This chapter presents findings relating to Evaluation Question 6 which asks: To what extent has the Better Access initiative impacted on the use of medications commonly prescribed for treatment of mental disorders, in particular antidepressant medications?

To assess whether the Better Access initiative has impacted on the use of medications commonly prescribed for treatment of mental disorders analyses combining MBS and PBS data were undertaken. Firstly, analyses examined whether there been a change in demand for PBS-subsidised antidepressant and anxiolytic medications, at the level of Division of General Practice, since the introduction of Better Access. Division–level analyses were conducted comparing supply of these medications for the two years prior to the introduction of Better Access, with the period of available data after the introduction of Better Access (i.e. up to the March 2009 quarter). Secondly, analyses examined whether Better Access uptake has impacted on demand for antidepressant and anxiolytic medications, since the introduction of Better Access.

For the purpose of these analyses, the focus was restricted to antidepressant and anxiolytic medications as these are the principal pharmacological agents used in the treatment of affective and anxiety disorders, which are the key disorders targeted by Better Access. Evidence–based treatments for affective and anxiety disorders include antidepressant and anxiolytic medications, as well as psychological therapies such as cognitive behavioural therapy.45 The medical treatment of depression is based on antidepressant medications. Antidepressants have, over time, replaced benzodiazepines (the class of medications that traditionally comprises anxiolytics) as the preferred medication for longer term management of anxiety disorders, including obsessive compulsive disorder and panic disorder.46 The primary application of benzodiazepines is now for the short–term treatment of anxiety disorders.46, 47

The following series of research questions was examined:

  1. Has there been a change in demand for antidepressant and anxiolytic medications since the introduction of Better Access?

  2. Has there been a change in demand for antidepressant and anxiolytic medications since the introduction of Better Access among people eligible to receive medications at a concession price?

  3. What is the relationship between Better Access uptake and demand for antidepressant and anxiolytic medications at a Division level?