Chronic conditions, financial burden and pharmaceutical pricing: insights from Australian consumers
Jennifer A. Whitty A B C I , Adem Sav C D , Fiona Kelly C D E , Michelle A. King C F , Sara S. McMillan C F , Elizabeth Kendall D G and Amanda J. Wheeler C D HA School of Pharmacy, The University of Queensland, Pharmacy Australia Centre of Excellence, 20 Cornwall Street, Woollongabba, Qld 4102, Australia.
B Centre for Applied Health Economics, School of Medicine, Griffith University, Meadowbrook, Qld 4131, Australia.
C Griffith Health Institute, Griffith University, Meadowbrook, Qld 4131, Australia. Email: a.sav@griffith.edu.au; f.kelly@griffith.edu.au; michelle.a.king@griffith.edu.au; s.mcmillan@griffith.edu.au; a.wheeler@griffith.edu.au
D School of Human Services and Social Work, Griffith University, Meadowbrook, Qld 4131, Australia.
E School of Pharmacy, University of Auckland, Auckland 1010, New Zealand.
F School of Pharmacy, Griffith University, Southport, Qld 4222, Australia.
G Centre for National Research on Disability Rehabilitation Medicine, Griffith Health Institute, Griffith University, Meadowbrook, Qld 4131, Australia. Email: e.kendall@griffith.edu.au
H Faculty of Medical and Health Sciences, University of Auckland, Auckland 1010, New Zealand.
I Corresponding author. Email: j.whitty@uq.edu.au
Australian Health Review 38(5) 589-595 https://doi.org/10.1071/AH13190
Submitted: 4 October 2013 Accepted: 2 June 2014 Published: 7 August 2014
Abstract
Objective To explore the perceptions of Australian consumers and carers about the financial burden associated with medicines used for the treatment of chronic conditions.
Method Semi-structured interviews were undertaken with individuals (n = 97) who identified as having a chronic condition(s) (n = 70), cared for someone with a chronic condition(s) (n = 8), or both (n = 19). Participants included individuals identifying with an Aboriginal or Torres Strait Islander (n = 23) or Culturally and Linguistically Diverse (n = 19) background. Data were analysed using the constant comparison method and reported thematically.
Results Participants described substantial costs associated with medicines use, along with aggravating factors, including the duration and number of medicines used, loss of employment, lack of pricing consistency between pharmacies and the cost of dose administration aids. Consequences included impacts on medicine adherence, displacement of luxury items and potentially a reduced financial incentive to work. Understanding and beliefs related to pharmaceutical pricing policy varied and a range of proactive strategies to manage financial burden were described by some participants.
Conclusions The financial burden associated with medicines used for the management of chronic conditions by Australian consumers is substantial. It is compounded by the ongoing need for multiple medicines and indirect effects associated with chronic conditions, such as the impact on employment.
What is known about the topic? Medicines are a common form of treatment in chronic conditions. The financial burden related to medicines use, including co-payments, is associated with reduced adherence and other cost-coping strategies. Out of pocket costs for prescription medicines are relatively high in Australia compared with some other countries, including New Zealand and the United Kingdom. Australian consumers with chronic illness are likely to be at particular risk of financial burden associated with medicines use.
What does this paper add? This paper explores the perceptions of consumers and carers around the financial burden associated with the use of medicines for the treatment of chronic conditions in Australia. It draws on the experiences and perceptions of a diverse group of consumers in Australia who identify as having, or caring for someone with, a chronic condition(s).
What are the implications for practitioners? Health professionals who assist consumers to manage their medicines need to be aware of the potential for financial burden associated with medicines use and its potential impact on adherence. There is a need for health professionals to educate and assist consumers with chronic conditions to ensure they can navigate the health system to maximum benefit and receive financial entitlements for which they are eligible.
Additional keywords: financial burden; pharmaceuticals; chronic conditions; Australia; consumer experience.
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