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Program 2.3: Veterans’ Pharmaceutical Benefits

Objective

Under Program 2.3 the Repatriation Pharmaceutical Benefits Scheme (RPBS) provides entitled beneficiaries with access to a comprehensive array of pharmaceuticals and wound dressings for the treatment of their health care needs, including those items available under the Pharmaceutical Benefits Scheme (PBS).

Overview

In 2012-13, DVA met its commitment to maintain a comprehensive RPBS Schedule that meets the health care needs of entitled beneficiaries and maintains consistency with trends in the delivery of health care services.

The department supported programs to enhance veterans’ access to quality pharmaceutical care, including the Veterans’ Medicines Advice and Therapeutics Education Services (MATES) program, and provided relief to eligible veterans in meeting the costs of pharmaceuticals through the Veterans’ Pharmaceutical Reimbursement Scheme (VPRS).

Overall use of the RPBS decreased in line with the declining treatment population, though the effect of this was offset through the use of higher-cost medications. The overall reduction in expenditure was a product of these factors, combined with the effect of mandatory price reductions under the PBS that flowed through to the RPBS.

Expenses

Administered and Departmental expenses
  2012–13 PBS1($ million) Estimated actual22012–13 ($ million) Outcome 2012–13 ($ million)
Administered 430.3 448.8 424.9
Departmental 3.3 1.7 1.5
Total resources 433.6 450.5 426.4

1 PBS in performance reporting tables means Portfolio Budget Statements.

2Estimated actual means the estimated expense or total for 2012–13 provided in the 2013–14 Portfolio Budget Statements. As the Budget is released in May each year but the financial year does not close off until 30 June, the current year numbers in the Budget can only be estimates.

Deliverables

Treatment population
  2012–13 PBS Estimated actual 2012–13 Outcome 2012–13
Treatment population 221 700 222 500 223 181

Key performance indicators

Unit cost per cardholder
  2012–13 PBS Estimated actual 2012–13 Outcome 2012–13
Price: Unit cost per cardholder $14 $7 $6

Report on performance

The Commonwealth subsidises a range of pharmaceuticals under the RPBS. Items available under the scheme are generally those medicines listed on the PBS that are available to the broader community. In addition to PBS-listed medicines, veterans have access to an extended range of medicines and wound dressings as listed in the Repatriation Schedule of Pharmaceutical Benefits. Payments to pharmacy providers are made through arrangements with the Department of Human Services on behalf of DVA.

Administered expenditure for pharmaceutical items

In 2012–13, expenditure under the RPBS was $424.9 million, an 8.4 per cent decrease on 2011–12.

This decrease is due to the combination of a continuing decline in the treatment population and the specific price decreases under the PBS price disclosure arrangements that flow through to the RPBS.

Price

The unit cost of $6 per cardholder in 2012-13 was below the estimate, and below that for 2011–12. The unit cost per cardholder is reported as the program staff and administration expenses (Program Support costs) per treatment population cardholder.

Number of pharmaceutical items dispensed

The number of RPBS-listed items dispensed in 2012–13 was 12.38 million, a decrease of 4.4per cent from 2011–12.

Percentage of treatment population using the Repatriation Pharmaceutical Benefits Scheme

In 2012–13, 90 per cent of the treatment population accessed the RPBS, a decrease of 0.5 per cent on 2011–12.

Veterans’ Pharmaceutical Reimbursement Scheme

In March 2013, the first payments were made to eligible veterans under the Veterans’ Pharmaceutical Reimbursement Scheme. Approximately 46 000 veterans received payments under the Scheme, for an average reimbursement of $116.

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