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ABC News
Health
the Specialist Reporting Team's Alison Branley and medical reporter Sophie Scott

As cost-of-living pressures bite, reset of Pharmaceuticals Benefits Scheme co-payments needed, experts say

Rick Parsons needs to take nine medications every day.  (Supplied)

Rick Parsons had two heart attacks and has type 2 diabetes, so taking regular medications are often all that stands between living and dying.

The Adelaide man takes nine different prescription medications, including blood sugar regulators, blood thinners, vein dilators, statins and cholesterol medications.

He pays the maximum price of $42.50 for most of his scripts under the federal government's Pharmaceuticals Benefits Scheme, known as a co-payment.

However, he does have support from a government safety-net scheme. It means that, once Mr Parsons spends a certain amount on scripts for the year he can apply for a discount for the rest of his scripts.

Prior to this year's federal budget, the threshold sat at $1,542. It will change to $1,457 on July 1. 

Mr Parsons said he would usually hit the threshold by about July each calendar year, and then his costs would go down to $6.80 for each medication dispensed.

For Mr Parsons, the government's change in the budget equates to the value of about two scripts.

"We just have to make sure that we've got enough money set aside for medication," he said.

Rick said the changes wouldn't make much of a difference. (Supplied)

He said it would be much easier if the $42.50 co-payment for prescriptions was generally lower all year round.

"If they just averaged it out, it would make it a whole lot easier to budget for," he said.

"I just don't know that they really thought about how it works for people on long-term medication."

Going without

Both sides of politics are being urged to do more to ease cost-of-living pressures, including out-of-pocket health costs, in the lead up to the federal election.

Pharmacy Guild of Australia president Trent Twomey said the rising cost of prescription medications meant many patients were skipping important drugs.

"It's a conversation that patients are having more and more often with their local pharmacist about which ones they can prioritise and which ones they can go without," he said.

A survey of 2,000 voters done for the Pharmacy Guild across 15 marginal electorates found that 30 per cent of people had trouble affording scripts in the past three years. 

Calls to bring down the co-payment

The federal government accidentally revealed it had been considering reducing the maximum price of medicines by $10 to $32.50 in the federal budget, but then scrapped the measure.

It was only brought to light when Assistant Treasurer Michael Sukkar and Financial Services Minister Jane Hume mentioned it in their budget speeches. 

Senator Hume then asked to have it deleted from Hansard, the official record of parliament.

Professor Twomey said that reducing the price to $32.50 wouldn't have gone far enough and would have only helped about 3 per cent of Australians.

The guild thinks the price should be closer to $20.

"For the general co-payment to have some form of real benefit, it at least needs to be halved from the $42.50 that it is now," he said.

Professor Twomey said the whole safety net system was an "affront" to Australians and undermined the principles of universal healthcare.

"There are only two levers the government can pull," he said.

"Tinkering around the edges for a $100 decrease in a $1,500 safety net doesn't help people who are struggling to make ends meet.

"Lowering the general co-payment is the only real way to address this problem."

Trent Twomey said the changes would not address the core issue.  (Supplied)

A spokesman for Health Minister Greg Hunt said the government spent $2.4 billion adding new drugs to the PBS in the recent budget.

It said 91 per cent of all medications dispensed to concession card holders went for $6.80, meaning only 9 per cent attract the full $42.50 price. According to the PBS, that equates to just under 20 million scripts a year paying the full price.

In a statement a Labor spokesperson said all Australians should have access to affordable medicines and it will be announcing all its policies prior to the election.

Patients skipping meds

Professor Twomey said there were strong economic reasons for a reduction because people skipping medications was one of the top 10 reasons for preventable hospital admissions.

The Consumer Health Forum said a 50 per cent reduction across the board would be a costly measure.

Its chief executive, Leanne Wells, said a better approach might be adding another price point tier to the co-payment system, that sits between the concessional co-payment, which is $6.80, and the $42.50 price for everyone else.

Consumers Health Forum of Australia chief executive Leanne Wells.

"We would encourage any incoming government to look at how medicine affordability could be better targeted, like an additional safety net for people with long-term chronic conditions," she said.

Ms Wells said many people also did not receive help with other pharmacy items needed to help manage chronic conditions such as supplements, stomach relief, pain medication and some specially-made medications from a compounding chemist.

"They'd be amongst the medicines that people are making choices, from time to time, to miss out on because of cost-of-living pressures."

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