2006 年至 2018 年澳大利亚牙医开出的配药中患者自付费用：成本分析研究。

Financial contributions made by patients towards dispensed medicines prescribed by Australian dentists from 2006 to 2018: a cost-analysis study.

机构信息

International Research Collaborative - Oral Health and Equity, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. Email:

出版信息

Aust Health Rev. 2021 Mar;45(2):167-172. doi: 10.1071/AH20140.

DOI:10.1071/AH20140

PMID:33176901

Abstract

Objective This cost-analysis study explored Pharmaceutical Benefits Scheme (PBS) data to determine the financial patient contribution (PC) towards dispensed medications prescribed by dentists and temporal trends in cost contributions. Methods For this study we used the PBS online dataset and only included concessional data in the analysis. Data on dental medications dispensed under the PBS from 2006 to 2018 were accessed. For all medicines aggregated to different pharmacological categories (antibiotics, analgesics and opiates, anti-inflammatories, antifungals, benzodiazepines, anticonvulsants and anti-emetics, and emergency medications), a temporal trend was generated using annual PC data. Cumulative patient and mean annual PC data were also generated in a similar manner. Results Cumulative PC over the study period for dental PBS prescriptions was A$28783361 (A$5.55 per dispensing). The mean annual PC for dental PBS was A$2214105 (for the entire concessional population from 2006 to 2018), with a statistically significant and strong correlation between year and PC (Dental PBS, A$59756 per year; r=0.98: P<0.0001). Antibiotics represented the highest proportion of PC (87.8%), whereas the lowest proportion of PC was for emergency medications (e.g. adrenaline, atropine, glucagon, naloxone), which amounted to 0.003%. Conclusions This study highlights the increasing contributions made by patients towards antibiotic prescriptions. What is known about the topic? Australian dentists can independently prescribe subsidised medications as per a set scope for general and specialist dentists, regulated under the PBS with requisite adherence to specific legal requirements. What does this paper add? This is the first study highlighting the increased level of patient financial contributions towards dental medicines, according to different pharmacological categories, dispensed by pharmacists in Australia. What are the implications for practitioners? This study creates a base for future research assessing the appropriateness of the PBS subsidy and the PBS Safety Net threshold, possibly reassessing the out-of-pocket pricing on brand substitution and appropriately reassessing the current dental PBS schedule.

摘要

目的本成本分析研究利用药品福利计划（PBS）数据，确定了牙医开具处方的配药患者自付费用（PC），并探讨了成本分担的时间趋势。

方法本研究使用了 PBS 在线数据集，仅对优惠数据进行了分析。获取了 2006 年至 2018 年期间根据 PBS 分发的牙科药物的数据。对于汇总到不同药理学类别的所有药物（抗生素、镇痛药和阿片类药物、消炎药、抗真菌药、苯二氮䓬类、抗惊厥药和止吐药以及急救药物），根据年度 PC 数据生成了时间趋势。以类似的方式生成了累积患者和年度平均 PC 数据。

结果在研究期间，牙科 PBS 处方的累积 PC 为 28783361 澳元（每次配药 5.55 澳元）。2006 年至 2018 年期间，牙科 PBS 的年均 PC 为 2214105 澳元（针对整个优惠人群），年度和 PC 之间存在统计学上显著且较强的相关性（牙科 PBS，每年 59756 澳元；r=0.98：P<0.0001）。抗生素占 PC 的比例最高（87.8%），而占比最低的是急救药物（如肾上腺素、阿托品、胰高血糖素、纳洛酮），占 0.003%。

结论本研究强调了患者对抗生素处方自付费用的不断增加。

关于这个话题已知的内容是什么？澳大利亚牙医可以根据一般和专科牙医的规定范围，独立开具有补贴的药物，受 PBS 监管，需遵守特定的法律要求。

这篇论文增加了什么新内容？这是第一项研究，强调了根据不同的药理学类别，药剂师在澳大利亚分发的牙科药物，患者自付费用的水平有所增加。

这对从业者有什么影响？本研究为未来评估 PBS 补贴和 PBS 安全网门槛的适当性、重新评估品牌替代的自付费用定价以及适当重新评估当前牙科 PBS 时间表的研究奠定了基础。