Home > MYEFO > Appendix A: Policy decisions taken since the 2009‑10 Budget > Expense Measures > Health and Ageing

Health and Ageing

E‑Health — development of a business case for individual electronic health records

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	3.7	-	-	-
Department of Finance and Deregulation	-	0.1	0.2	0.1	0.1
Total	-	3.8	0.2	0.1	0.1

The Government will provide $4.2 million over four years to fund a business case for establishing a national individual electronic health record system. Individual electronic health records have the potential to improve patient care by enabling health professionals across the health system to share patient information with the patient's consent. The business case, to be completed in early 2010, will help inform the Government's future decisions on e‑Health.

As part of this measure, the Government is committing $0.5 million over four years to fund a Gateway Review of the implementation of individual electronic health records. The Gateway Review process provides quality assurance during the implementation of major government projects so that the intended outcomes of the projects are achieved. This funding will be returned to the budget should it be determined that the development of individual electronic health records is not to proceed.

General Practice Super Clinics — further five clinics

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	-	-	-	-

The Government will provide $26.3 million over four years for five additional General Practice Super Clinics to further improve access to, and support for, better integrated primary health care services.

The five additional General Practice Super Clinics will be located in:

Cockburn, WA;
Gunnedah, NSW;
Portland, Vic;
Wodonga, Vic; and
South Morang, Vic.

The Government has provided $275.2 million over five years to establish General Practice Super Clinics across Australia. The additional Super Clinics will be funded from the existing program allocation.

The level of capital funding provided for each Super Clinic has been determined according to the particular health needs of the local community and whether the particular clinic is to be purpose‑built or an upgrade of an existing facility. Each clinic will focus on particular health issues that relate to its service area. These include increased child and maternal health services, increased access to diabetes‑related allied health services, the reduction of avoidable hospital admissions and chronic disease self‑management.

Further information can be found in various press releases issued by the Minister for Health and Ageing.

Medicare Benefits Schedule — new and revised listings

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	1.0	0.6	-0.3	-1.3
Medicare Australia	-	0.1	..	-0.1	-0.1
Department of Veterans' Affairs	-	0.1	..	-0.1	-0.3
Total	-	1.2	0.6	-0.4	-1.6

The Government has added several new items to the Medicare Benefits Schedule and Veterans' Benefits since the 2009‑10 Budget. The new listings are estimated to provide savings of $0.3 million over four years due to the expected reduction in the use of other Medicare Benefits Schedule listings.

The additions to the Medicare Benefits Schedule are:

magnetic resonance imaging items for better detection of rectal carcinoma;
deep brain stimulation items for the management of tremor conditions;
endoscopic ultrasound items to assist in the diagnosis of non‑Hodgkin's lymphoma, and endobronchial ultrasound items to assist in the diagnosis of peripheral lung lesions; and
positron emission tomography items for the detection of liver, lung and head and neck cancers.

Further information is available in the summary of changes included in the Medicare Benefits Schedule issued by the Department of Health and Ageing.

Medicare Benefits Schedule — promoting better use of selected spinal x‑ray items

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Medicare Australia	-	..	..	..	..
Department of Veterans' Affairs	-	..	..	..	..
Department of Health and Ageing	-	-2.0	-4.6	-5.0	-5.5
Total	-	-2.0	-4.6	-5.0	-5.5

The Government will amend schedule fees for two Medicare Benefits Schedule spinal x‑ray items to limit allied health professionals to being able to request one of these spinal x‑ray items per patient per episode of care.

This measure will help ensure that these x‑ray items are not overused and will reduce the risk of unnecessary exposure of patients to high levels of radiation.

Patients will still be able to have more than one spinal x‑ray per episode of care if deemed necessary by their general practitioner or specialist.

This measure will take effect from 1 January 2010 and will result in savings of $17.1 million over four years.

Pharmaceutical Benefits Scheme — additional therapeutic groups

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Medicare Australia	-	0.3	0.1	0.1	0.1
Department of Veterans' Affairs	-	-0.1	-1.0	-1.0	-1.0
Department of Health and Ageing	-	-1.2	-13.8	-14.7	-16.0
Total	-	-1.0	-14.7	-15.6	-16.8

The Government will establish three new therapeutic groups covering selected bisphosphonate drugs and selected antidepressants on the Pharmaceutical Benefits Scheme. Consistent with current practice, once the groups have been established, the Government will use the cheapest medicine in the group as the basis for the price paid for other medicines within the same group. The Government will maintain current arrangements whereby doctors can obtain an exemption from Medicare Australia for individuals who, for clinical reasons, require a higher priced medicine within a group. Under these arrangements, patients requiring the higher priced medicine will not pay a premium.

These additional therapeutic groups are expected to deliver savings of $48.2 million over four years commencing 1 April 2010.

Pharmaceutical Benefits Scheme — chemotherapy drugs — deferred implementation

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	33.4	-	-	-
Department of Veterans' Affairs	-	2.9	-	-	-
Total	-	36.3	-	-	-
Related revenue ($m)
Department of Health and Ageing	-	nfp	-	-	-

The Government will defer the implementation of the 2008‑09 Budget measure Responsible Economic Management — Chemotherapy Drugs — more efficient arrangements.

The measure, when implemented, will put in place more efficient arrangements for funding chemotherapy drugs listed on the Pharmaceutical Benefits Scheme and under the Chemotherapy Pharmaceuticals Access Program by only funding the amount of active ingredient used, rather than by the number of vials used. The deferral will allow further consultation with industry stakeholders to address implementation issues.

The deferral will reduce savings to the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme by $36.3 million in 2009‑10. This includes an impact on the listing of Avastin (bevacizumab), a drug used in the treatment of bowel cancer. There will also be an associated impact on revenue as pricing agreements between the Government and drug manufacturers allow for offsets to the gross cost of certain cancer drugs.

Further information can be found in the press release of 20 August 2009 issued by the Minister for Health and Ageing.

Pharmaceutical Benefits Scheme — listing of Revlimid® (lenalidomide)

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	15.6	25.5	26.1	26.7
Department of Veterans' Affairs	-	1.6	2.5	2.5	2.4
Medicare Australia	-	..	0.1	0.1	0.1
Total	-	17.2	28.0	28.6	29.2
Related revenue ($m)
Department of Health and Ageing	-	nfp	nfp	nfp	nfp

The Government will list Revlimid® (lenalidomide) on the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme from 1 November 2009, at an estimated cost of $103.0 million over four years. This includes funding for administering payments through Medicare Australia. A pricing agreement negotiated between the Government and the drug manufacturer allows for offsets to the gross cost of Revlimid®.

Revlimid® is used for the treatment of multiple myeloma, a cancer of the bone marrow.

Each patient requires approximately seven prescriptions per year, resulting in an average annual cost to the Pharmaceutical Benefits Scheme of approximately $47,000 per patient. General consumers will pay a $32.90 co‑payment per prescription and concession card holders will pay a $5.30 co‑payment per prescription.

Further information can be found in the press release of 10 October 2009 issued by the Minister for Ageing.

Pharmaceutical Benefits Scheme — minor new listings

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	21.7	32.8	41.6	47.4
Department of Veterans' Affairs	-	1.1	1.6	1.8	2.0
Medicare Australia	-	0.3	0.3	0.3	0.3
Total	-	23.2	34.7	43.7	49.8
Related revenue ($m)
Department of Health and Ageing	-	nfp	nfp	nfp	nfp

The Government has agreed to a number of minor new listings on the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme since the 2009‑10 Budget, at a cost of $151.4 million over four years. This includes funding for administering payments through Medicare Australia. Pricing agreements negotiated between the Government and the drug manufacturers allow for offsets to the gross cost of some of the minor new listings.

The minor new listings (including extensions to current listings) are medicines that have been listed at either no additional cost to the budget (because they replace existing listings) or at an estimated cost each of less than $10.0 million per annum.

Minor new listings include:

Enbrel®, for the treatment of chronic plaque psoriasis, a relapsing and inflammatory skin disorder;
Intelence®, for the treatment of HIV;
Xarelto®, for the prevention of venous thromboembolism, the formation of a blood clot within a vein, in patients who have undergone total hip or knee replacement; and
Oxytrol®, for the treatment of urinary incontinence.

Further information can be found in the press releases of 1 June 2009, 1 July 2009, 1 August 2009 and 1 September 2009 issued by the Minister for Health and Ageing and the updates to the Schedule of Pharmaceutical Benefits issued by the Department of Health and Ageing.

Protection against bovine spongiform encephalopathy

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Food Standards Australia New Zealand	-	0.6	0.7	0.7	0.7
Department of Health and Ageing	-	-	-	-	-
Department of Agriculture, Fisheries and Forestry	-	-	-	-	-
Total	-	0.6	0.7	0.7	0.7

The Government will provide $3.9 million over four years to ensure that imported beef and beef products available on the Australian domestic market remain safe for human consumption while meeting Australia's obligations under the World Trade Organisation Sanitary and Phytosanitary Measures Agreement. As part of this agreement, the Government will implement a new range of risk mitigation strategies to ensure a safe food supply in Australia is maintained.

The cost of this measure for the Department of Agriculture, Fisheries and Forestry of $1.0 million over four years and for the Department of Health and Ageing of $0.2 million over two years will be met from within the existing resources of these departments. Additional funding of $2.7 million over four years will be provided to Food Standards Australia New Zealand.

Further information can be found in the joint press release of 20 October 2009 issued by the Minister for Agriculture, Fisheries and Forestry, the Minister for Trade, the Minister for Health and Ageing and the Parliamentary Secretary for Health.

Seasonal influenza vaccine — expanded eligibility

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	10.8	10.3	11.3	11.4
Medicare Australia	-	-0.1	-0.1	-0.1	-0.1
Total	-	10.7	10.2	11.2	11.4

The Government will provide $43.5 million over four years to expand access to the seasonal influenza vaccine to all pregnant women, Aboriginal and Torres Strait Islander people aged 15 to 49 years and people medically at risk aged six months to 64 years, such as those suffering chronic diseases including diabetes, cystic fibrosis and cardiac disease.

These new groups will be eligible for free vaccinations under the National Immunisation Program from 1 January 2010. This measure is expected to increase uptake of seasonal influenza vaccinations under this program from 860,000 to 1.7 million people per year.

Further information can be found in the press release of 19 July 2009 issued by the Minister for Health and Ageing.

Skin cancer awareness campaign — continuation of funding

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	-	-	-	-

The Government will provide $2.5 million in 2009‑10 to continue funding for a further year for the National Skin Cancer Awareness Campaign. This campaign maintains public awareness about the dangers of sun exposure and actions that should be undertaken to prevent skin cancer. This extension of funding will enable the campaign to continue, pending consideration of a review conducted in 2009 on the future of the campaign.

The cost of this measure will be met from within the existing resourcing of the Department of Health and Ageing.

Swine flu (H1N1 influenza virus) pandemic response

Expense ($m)
	2008‑09	2009‑10	2010‑11	2011‑12	2012‑13
Department of Health and Ageing	-	45.2	0.8	0.3	0.3
Department of Agriculture, Fisheries and Forestry	-	-	-	-	-
Total	-	45.2	0.8	0.3	0.3
Related capital ($m)
Department of Health and Ageing	-	26.0	-	-	-

The Government will provide $229.6 million over five years (including $21.0 million in 2008‑09) in response to the H1N1 influenza virus pandemic. This funding supports the following activities designed to manage this pandemic and to enhance preparedness for any future pandemics:

storage, compounding and distribution of antivirals and personal protective equipment;
purchase of H1N1 influenza vaccine and associated clinical trials;
production, processing and distribution of immunisation consent forms;
monitoring and policy development;
immunisation awareness campaign;
purchase of the antiviral Relenza®; and
immediate communications, border protection, surveillance and health care worker support and training in 2008‑09. This included expenditure by the Department of Health and Ageing of $15.3 million, by the Department of Agriculture, Fisheries and Forestry of $4.2 million and by the Australian Customs and Border Protection Service of $1.5 million.

Funding for these programs will consist of up to $72.6 million of additional funding, with the remaining $152.8 million of the cost of this measure being met from within the existing resourcing of the Department of Health and Ageing and the Australian Customs and Border Protection Service. The Government will also provide an equity injection of $4.2 million in 2009‑10 to the Department of Agriculture, Fisheries and Forestry as reimbursement for costs incurred in 2008‑09.

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