Amal Trivedi and Margaret Kelaher, CTG, s100 and QUMAX

1. NACCHO Members’
Conference and Annual
General Meeting 2018
Aboriginal health in Aboriginal hands | www.naccho.org.au
Stay connected, engaged and informed with NACCHO www.naccho.org.au/connect
‘Investing in What Works:
Aboriginal Community Controlled Health’

2. Effects of Medication Co-
payment Reductions
among Indigenous
Australians
Aboriginal health in Aboriginal hands | www.naccho.org.au
Stay connected, engaged and informed with NACCHO www.naccho.org.au/connect
Amal Trivedi and Margaret Kelaher

3. Closing the Gap PBS Co-payment
Measure
• Implemented in July 2010
• Applied to all non-remote general practice
• Reduces monthly medication copayment to
$5.40 (from max of ~$35) for non-concessional
patients and $0 for concessional
• Registration through GP
• “With chronic disease or at risk for chronic
disease”

4. Closing the Gap PBS Co-payment
Measure
• Uncapped
• Estimated to cover 70,000 Indigenous persons
at cost of $90 million
• Most recent data: 182,000 Indigenous patients
access the benefit by 2012
• Part of $1.6 billion effort to address Indigenous
health disparities

5. Trends in PPH for Indigenous people in
high and low uptake areas
d low uptake areas
PH for Indigenous and non-Indigenous people in high and low
uptake areas
PPH admissions per 1000 Aboriginal and Torres Strait Islander
people aged ≥15 years 2009-2011 in areas of high and low uptake
of the PBS Co-payment measure
103.3
93.3
60
63.3
56 58
0
20
40
60
80
100
120
140
2009 2010 2011
Admissions/1000Persons
Indigenous (High-Uptake) Indigneous (Low-Uptake)

6. Trends in PPH for Indigenous and non-
Indigenous people in high and low
uptake areas
103.3
93.3
60
63.3
56 5828.3 25.5 20.5
20.2 19.2 17.50
20
40
60
80
100
120
140
2009 2010 2011
Admissions/1000Persons
Indigenous (High-Uptake) Indigneous (Low-Uptake)
Non-Indigenous (High-Uptake) Non-Indigenous (Low Uptake)
PPH admissions per 1000 people aged ≥15 years 2009-2011 in
areas of high and low uptake of the PBS Co-payment measure

7. Objectives
• Evaluate the impact of the Closing the Gap PBS
Incentive on the use of medications
• Assess effects on out-of-pocket and government
spending for prescription medications
• Examine heterogeneities of effects for
concessional vs non-concessional patients and
types of medication classes

8. Out-of-pocket Spending

10. Registration

11. CTG Registration

12. Medication Use

14. CTG Registration

15. CTG Registration

16. Conclusions
• High takeup, but many eligible patients left out
• CTG Incentive associated with decreased out-
of-pocket spending and increased use of
medications
• Use of medications particularly increased for
non-concessional patients, who had the greatest
copay reductions
• 70%-100% increase in diabetes/antihypertensive
medications among non-concessional patients