The community services card: does it make a difference to pharmaceutical utilisation?

To estimate the utilisation rate, and amount of state subsidy of prescription items per head by age, sex and community Services Card (CSC) for the year ended June 1999.

Data from a market research company (IMS Health), Health Benefits Limited, Statistics New Zealand and Work and Income New Zealand were used to calculate average per head per year pharmaceutical utilisation rate and subsidy cost for CSC holders and non-holders.

For both sexes, and for all age groups, CSC-holders tended to use more prescription items per head and incur higher subsidy cost than non-holders. The standardised CSC utilisation rate was 2.6 times the non-CSC rate. For children, average per-item subsidy cost for CSC-holders was lower than for non-holders; the reverse was true for adults.

CSC holders had higher pharmaceutical utilisation rates than non-holders at a national level (but not necessarily at a local level). If non-uptake of cards and health status were taken into account, however, it is possible that pharmaceutical utilisation rates were suboptimal amongst those most in need of services. Analyses are urgently required to examine prescribing patterns at a regional level.