Consumer Co-payments For Subsidised Medicines: Impact On Access And Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$465,838.00
Summary
Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and di ....Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and discretionary medicines fell immediately after the introduction of copayments for concessional card holders in 1991(5). Subsequent analysis found that low income general beneficiaries bore the greatest burden of copayments, with PBS expenditure accounting for 7.4% of their income, compared with 2.4% for those with high incomes(6). Costs appear to be becoming a barrier to medicine use in Australia, with a 2005 survey of 702 Australian adults who required regular medications finding 22% did not fill a prescription because of cost in the last 2 years(7). Similar results were reported in 2002 for 23% of 844 sicker Australian adults(8). A regional survey of 420 households found 20% reported they did not purchase all of their prescription medicines due to costs(9). Apart from the initial analysis of medication changes in 1991 as a result of copayment introduction(5), no Australian study has assessed the impact of these on medication use, nor on the impact of any changes in medication use on health outcomes. While copayments may effectively reduce the cost burden of the PBS to government, they may have an unintended negative effect if costs are generated elsewhere in the health system through increased hospitalisations or emergency department attendances as a result of omission of medicines. This research will explore the association between increasing copayments, medication and health service utilisation, information critical for informing policy on increasing consumer copayments.Read moreRead less
Evaluation Of Long-Term Clinical And Health Service Outcomes Following Coronary Artery Revascularisation In Western Australia: Future Implications
Funder
National Health and Medical Research Council
Funding Amount
$638,412.00
Summary
Heart attacks occur when arteries of the heart become blocked, and current treatment involves unblocking the affected vessel by inserting a stent fed through a leg artery or using bypass surgery. There are different types of stents and whether they offer better outcomes than surgery in the long-term is currently undecided. We will evaluate whether patients who receive stents have better outcomes after 5 years than patients who have surgery, and what the various costs are to the health system.
Higher Returns In Prawn Aquaculture: Pilot Program To Create Production Stocks That Are All Female
Funder
Fisheries Research and Development Corporation
Funding Amount
$163,967.00
Summary
Objectives: 1. Establish the genetic mechanism of sex determination in penaeid prawn and provide genetic markers that will allow sex to allow sex to be determined before visible signs are evident 2. Identify and isolate gene(s) involved in, and ideally resposible for triggering sex determination. Studies of the potential for hormones to induce sex reversal will also be undertaken 3. Produce the first sex reversed prawns as broodstock.
Rock Lobster Enhancement And Aquaculture Subprogram: The Nutrition Of Juvenile And Adult Lobsters To Optimise Survival, Growth And Condition
Funder
Fisheries Research and Development Corporation
Funding Amount
$242,418.50
Summary
Because Australia's rock lobster fisheries are at their maximum sustainable capacity, the value of the industry can be increased only through the development of aquaculture. In the immediate term, this could be achieved by on-growing of juveniles taken from the wild and the holding of adults for weight gain or niche marketing opportunities. In the longer term, domestication of the specie/s and hatchery propagation of the juveniles will enable a sustainable rock lobster aquaculture industry to d ....Because Australia's rock lobster fisheries are at their maximum sustainable capacity, the value of the industry can be increased only through the development of aquaculture. In the immediate term, this could be achieved by on-growing of juveniles taken from the wild and the holding of adults for weight gain or niche marketing opportunities. In the longer term, domestication of the specie/s and hatchery propagation of the juveniles will enable a sustainable rock lobster aquaculture industry to develop. In Australia, these opportunities are seriously constrained by the lack of a cost-effective and efficacious rock lobster feed. This contrasts with the developing industry in New Zealand where waste from the large mussel industry is an available and inexpensive source of feed. If feed comprises from 40 to 50% of rock lobster production costs as is the case for prawn and finfish grow-out operations, the availability of a suitable formulated pelleted feed is seen as a necessity for commercial production.
Preliminary feed’s development work (FRDC 98/303) for juvenile and adult lobsters has been initiated in an 18-month project that terminated in December 1999. Although all lobster species consumed the developed dry feed pellets, the productivity of juvenile animals was inferior to the feeding of fresh mussels. However, with adult J. edwardsii held in sea cages, the pelleted diets were equal to fresh mussel in maintaining the condition (moult frequency, weight increase and survival) and colour of the lobsters The sub-optimal performance of the pelleted diets for the juveniles is thought to have been due to the reduced attractiveness and /or sub-optimal nutrient specifications of the diet for the lobsters. This project will seek to develop improved and more cost-effective pelleted dry lobster feeds for P. ornatus and J. edwardsii juveniles and to improve the feeds management of adult J. edwardsii. Dietary improvements made with the juvenile work will be applied to adult lobsters being held under commercial sea cage conditions in Professor Geddes’ ‘On-growing Project’ (98/305). A collaborative research approach involving CSIRO, TAFI and UA and other agencies in the RLEAS will give the best prospects for achieving our aims. The likelihood of the project being successful is high because:
1. The initial Feed’s Development Project has shown dry pelleted diets to be well accepted by the lobsters and further improvements are likely upon implementation of the proposed targeted research. 2. The project will build on the already established strong collaborative linkages between related rock lobster research being carried out at CSIRO, QDPI, TAFI, UA and by industry. 3. The assembled project team has considerable expertise and an established track record in delivery of successful feed development for other crustaceans (prawns) and finfish, and have established strong collaborative linkages with the aquafeed industry to aid the rapid commercialisation of the research. Objectives: 1. Develop manufactured feeds for juvenile rock lobsters (ie puerulus - year 1 and beyond) that optimise survival and growth by: a) defining the chemicophysical cues that stimulate food consumption in juvenile rock lobsters, b) developing pelleted feeds that remain attractive to lobsters for periods in excess of four hours after immersion, and c) determining the optimum dietary specifications of selected nutrients required by juvenile rock lobsters for growth and development. 2. Develop manufactured feeds for adult lobsters for body maintenance and moult manipulation by a) determining the optimum pellet size and feeding frequency for maintaining the condition of adult rock lobsters and b) providing continued advice to project 98/305 on feeds development for adult lobster holding. Read moreRead less
Objectives: 1. Attempt to reduce production costs & increase production of high quality cultured pearls by investigation of shell turning, cleaning & opening; wild spat collection; mantle tissue compatibility; & Australian made nuclei
The Economic And Social Impacts Of Genetic Sequencing For Intellectual Disability
Funder
National Health and Medical Research Council
Funding Amount
$1,263,576.00
Summary
In this project we will quantify the social and financial costs to families of severe intellectual disability that is genetic in origin. We will assess these impacts in terms of poorer carer health, relationship breakdown, lost income and risk of poverty, as well as increased dependence on government, particularly on welfare payments, and reduced personal income tax paid. We will then determine the extent to which modern clinical genomics can contribute to ameliorating these impacts.
Atlantic Salmon Aquaculture Subprogram: Hydrogen Peroxide Treatment Of Atlantic Salmon Affected By AGD
Funder
Fisheries Research and Development Corporation
Funding Amount
$27,252.00
Summary
Amoebic Gill Disease (AGD) is one of the most serious health issues significantly increasing production costs of Atlantic salmon in Tasmania. While freshwater bathing has been used successfully to control losses, the shortage of fresh water in some salmon farming areas resulted in a quest for another treatment. Hydrogen peroxide is used overseas to control sealice infections of Atlantic salmon. Previous research suggested that it may be possible to develop a successful hydrogen peroxide treat ....Amoebic Gill Disease (AGD) is one of the most serious health issues significantly increasing production costs of Atlantic salmon in Tasmania. While freshwater bathing has been used successfully to control losses, the shortage of fresh water in some salmon farming areas resulted in a quest for another treatment. Hydrogen peroxide is used overseas to control sealice infections of Atlantic salmon. Previous research suggested that it may be possible to develop a successful hydrogen peroxide treatment against AGD, reducing the reliance of the industry on fresh water. Objectives: 1. Determine effective in vitro treatment with hydrogen peroxide against Neoparamoeba perurans 2. Determine effective in vivo treatment against Amoebic Gill Disease Read moreRead less