Introduction
Key findings
- In 2017–18, over 1 million medications were dispensed to around 70,000 contemporary ex-serving ADF members
- Around two thirds (64%) of all contemporary ex-serving ADF members were dispensed at least one medication
- 72% of contemporary ex-serving ADF members and 71% of all Australians were dispensed at least one medication, after adjusting for age and sex differences
- 22% of contemporary ex-serving ADF members and 24% of all Australians were dispensed cardiovascular medications, adjusted for age and sex differences
- 20% of contemporary ex-serving ADF members and 15% of all Australians were dispensed antidepressants, adjusted for age and sex differences
- 41% of contemporary ex-serving ADF members and 41% of all Australians were dispensed anti-infectives (including antibacterials, antivirals and vaccines), adjusted for age and sex differences
- 17% of contemporary ex-serving ADF members and 15% of all Australians were dispensed opioids, adjusted for age and sex differences
- 15% of contemporary ex-serving ADF members and 12% of all Australians were dispensed non-steroidal anti-inflammatory drugs NSAIDs, adjusted for age and sex differences
Medications play a key role in the healthcare of Australians through treating or delaying onset of disease, relieving symptoms and preventing health complications. The Australian government subsidises many medications dispensed through the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS). The PBS is available to all Australian residents who hold a current Medicare card, providing subsidies for all prescription medications listed under the scheme, subject to patient entitlement status. The RPBS is funded by the Australian Government Department of Veterans’ Affairs (DVA) and subsidises medications listed under the PBS, as well as additional medications and items for eligible veterans, war widows and widowers, and their dependents (Australia’s Health 2018).
Analysis of the PBS and RPBS within the population of ex-serving Australian Defence Force (ADF) members can provide insights into the use of pharmaceuticals by Australian veterans.
DVA commissioned the Australian Institute of Health and Welfare (AIHW) to investigate the medications dispensed to Australians who have served in the ADF since 2001, described here as the contemporary ex-serving ADF population.
The results presented in this report are based on data generated by linking information from the Department of Defence staff and payroll management system—the Personnel Management Key Solution (PMKeyS)—with the PBS and RPBS in 2017–18. This means that the scope of the ex-serving ADF members examined in this report is defined by the PMKeyS.
This report analyses the contemporary ex-serving population as a whole, as well as different cohorts within this population. Results presented in the web report focus on patterns of medication dispensing under the PBS and RPBS, with the accompanying interactive data visualisations providing results at a more detailed level.
Scope of analysis
The contemporary ex-serving ADF population
‘Contemporary ex-serving ADF members’ includes ADF members who had at least 1 day of service on or after 1 January 2001. This date defines the study population because this is when PMKeyS software was introduced. The study population includes individuals who discharged after this date but before 1 July 2017. All data about ex-serving ADF members presented in this report refer to this population.
Cohorts within the contemporary ex-serving ADF population
DVA cardholders—contemporary ex-serving members who have ever held either a DVA Gold or White card.
Concession cardholders—contemporary ex-serving members who have never held a Gold or White card and dispensed at least 1 medication as a concession cardholder in 2017–18.
The underlying population for this cohort is calculated as all those members who have never held a Gold or White card and dispensed at least 1 medication as a concession cardholder in 2016–17 or 2017–18, as there is no indicator on the underlying PBS or RPBS databases which indicates whether or not a person has a concession card.
General beneficiaries—contemporary ex-serving members who have never held a Gold or White card and not dispensed any medications as a concession cardholder in 2017–18.
The underlying population for this cohort is calculated as all those members who have never held a Gold or White card and not dispensed any medications as a concession cardholder in 2016–17 or 2017–18, as there is no indicator on the underlying PBS or RPBS databases which indicates whether or not a person has a concession card.
Dispensings from the PBS/RPBS
In this report, the terms ‘dispensing’ and ‘medication dispensed’ have been used to describe the supply of a pharmaceutical benefit under the PBS, or RPBS. It does not measure prescriptions written, nor does it infer that the medications were taken.
It should be noted that more items are listed under the RPBS than the PBS. In addition, the pharmaceutical benefit received under the RPBS may not be a medication specifically, as other items are covered, for example, medical dressings. Medications that are not listed on either the PBS or RPBS Schedules (including over the counter medications) may also be prescribed for eligible RPBS members, where deemed appropriate. These unlisted items will not be included in breakdowns by medication class as no detailed coding information is available.
The PBS/RPBS does not cover medicines supplied to public hospital in-patients, non-RPBS over the counter medicines or private dispensings. See Technical notes for more information on what is included under the PBS and RPBS. More information on items covered by the RPBS is also available at the PBS website.
All results presented of dispensings in the Australian population (crude and standardised rates) have been age-matched to the lower and upper age limits of the Australian population, 17–91 years.
References
AIHW (Australian Institute of Health and Welfare) 2018. Australia’s health 2018. Australia’s health series no. 16. Cat. no. AUS 221. Canberra: AIHW.