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Program 2.3: Veterans' Pharmaceuticals Benefits

Description

The Repatriation Pharmaceutical Benefits Scheme (RPBS) provides DVA clients access to a comprehensive array of pharmaceuticals and wound dressings for the treatment of their healthcare needs.

Delivery

  • Ensure DVA clients have access to a comprehensive range of pharmaceuticals and wound dressings that meet their healthcare needs.
  • Facilitate arrangements with pharmaceutical sponsors for the listing of the range of items appropriate to the DVA treatment population.
  • Facilitate effective payment of approved pharmacies for supplying items under the RPBS.

Veterans' pharmaceutical benefits

Pharmaceutical items on the Repatriation Pharmaceutical Benefits Scheme (RPBS) are monitored by the Repatriation Pharmaceutical Reference Committee (RPRC).

The RPRC includes experts nominated by medical and pharmaceutical associations and veteran community groups, who advise the Repatriation Commission and the Military Rehabilitation and Compensation Commission on the clinical appropriateness and conditions of supply for veterans' pharmaceutical and wound dressing needs.

In delivering the RPBS, DVA supports a Quality Use of Medicines program, which is designed to encourage best practice in the prescribing, dispensing and use of medications for DVA clients. Through the Veterans' Medicines Advice and Therapeutics Education Services (Veterans' MATES) program, DVA promotes education and intervention programs to assist both its clients and health service providers better manage specific health problems, reduce the use of unnecessary medicine, and improve utilisation of health services.

In 2016–17, through DVA's Veterans' MATES program, advice on several topics—dementia and changes in behaviour; reviewing the medicine routine; chronic obstructive pulmonary disease (keeping well this winter); and, wound care—was disseminated to DVA clients and their health professionals, community pharmacists, accredited pharmacists and residential aged care facilities.

The Veterans' Affairs Pharmaceutical Advisory Centre continues to deliver service delivery aspects of DVA's pharmaceutical programs. This includes assisting prescribers in selecting suitable medication management options, choosing medicines wisely to ensure safe and effective use, and advising on treatment options to provide the best health outcomes for DVA clients.

The centre offers a 24-hour, 365-day service and received over 350,000 enquiries and prior approval requests from prescribers and pharmacists during 2016–17. It is staffed by registered pharmacists with a special interest in veterans' health care and aims to achieve the best possible use of medicines by putting the client at the centre of this care.

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Administered expenditure for pharmaceutical items (cash basis)

In 2016–17, expenditure under the RPBS was $305.3 million, which is a 9.4 percent decrease compared to $337.07 million in 2015–16. The decrease in expenditure reflects the continuing decline in the treatment population, together with the ongoing impact of a reduction in prices for Pharmaceutical Benefits Scheme items and the flow-through to the RPBS for dual-listed drugs.

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Number of pharmaceutical claims paid

Payments to pharmacy providers are made by DHS on behalf of DVA. In 2016–17, DHS paid 9.56 million claims for RPBS-listed items on behalf of DVA, a decrease of 9.4 percent compared to 10.55 million claims in 2015–16.

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Percentage of treatment population using the Repatriation Pharmaceutical Benefits Scheme

In 2016–17, 87.6 percent of the treatment population accessed the RPBS compared to 89.3 percent in 2015–16.

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Veterans' Pharmaceutical Reimbursement Scheme

The Veterans' Pharmaceutical Reimbursement Scheme reimburses eligible DVA clients for out-of-pocket costs associated with the concessional pharmaceutical co-payment.

In March 2017, annual payments under the scheme were made to approximately 32,000 eligible DVA clients. The total payment was approximately $4 million, with an average payment of $124.37 per eligible client.

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