Around The Globe

Delivering ‘Quality Use of Medicines’ to Australia

NPS MedicineWise celebrates 20 years and large healthcare budget savings

Richard Day
Professor of Clinical Pharmacology,
UNSW and St. Vincent’s Hospital, Sydney

T

his year, a remarkable national organization, NPS MedicineWise (previously known as the National Prescribing Service) celebrates its first 20 years of service to the Australian people.

The NPS was founded in 1998 by the Australian Government to promote Quality Use of Medicines (QUM), the centerpiece of Australia’s National Medicines Policy. The underlying premise of the QUM policy is that better outcomes from medicines use can only be achieved by inducing a ‘behaviour change’ of, and ‘partnerships’ between, patients, families, and caregivers along with health care practitioners and their organisations, the pharmaceutical industry, and governments. Critical to the QUM strategy is that the patient should occupy the centre, and crucially, the Consumers Health Forum (the umbrella body for consumer health organisations in Australia) was instrumental in driving the government and stakeholders towards the National Medicines Policy, the QUM national strategy (1992), and ultimately NPS MedicineWise.

Consumer involvement and support is a major reason for the extraordinary success of NPS MedicineWise in delivering evidence-based information to GPs and other health professionals, and to consumers using innovative and evidence-based methods. A core approach has been academic detailing, seminal work pioneered and shown to be highly effective by Drs. Jerry Avorn and Steven Soumerai, of Harvard University. NPS MedicineWise started peer educational visits to GPs in 1999. Since then, the highly skilled Clinical Services Specialists field force have made over 300,000 educational visits that led to measurable improvements in prescribing decisions.

The NPS was established as a not-for-profit, independent, public company with its own board of directors and, importantly, at arm’s length from the Government. Almost 50 organisations representing the peak bodies of consumers, health practitioners, industry, and government are Members of NPS, working together in a collaborative and extremely effective way.

NPS has been committed from the outset to measuring its own impact. The argument to support its substantial government funding, supported by evidence, was that achieving QUM through good-quality prescribing and use of medicines would not only achieve better health outcomes but also be cost-effective for the national Pharmaceutical Benefits Scheme and tax payers (see the NPS Annual Report 2016-17). Over its twenty years existence, this premise has been confirmed repeatedly to such an extent that 5-yearly budgets have risen dramatically on the basis of projected savings and over 300 staff are employed. There has been bipartisan political and strong stakeholder support, and it is estimated that over a billion dollars have been saved by promoting QUM.

The NPS caters to patients/consumers by providing timely medicines information and health education. Successful, award-winning, national campaigns employing television, radio, print, and social media have addressed important topics where there is a recognized need for better use of medicines and better health outcomes, such as Lower Back Pain, and Appropriate use of Antibiotics. A suite of ‘Current Topics’ addresses these and many other important QUM issues so that prescribers, nurses, pharmacists, students, and consumers are provided simultaneously with educational materials, such as on-line case studies, resources to use in their daily work, and ‘continuing professional development (CPD) options (e.g., practice audits).

Current topics being addressed include Managing Lipids (targeting adherence and achieving targets), Chronic Pain (affecting 1 in 5 Australians), and Depression (management options). These programmes meet their targets:

  • The reach of NPS MedicineWise into primary care is outstanding, knowledge of NPS among General Practitioners is approaching 100%, and NPS resources are accessed by 6 out of 10 pharmacists.
  • A National Prescribing Curriculum, developed with expert clinicians, is used via interactive case studies by senior medical students of all national medical schools and the majority of pharmacy students and schools.
  • Almost one third of Australia’s population are aware of NPS MedicineWise, and one million of Australia’s 25 million people engage with NPS resources annually.
  • More recently, an exciting initiative, MedicineInsight, draws automatically on the data of over 650 participating GP practices, 3,300 active GPs, and 3.6 million regular patients. It provides real time intelligence to improve practice.

There are many more proven, innovative interventions that are well worth exploring and accessing. Congratulations NPS MedicineWise on 20 years of accomplishment!