Drug Utilization Sub-committee
The Drug Utilization Sub-committee (DUSC) of the PBAC was formed in 1988. Its terms of reference include developing mechanisms for collection, analysis and interpretation of data on drug utilization; identifying potential health problems and benefits related to pattern of drug utilization; disseminating information on drug utilization; comparing drug utilization with that of other countries; and providing education on quality use of drugs . Patients are given duplicate prescriptions so that one part can be returned to the PBS to pay the claim and for drug utilization purposes.
A computerized database of all prescriptions dispensed in community pharmacies that are subsidized by the PBS is maintained. The database is not complete because prescription costs below the copayment (A$20.00 for general patients) or costs not covered by the PBS are not included . In 1994, 20.6% of community prescriptions fell under the copayment, and 6.7% were not covered by the PBS. In addition, the patient’s name or identifier is not on the prescription so that it cannot be linked with other databases. The DUSC, in conjunction with the Pharmacy Guild of Australia, has an ongoing community pharmacy survey to examine prescribing of cheap drugs that are not government subsidized. DUSC produces an annual report, Australian Statistics on Medicines . These data can determine the impact of listing a new drug. Studies examining the patterns of use of various categories of drugs have been published . The reasons for cost increases have been examined for some drug categories. For example the most expensive and most frequently prescribed antidepressants more than doubled from 1994/95 to 1995/96 (A$0.65 million to A$1.48 million). There was a 20% increase in the prescription of antiulcer agents, with an associated increase in cost of AUST$60 million . Further work needs to be done on the reasons for these cost increases and on the effect of selection or restriction of certain drugs on patient outcomes and satisfaction. Cross national studies are also needed, including per capita use and cost of drugs for specific disease episodes .