Patterns in PBS medicines by medicine group
Medicines are categorised by the Anatomical Therapeutic Chemical (ATC) Classification System, a classification system of 5 hierarchical levels (Level 1 being the most general level, 5 being the narrowest) based on active ingredients and according to what part of the body the medicine acts on and other such properties (therapeutic, pharmacological and chemical). This report uses the most general level of classification (Level 1). For more detail see Technical notes.
The 2 medicine groups with the highest annual prescription rates per person were:
- Medicines for the cardiovascular system with an annual average of 4.2 prescriptions dispensed per person in 2023 (Table 2)
- Medicines for the nervous system with an annual average of 2.8 prescriptions dispensed per person in 2023 (Table 2).
Medicines for the cardiovascular system include antihypertensives, diuretics, beta blocking agents & lipid modifying agents. Medicines for the nervous system include anaesthetics, analgesics (painkillers, opioids), psycholeptics & psychoanaleptics. Both have relatively stable monthly PBS prescription rates per person over time (Figure 2).
Antiinfectives for systemic use (which include antibiotics) saw (Figure 2):
- an increase in the number of dispensed prescriptions in March 2020 (the arrival of COVID‑19 in Australia)
- followed by a decrease in dispensed prescriptions for the remainder of 2020 and 2021 (Figure 2)
- the dispensing of these antiinfectives prescription medicines subsequently increased in 2022 and 2023, however not to pre-pandemic levels.
COVID‑19 may have had an impact on the overall decline (ACSQHC 2023a) of antiinfectives for systemic use via (ACSQHC 2022, ACSQHC 2023b):
- decreased prescribing of some of these medicines by general practitioners
- physical distancing restrictions resulting in fewer respiratory tract infections
- policy changes in April 2020 encouraging prescribers to issue repeat prescriptions for antimicrobials only when indicated.
The 2 medicine groups with the highest annual expenditure rates per person in 2023 were (Table 2):
- antineoplastic and immunomodulating agents (including antineoplastic agents; immunostimulants & immunosuppressants), at an annual average of $259 per person
- medicines for the nervous system at an annual average of $56 per person.
In contrast, systemic hormonal preparations (excluding sex hormones and insulins) had some of the lowest PBS expenditure rates in 2023, averaging $6.20 per person annually.
| Category | Annual PBS prescription rate (N per person) | Annual PBS expenditure rate ($ per person) |
|---|---|---|
| National | 12.6 | 641.52 |
| Alimentary tract and metabolism | 1.9 | 53.68 |
| Antiinfectives for systemic use | 0.9 | 50.23 |
| Antineoplastic and immunomodulating agents | 0.2 | 258.75 |
| Blood and blood forming organs | 0.5 | 36.93 |
| Cardiovascular system | 4.2 | 48.57 |
| Dermatologicals | 0.2 | 14.83 |
| Genito urinary system and sex hormones | 0.3 | 12.07 |
| Musculo-skeletal system | 0.4 | 22.85 |
| Nervous system | 2.8 | 55.73 |
| Respiratory system | 0.5 | 48.48 |
| Sensory organs | 0.4 | 30.75 |
| Systemic hormonal preparations, excl. sex hormones and insulins | 0.3 | 6.20 |
Figure 2: Monthly PBS prescription and expenditure rates by medicine group
See the following for an extended description.
Medicines for the cardiovascular system and for the nervous system have the highest prescription rates among the medicine groups and this is consistent over time. Antineoplastic and immunomodulating agents have the highest expenditure rates over time, with medicines for the nervous system second.