Department of Medicine, Redland Hospital, Metro South Hospital and Health Service, Weippin Street, Cleveland, Qld 4163, Australia.
Aust Health Rev. 2021 Dec;45(6):704-717. doi: 10.1071/AH20330.
Objective The provision of medicines through state public hospitals is comparatively restrictive compared with the federally funded Pharmaceutical Benefits Scheme (PBS). Individual states are progressively moving towards statewide medicines formularies. Although a statewide formulary has existed in Queensland for some time. The effects of hospital formularies on medicines utilisation and policy in Australia has not been quantified. Thus, the aim of the present study was to quantify the effects of the Queensland Health List of Approved Medicines (LAM) on medicines utilisation in Queensland at a state and PBS-purchasing level and describe the implications for medicines policy. Methods This study used a quasi-experimental design with an interrupted time series (with control for PBS) examining utilisation effects of medicines within the therapeutic classes of proton pump inhibitors and non-vitamin K oral anticoagulants with LAM listing or delisting. Results The LAM was demonstrated to be highly effective at controlling utilisation within Queensland Health purchasing. Effects on PBS utilisation were evident, resulting in increases in generic utilisation (where available) and associated reduced total costs both within Queensland Health and to the PBS. The full benefit is likely underestimated due to limitations in the PBS datasets. Conclusion The LAM is a highly effective state medicines policy tool with demonstrable effects on PBS utilisation. With increased use of statewide medicines formularies, this will be an increasingly relevant aspect of Australia's overall medicines policy. What is known about the topic? State medicines policy is comparatively restrictive compared with the federal PBS. Most Australian states have, or are developing, statewide medicines formularies. What does this paper add? By examining several classes of medicines, a substantial quantitative effect of the Queensland state formulary on both state and PBS medicines utilisation can be demonstrated. Increased use of generic medicines and reduced costs are seen. What are the implications for practitioners? With increased use of state medicines formularies, state medicines formularies will become increasingly relevant to medicines policy makers and advocates at both the state and federal level.
目的
与联邦政府资助的药品福利计划（PBS）相比，通过国家公立医院提供药品的限制较多。各州正在逐步推行全州药品处方集。尽管昆士兰州已经有一段时间存在全州处方集，但医院处方集对澳大利亚药品使用和政策的影响尚未量化。因此，本研究的目的是量化昆士兰州卫生署批准药品清单（LAM）对昆士兰州在州和 PBS 采购层面的药品使用的影响，并描述其对药品政策的影响。
方法
本研究使用准实验设计，带有中断时间序列（PBS 控制），检查质子泵抑制剂和非维生素 K 口服抗凝剂治疗类别中 LAM 列入或删除对药品使用的影响。
结果
LAM 在控制昆士兰州卫生署采购范围内的使用方面非常有效。对 PBS 使用的影响是明显的，导致在昆士兰州卫生署和 PBS 内增加了通用药物的使用（在可用的情况下），并降低了总成本。由于 PBS 数据集的限制，完整的益处可能被低估。
结论
LAM 是一种非常有效的州级药品政策工具，对 PBS 使用具有明显的影响。随着全州药品处方集的使用增加，这将成为澳大利亚整体药品政策的一个日益重要的方面。
州级药品政策与联邦 PBS 相比较为严格。
大多数澳大利亚州都有或正在开发全州药品处方集。
通过检查几种药物类别，可以证明昆士兰州州级处方集对州和 PBS 药物使用都有实质性的定量影响。可以看到更多的通用药物使用和成本降低。
随着全州药品处方集的使用增加，州级药品处方集将成为州和联邦层面的药品政策制定者和倡导者越来越重要的参考。
