PBS community awareness campaign: how helpful is blaming patients?
EMBARGOED UNTIL 1.00AM MONDAY 20 OCTOBER 2003
The current Pharmaceutical Benefits Scheme (PBS) Community Awareness Campaign, said to have cost Australian taxpayers $27 million, is misdirected in its emphasis on consumer 'waste' of medications, according to a special Medical Journal of Australia online article, due for publication on Monday.
Researchers Dr Evan Doran, and Professor David Henry from the Discipline of Clinical Pharmacology at the University of Newcastle, say the campaign, run by the National Strategy for Quality Use of Medicines, distorts reality by suggesting that patients are taking advantage of affordable access to prescription medicines, and that patient responsibility is "the prescription for a healthy PBS".
"The present federal Government, thwarted thus far by the Senate in its attempt to increase the patient co-payment, is trying an alternative - appealing to patients' moral sensibilities rather than their hip-pocket nerve," Dr Doran said.
While acknowledging the benefit of informing the Australian public about the operation, cost and strengths of the PBS, Dr Doran said the tone of the campaign is "morally charged, with the suggestion that many Australian patients are not acting responsibly in their use of prescription medicines".
"The present campaign appears to selectively choose more extreme examples of misuse of medicines to establish a moral position and place the responsibility for increasing prescription demand on patients," Dr Doran said.
"The campaign material says 'some people like to get a prescription every time they visit a doctor'. This statement implies that patients drive the demand for prescriptions and that the low cost of prescription medicines promotes wasteful behaviour.
"However, prescribing data cannot show whether the changes in pharmaceutical use reflect appropriate or inappropriate patient responses to increased cost.
"Increased demand when drugs are affordable does not mean that patients are using medicines unnecessarily.
By focusing on patient responsibility, the campaign has missed an opportunity to inform the public about other important factors contributing to increasing PBS expenditure, such as intensive drug promotion by pharmaceutical companies and doctors neglecting to prescribe older, cheaper medicines.
"Rather than blame patients for the difficulties facing the PBS, a more balanced approach to informing the community about these problems would be to acknowledge the role of patients, health professionals and the pharmaceutical industry in creating demand.
"It would also be useful to initiate an informed debate on how to sustain the PBS," the researchers said.
Dr Doran's article is attached to this media release and will be available on the MJA website, www.mja.com.au, at 1.00am on Monday 20 October.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Dr Doran, Weekend 02 49 529269, Mobile 0418405198
Professor David Henry, Weekend 02 49 505576, Mobile 0419284883
Judith Tokley, AMA Public Affairs, 0408 824 306