SENIOR AUSTRALIANS AND PRESCRIPTION MEDICINES Australian Association of Gerontology NSW 30 August 2013

 National Seniors is Australia’s leading non-profit, independent organisation for over 50s  We represent around 200,000 members - workers, pensioners, part-funded retirees, self-funded retirees  We provide a well-informed, independent voice and advocate on issues of concern for older Australians  Our Productive Ageing Centre conducts research on lifestyle issues for seniors and healthy ageing Who is National Seniors Australia?

Senior Australians and Prescription Medicines Outline of presentation  National Seniors research  Members responses Health status Use of medicines Affordability of medicines Actions taken by members  Possible assistance

National Seniors Research Senior Australians and Prescription Medicines: Usage, Sources of Information and Affordability  2012 National Seniors Social Survey  Demographics and Health module  10,000 members 50 years and older  3,188 completed questionnaires  Response rate 32% Productive Ageing Centre Research

Results: Self-rated health status Percentage

Results: Treatment and prescription medicines In the 5 years prior to 2012:  79% reported a health condition requiring treatment  92% took prescription medicines In January – February 2012:  81% were taking prescription medicines

Results: Health concerns Primary concern %In top 3 concerns % Heart disease/ stroke2358 Cancer2150 Dementia/ Alzheimer's1340 Arthritis/ bone disease934 Diabetes619 Obesity618 Mental health517 Eye disease416 Pain414 Lung disease/ asthma310 Others36

Results: use of medicines

Information Sources and Awareness  Decisions on treatment options: 50% with doctor or health care professional, 46% not involved in decision 33% used each of internet and pharmacist (espec. younger, higher educated, females)  Medicines reviewed with doctor 87%, pharmacist 16%  Consumer Medicines Information Leaflet ever received 58%  Good understanding of information 67%, some 25%  Aware that listing a new PBS medicine may take 3 years 46%.

Results: Financial strain by age

Financial strain by category 2012

Influences on affordability Cost of Living  Utilities, rates, daily essentials  Health care costs Private Health Insurance premiums Commonwealth Seniors Health Card Out of Pocket Health Care costs  Reduced Private Health Insurance rebates  Reduced income from investments.

Cost of Living Research  Older Australians ‘go without basics’ of food, medicines, heating/cooling to make ends meet  750,000 of 50+ households spend half income on groceries, electricity, gas, healthcare  Rated important/most important by 90% Able to afford aged care and medical expenses Regular income to cover the bare essentials Purchasing power keeps pace with inflation. Productive Ageing Centre Reports

Health Care Costs  Australians out-of-pocket health costs at $1,075 are fifth highest in the world, double Britain or France  65% of mature age people (aged 50-79) unable to afford private health insurance  570,000 people 55+ spend over 10% of income on health and about 250,000 spend over 20%  People 50+ spend out of pocket av. $353/quarter $882/ quarter if have 5+ chronic conditions. Productive Ageing Centre Reports

Actions taken  Seek cheaper alternatives 37%  Rationed prescription 17%  Delayed taking prescription 16%  Did not fill prescription 13%  People in 50s far more likely to take action  Took none of the above actions 40%. Productive Ageing Centre Reports

External actions  Lower the PBS Safety Net threshold for singles  Wider safety net for multiple chronic diseases  Increase Commonwealth Seniors Health Card thresholds  Re-negotiate PBS contracts –reduce cost to consumers and system  Integrate care across health system  Monitor and review medications dosage, interactions  Promote lifestyle changes.

Outcomes of non-compliance  Increased morbidity  Escalation of existing conditions  Increase in avoidable admissions  Reduced engagement with community  Poorer quality of life  Increased cost to health system/ society.

Any Questions? Thank you Website: nationalseniors.com.au National Seniors Australia Productive Ageing Centre: productiveageing.com.au/site/productiveageing.com.au/site/ Like us: facebook.com/nationalseniors Follow us: twitter.com/nationalseniors

Panel discussion  Prescription medicines used judicially enable people to maintain their independence and manage their health conditions for as long as possible.  Prescribing behaviour needs to take account of potential for interactions and side effects and monitor these to ensure an appropriate balance between benefits to the patient compared with disadvantages.  While supporting advice for people to adopt healthy practices we need to remember that not all influences on health behaviours are subject to personal choice. Most people do their best to adopt healthy practices.

 Health status  Usage of medicines  Sources of information  Affordability  Awareness and attitudes - health issues Members’ responses

Health concerns nominated

Sustainable Cost of Living

Voting preferences  Would be affected for 55% people if they had to pay more due to reduced government subsidies  Highest influence on those unable to function (70%), poor/ very poor health status, lower incomes, aged years  Lowest influence on those experiencing no impact on function, aged 75+ years, very good health

% of respondents willing or somewhat willing Total If unwell with condition the medicine treats66% If recommended by health care professional62% Access to treatment not otherwise available52% If it would help community by having more treatments available40% If family member unwell with condition the medicine treats32% Free treatment of condition the medicine treats28% Influences on participation in medical research