The costs of taking multiple medicines
Taking multiple medicines can be costly, even despite subsidies such as the Pharmaceutical Benefits Scheme (PBS) & the PBS Safety Net threshold. Listen to patients taking about how they manage the expense of their medications
How they are going to afford their medicines is an important consideration for many of the people we spoke to. Many medicines in Australia are subsidised by the government via the Pharmaceutical Benefits Scheme (PBS), of which everyone was aware. Everyone with an Australian Medicare Card is entitled to pay the PBS subsidised price; concession card holders receive further benefits. War veterans are covered by the Repatriation Pharmaceutical Benefits Scheme (RPBS), which provides pharmaceutical and other benefits.
Many people also reach the PBS Safety Net threshold every year, which means general patients pay for further PBS prescriptions at the concessional rate and concession card holders are not charged for the rest of the calendar year. They are acutely aware that the PBS Safety Net makes it easier for them to take their medicines. However, medicines can be difficult to afford in certain circumstances. For example, medicines that are not covered by the PBS can be a significant cost for people who need to take them.
Furthermore, the expense of taking multiple medicines does add up and is compounded by other necessary health-related expenses, such as numerous GP, specialist and allied health appointments.
Medicines expenses can be high
The cost of Niall’s medicines contributes to the overall high expense of his healthcare.
- Micaela has found that she has been disadvantaged by recent changes to the PBS.
‘Doing without’ to afford medicines
Many people describe the benefits of their medicines as being well worth the expense. As such, they prioritise their health over other areas of life, often ‘doing without’ other things if necessary. Several people told us that they have become accustomed to the cost of their medicines over time. As Jane said, ‘I don’t get shocked anymore when I get to the checkout’. However, they often need to keep careful track of what they spend on their medicines. This is particularly the case for those who are not on concession or pension-level subsidy (i.e. ‘general patients’).
Like many people we spoke to, Gordon budgets carefully and limits other activities so as to afford his medicines.
Jane was initially concerned about the affordability of her medicines. But her husband regarded them as an investment, which has been an extremely helpful way for Jane to regard her medication.
Karen decided to do all she could to reduce pain and heal in the first year following her injury, despite needing to incur debt to do so. She needed to revise this when she found herself in significant debt due to her medical expenses.
The cumulative burden of medicines expenses
For some people we spoke to, the expense became greater as more medicines were added to their regimen and did not become a burden until they reached a particular number of medicines that collectively increased the cost.
Niall really noticed the cost once he was taking five medicines.
The impact of reduced work hours and low income
Some people needed to stop working or reduce their work hours to manage their medical conditions, which impacts on the affordability of their medicines. When this occurs, the difference between paying for medicines when they are employed compared to when they are not can be quite a shock.
Micaela’s conditions are ongoing, so she has had to drop to part-time hours, which impacts on the affordability of her medicines.
Glenn compares the affordability of his medicines with a Health Care Card to when he is working.
People we spoke to who are employed in entry-level positions find paying for their medicines a significant challenge. Even though they are employed full-time, their earnings are minimal and their expenses for medicines are the same as if they earned more.
Diana finds affording her medicines difficult regardless of whether she is studying, has a Health Care Card or is in full-time work.
Mia was relieved when a medicine that was not government-subsidised was ineffective, as the cost was too high for her. She just misses out on the PBS Safety Net most years and, although she can afford her medicines, it is money other people her age can spend on other things.
The transition from work to retirement can be difficult financially. Some of the people we spoke to find they are in the ‘gap’ between having the income to afford their medicines and qualifying for low-income assistance. For example, one person retired early because of poor health, yet she still needs to pay the full government-subsidised price and does not receive any concessional benefit for her medicines because her husband works full-time. They no longer have the money they used to, yet their medicines are costing them the same amount as always.
Jan’s first 12 months of retirement were necessarily self-funded, which posed problems for the affordability of her medicines. Now she is on an Age Pension, it is much easier.
Helen can manage her medicines now because she is working full-time. She is concerned about how she will afford her medicines in retirement.
Pharmaceutical Benefits Scheme (PBS) assistance
The people we spoke to who were on an Age Pension were greatly assisted by the Pharmaceutical Benefits Scheme (PBS). Many of them reached the PBS Safety Net within a year, meaning many additional medicines are cost-free (except for mandatory brand price and therapeutic group premiums, which exist for some medicines). They all report this as being of tremendous help.
One person notes that having all her prescriptions filled at the one pharmacy means that she can get an itemised record for the whole year when it is time to do her tax return. They also find additional ways to help offset the expense, which means that their medicines are within their capacity to afford.
Lyn and her husband have not had a problem affording her medicines, as most of them are covered by the PBS. She can buy one that is not covered through a hospital pharmacy, which reduces the cost.
Views of health professionals
The health professionals we spoke to were very aware that the expense of medicines could be an issue for many people.
Dr Elisabeth Wearne, GP, knows that affordability is a major issue for many of her patients and others in her area. She is concerned that people are more likely to believe unsubstantiated media reports and to stop taking their medicines if they are already struggling to pay for their medicines.
Emily Klopper, pharmacist, describes some of the things she can do in her pharmacy to help customers who are having problems affording their medicines.
What people also talk about
The Living with multiple medicines project was developed in collaboration with
