National Medicines Use Dynamics: Influencing Health Policy with System Dynamics

摘要

The Australian Government is required to report every five years on the impact of current fiscal policies on future generations. The first Intergenerational Report (IGR) in 2002 projected future Federal income and expenditure for the next forty years based on expected demographic changes due to the baby boomers effect of increased fertility rates from 1946-1973. The projected growth in GDP was 2.5 times while the federal Government outlays on prescription medicines through the universal Pharmaceutical Benefits Scheme (PBS) was expected to grow fifteen-fold by 2042. We developed with The National Healthcare Alliance a system dynamics model of a broader view of future medicines use. This joint model replicated the IGR case as context, with additional detail on drivers of new drug use, feedback of benefits of medicines use on macroeconomics, and structural changes in over, under and mis-use of medicines over the next four decades. Main findings are: IGR projections are sensitive to assumptions, especially workforce participation and productivity growth; effective medicines use contributes to National Health and Wealth, and this contribution depends on the level of under-use, overuse and misuse of medicines. The results from this System Dynamics modelling formed the basis for a 2004 Federal Budget Submission to Treasury from the Alliance.