Evaluation of the Better Access to Psychiatrists, Psychologists and GPs through the Medicare Benefits Schedule initiative: component B: an analysis of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) administrative data

8.3 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?

Page last updated: August 2010

The following analyses focus on the population of concession card holders. Here, the intent is to examine whether the increased rates of medication use after the introduction of Better Access might be greater among people for whom cost may have previously been a barrier to accessing some mental health services. Table 8.3 shows the results of the comparison of the trends in PBS-subsidised antidepressant medication supply for the pre– and post–Better Access periods forconcession card holders. Prior to the introduction of Better Access, the number of persons using antidepressants and rate of scripts supplied was stable. Following the introduction of Better Access, there was a significant increase in the number of persons using antidepressants and scripts supplied for antidepressants. The change in trend was statistically significant for persons using medications.

In interpreting these results it is assumed that the stable trend in concession card holders using antidepressant medications in the period prior to Better Access (compared to the small downward trend in the total population shown in section 8.2) occurs because the effect of medications falling below the co–payment threshold is not an issue for this group. The growth in persons using and scripts supplied for PBS–subsidised antidepressants post–Better Access however, was the same for concession card holders (1.0% and 1.5% per quarter, respectively) as for the total population (0.9% and 1.5% per quarter; see section 8.2).

In contrast to the findings for antidepressants, there was no significant change in trend for persons using or supply of PBS–subsidised anxiolytic medications for concession card holders, with time trends stable across the pre– and post– Better Access periods. The stable trends in persons using and scripts supplied for anxiolytic medications post–Better Access was consistent with the results for the total population (see section 8.2).

Table 8.3 Estimated change in trend for uptake of PBS–subsidised antidepressant medications, before and after the introduction of Better Access, among people eligible to receive these medications at a concession price.

Trend pre-Better Access
RR (95% CI)
PTrend post-Better Access
RR (95% CI)
PRatio of trendsaP
Persons using medication
0.993 (0.985-1.002)
0.136
0.999 (0.995-1.003)
0.539
1.005 (0.996-1.014)
0.240
Scripts supplied
0.992 (0.979-1.007)
0.297
0.998 (0.992-1.004)
0.558
1.006 (0.991-1.020)
0.435

2004 through 2008 figures have regard to all claims processed up to and including August 2009; 2009 figures have regard to all claims processed up to and including June 2010.
RR, rate ratio; CI, confidence interval. Data exclude the December 2006 quarter.
a The ratio of the post–Better Access trend to the pre–Better Access trend.

Table 8.4 Estimated change in trend for uptake of PBS–subsidised anxiolytic medications, before and after the introduction of Better Access, among people eligible to receive these medications at a concession price.

Trend pre-Better Access
RR (95% CI)
PTrend post-Better Access
RR (95% CI)
PRatio of trendsaP
Persons using medication
0.993 (0.985-1.002)
0.136
0.999 (0.995-1.003)
0.539
1.005 (0.996-1.014)
0.240
Scripts supplied
0.992 (0.979-1.007)
0.297
0.998 (0.992-1.004)
0.558
1.006 (0.991-1.020)
0.435

2004 through 2008 figures have regard to all claims processed up to and including August 2009; 2009 figures have regard to all claims processed up to and including June 2010.
RR, rate ratio; CI, confidence interval. Data exclude the December 2006 quarter.
a The ratio of the post–Better Access trend to the pre–Better Access trend.