Wednesday, January 5, 2011

Fat chance

The Pharmaceutical Benefits Scheme [PBS] is an Australian Government programme of subsidised prescription drugs, aiming to ensure all Australians have affordable access to necessary medications [1]. The PBS was established in 1948, and PBS medicines were free until 1960 when user co-payment charges began. The 1960 co-payment was 5 shillings (i.e. 50 cents). In 1990 it was A$10, and in 2010 A$33.30 [2]. In 1948 the PBS cost the government £149,000 (i.e. A$7.6M in 2009 dollars). In 2009 its actual government cost was A$6.5B. The reasons for this massive cost increase since 1948 include the number and cost of PBS drugs, the range of medical conditions treated by them, and our population size. To reinforce this, here are three Tables of data on the top 10 subsidised drugs in 2009-10 [3]. Atorvastatin (trade name Lipitor, used to lower blood lipid levels) tops all three Tables. In 2009-10 over 11M Lipitor prescriptions were written, and it cost the government a massive A$633M. Each day in 2009-10, 69 people per 1,000 population (i.e. 6.9%) took a standard dose of it (or 81 people counting combination products). Other similar drugs – simvastatin (Zocor) and rosuvatatin (Crestor) – feature in these Tables too. So as a nation we eat unhealthy foods which raise our blood lipid levels which are treated by expensive drugs which cost our government, and thus us, over A$1B annually. Me? I reckon the government should whack up the tax on fatty foods. Will it happen? Fat chance. Ho hum.


farmdoc said...

Here's an alternative approach, proposed by the AMA [1].

Geoffrey Brittan said...

How about a tax on fat people, rather than the fat in food? It could be collected, when a driver's licence is renewed or reinstated; the client would step on a weigh scale as their picture is being collected. The money could be directed to the PBS.

A financial incentive might be just the thing. I am puzzled; 6.5 million is less than 7.6 million, which gives the impression that the "actual cost in 2009" was less than the cost in 1948. That would be a good thing, wouldn't it?

My wife teaches in a primary school. Her pupils are 6 and 7 years old. Yesterday, she showed them how to make a snowman outside in the playground; not one knew how to do it!

Geoffrey Brittan said...

"..the client would step on a weigh scale as the (not their) picture is being collected." I click the send button, then wish I could pull it back to fix it!

On another subject, the flooding in Queensland has been discussed widely in the news here. A similar situation has arisen in our Atlantic provinces.

I am sorry to see such devastation. I suspect, as the planet 'warms,' one should expect more extreme weather in every part of the world. I trust that you and your family are well, despite the crisis.

Best wishes from Canada.

Chrows25 aka Leather Woman said...

This is something I struggle with; fat people are a burden on our health systems, but so am I; Scleroderma is costing my country a bundle.I am not sure if I did something wrong or not, The D peniciiamine I take is $12 a day, not to mention the other costs it causes, thru thyroid, blood pressure, GERD requiring 2 Losec a day...
I am totally for putting a tax on high salt and high fat foods,
When I was a kid in UK, our chip packages had a little screw of salt in a tiny blue paper, you sprinked on the amount you wanted. Weirdo here never used it !

We have been taught to like more salt and fat than we need, time to re-eduducate our palates!

Dee said...

So why is Lipitor so widely prescribed. At a full price of $70.05 why isn't Lipidil ( full price $41.75) a cheaper alternative.

Or is it simply that I was prescribed Lipidil as that works better with my AvaproHCT ????