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  3. > IMS Pharmaceutical Pricing & Reimbursement Concise Guide: Australia

The Pharmaceutical Pricing & Reimbursement Concise Guides are established as the definitive reference and training text for P&R professionals around the world, drawing on the long-standing expertise of the IMS pricing and reimbursement specialists to provide industry players and decision makers with a thorough understanding of the rules and regulations governing P&R in international markets. This report covers key developments in P&R, market access, cost containment, trade margins and healthcare issues.

Table Of Contents

IMS Pharmaceutical Pricing and Reimbursement Concise Guide: Australia
AUSTRALIA1
HEALTHCARE SYSTEM1
Facts and Figures 1
Market Indicators2
Provision and Funding 4
Medicare4
Private Insurance5
Healthcare Services 5
PRICING6
Prescription Drugs6
Pricing Procedure 6
Pricing Mechanisms 7
Background10
Generic Drugs 11
Hospital Drugs11
OTC Drugs 12
REIMBURSEMENT 12
Admission to Reimbursement 12
Application Process 12
Listing Recommendations 13
PBAC Reform 14
Formularies14
Reimbursement Restrictions 15
Timelines 16
Independent Reviews 16
Reimbursement Categories 16
Reimbursement Prices17
Hospital Reimbursement17
Formularies17
Funding17
Changes in Reimbursement Status 20
Minor Changes 20
Major Changes 20
Other Changes 20
Post-market Reviews20
Delisting of OTCs 21
Changes in Reimbursement Prices 21
Price Adjustments21
Price Reviews 21
Price Cuts 22
Price Disclosure22
PHARMACOECONOMICS25
Pharmacoeconomic Requirements25
Pharmaceutical Benefits Scheme25
Australia, Pharmaceutical Pricing and Reimbursement Concise Guide
v
Hospital Formularies25
PRICE BUILD UP 26
Wholesalers 26
Mark-ups26
CSO Funding Pool26
Background27
Retail Pharmacies 27
Margins 27
Background29
Dispensing Doctors 30
Sales Tax 30
COST CONTAINMENT 31
Industry Paybacks31
Promotional Costs31
Expenditure31
Controls over Advertising and Promotion31
Patient Co-payments32
Pharmaceuticals 32
Healthcare 34
Prescribing Controls35
National Prescribing Service 36
Hospital Prescribing36
Reimbursement Restrictions 37
E-Health37
Generics37
Substitution38
Sustainability Initiative 38
INN Prescribing 38
Rx-to-OTC Switches 38
Switch Procedure 38
Recent Switches39
Other Changes of Status 40
OTC Market 40
Parallel Trade40
FUTURE DEVELOPMENTS 40
Outlook40
New PBAC Guidelines40
Review of Pharmacy Remuneration and Location Rules41
Generic Medicines Working Group 41
NAMES and ADDRESSES 42

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