1)||151,016||139,096||( 11,920)|
|Departmental Appropriation 1||3,292||3,347||55|
|Expenses not requiring appropriation in the current year 2||76||128||52|
|Total for Program 2.3||154,384||142,571||( 11,813)|
|Program 2.4: Targeted Assistance - Aids and Appliances|
|Ordinary Annual Services (Annual Appropriation Bill 1)||745||538||( 207)|
|National Health Act 1953 - Aids and Appliances||284,592||282,600||( 1,992)|
|Departmental Appropriation 1||3,292||3,346||54|
|Expenses not requiring appropriation in the current year 2||76||128||52|
|Total for Program 2.4||288,705||286,612||( 2,093)|
|Outcome 2 Totals by appropriation type|
|Ordinary Annual Services (Annual Appropriation Bill 1)||675,797||648,773||( 27,024)|
|Special appropriations||9,750,950||8,928,129||( 822,821)|
|Departmental Appropriation 1||49,889||49,889||-|
|Expenses not requiring appropriation in the current year 2||1,500||2,823||1,323|
|Total expenses for Outcome 2||10,478,136||9,629,614||( 848,522)|
|Average Staffing Level (Number)||230||234||4|
- Departmental appropriation combines 'Ordinary annual services (Appropriation Bill 1)' and 'Revenue from independent sources (s31)'
- 'Expenses not requiring appropriation in the budget year' is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses - please refer to the departmental financial statements for further information.