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PHARMACEUTICAL BENEFITS ADVISORY COMMITTEE RECOMMENDATIONS IN AUSTRALIA

Published online by Cambridge University Press:  13 July 2017

Erika Turkstra Open the ORCID record for Erika Turkstra [Opens in a new window] ,
Emilie Bettington ,
Maria L. Donohue  and
Merehau C. Mervin
Erika Turkstra
Affiliation:
Crawford School of Public Policy, Australian National [email protected]
Emilie Bettington
Affiliation:
Centre for Applied Health Economics, Griffith University
Maria L. Donohue
Affiliation:
Centre for Applied Health Economics, Griffith University
Merehau C. Mervin
Affiliation:
Centre for Applied Health Economics, Griffith University
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Abstract

Objectives: The aim of this study was to examine submissions made to the Pharmaceutical Benefits Advisory Committee (PBAC) and assess whether the predicted financial impact was associated with a recommendation. The second objective was to assess whether the financial and utilization estimates for listing the proposed medicine were reliable.

Methods: Data were extracted from public summary documents of major submissions considered by the PBAC from 2012 to 2014. Information collected included whether submissions were accepted, rejected, or deferred; estimated use; and financial impact. For those submissions that were recommended in 2012 and listed on the Pharmaceutical Benefits Scheme (PBS) by January 2014, a comparison was made between predicted and actual use and cost in 2014, based on PBS utilization.

Results: In 2012 to 2014, the PBAC considered 142 unique major submissions; of those, 65 were recommended for listing. A higher financial cost to the government was a statistically significant factor in predicting rejection (p = .004 for cost > AUD 30 million Australian dollars [20.7 million Euros] compared with cost-saving). Of the submissions that were recommended in 2012 and listed by 2014, the actual use was higher than predicted for 5/19 medications. The estimated cost was outside the predicted bracket of cost for 10/19 medications, with 8/19 medications having threefold underestimated expenditure, and 2/19 items having lower than predicted expenditure.

Conclusions: This study highlights that the predicted financial impact of a medication to the PBS budget is associated with a PBAC recommendation and also highlights that predicted use may not reflect actual prescribing practices.

Keywords

ReimbursementHealth budgetResource allocationPharmaceutical Benefits Advisory CommitteeBudget impact analysis
Type
Policies
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 4: Mini-Theme: Stories of HTA Impact , 2017 , pp. 521 - 528
Copyright
Copyright © Cambridge University Press 2017 

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References

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