艾昆纬-弥合分歧：衡量药品改革协议对药品获取的影响（英）

White PaperBridging the Divide: Measuring the Impact of the Pharmaceutical Reform Agreements on Medicine Access A data-driven analysis of how PRAs shape equity, access, and care integration across AustraliaLELIN ZHANG, Associate Principal, IQVIA Management Consulting ANZ MARCO LAU, Consultant, IQVIA Management Consulting ANZ THOMAS AYLETT, Associate Consultant, IQVIA Management Consulting ANZTable of contentsIntroduction 1Background and objectives 1Data Source and methodology 2IQVIA data sources 2Molecule selection criteria 2Definitions and classifications 2Discussion 3Impact of PRAs on dispensation pattern 3Disparity in ATC classes dispensation patterns 3Deep dive on high-cost medicine dispensation in pubic hospitals 6Geographical and infrastructure influences 6Conclusion 8References 9About the authors 9 iqvia.com | 1The Pharmaceutical Reform Agreements (PRAs) are bilateral agreements between the Commonwealth and relevant jurisdictions that facilitate the access of Pharmaceutical Benefits Scheme (PBS) medications for admitted patients on discharge, non-admitted patients and same day admitted patients in public hospitals.2 Assessing disparities in the uptake and impact of PRAs is critical to understanding how policy differences across Australian states and territories influence equity of access, system efficiency and patient management pathways. The PRAs framework complements Australia’s efforts to gradually integrate elements of value-based healthcare1 with the key goal of enhancing provider and patient outcomes while improving equity of access.Background and objectives Using IQVIA’s national data assets, this paper examines how PRAs participation influences medicine access across jurisdictions — revealing practical insights for improving equity and system efficiency.Building on this perspective, the paper examines how the location of medicine dispensation — whether in hospital or community settings — varies between PRAs signatory and non-signatory regions. It explores these patterns across different channels, cost profiles, therapeutic areas, and geographic contexts, offering insights into how PRAs participation influences care integration.Key jurisdictions that have signed PRAs include Queensland (QLD), Victoria (VIC), Tasmania (TAS), South Australia (SA) and Northern Territory (NT). These states and territories benefit from uniform pricing through nationally negotiated drug prices, supply security guarantees and cost recovery for government via confidential rebates.2 New South Wales (NSW) and Australian Capital Territory (ACT) are yet to sign on due to state specific considerations. In addition, Western Australia (WA) is currently not a signatory to the Hospital Reform component of the PRAs, hence, WA public hospitals do not routinely access PBS medications at commonwealth subsidised prices and face similar access challenges to NSW and ACT. Introduction2 | Bridging the Divide: Measuring the Impact of the Pharmaceutical Reform Agr