Impact of Australias 60-Day Dispensing Policy on Medicine Use: An Interrupted Time Series of the Stage 1 Roll-out

Objective: To evaluate the real-world impact of Stage 1 of Australias 60-day dispensing policy on medicine utilisation and contextualise changes in dispensing with medicine shortages. Methods: We conducted an interrupted time series analysis of aggregated national monthly dispensing data from the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme for the 247 medicines included in Stage 1 of the 60-day dispensing policy. Data from January 2020 to October 2025 were analysed, with September 2023 defined as policy implementation. Linear regression assessed changes in monthly dispensing trends before and after implementation, accounting for autocorrelation and seasonal variation. A relative change of at least 5% in the post-intervention dispensing slope compared with the pre-intervention slope was prespecified as a potentially clinically meaningful change. Therapeutic Goods Administration shortage reports were used to contextualise observed changes. Results: Of 247 medicines, 131 (53%) had increasing and 116 (47%) had decreasing post-intervention dispensing trends; of which 86 (66%) and 71 (61%), were statistically significant, respectively. However, only 8 medicines (3%) demonstrated at least 5% relative change in dispensing slope, six of which had reported shortages. Medicine-specific changes coincided with shortages, product deletions and therapeutic substitution, complicated attribution of changes to the 60-day dispensing policy. Conclusion: Stage 1 of Australias 60-day dispensing policy was not associated with widespread changes in dispensing for most included medicines. Limited changes were plausibly influenced by concurrent shortages and other supply-related events. These findings provide reassurance that extended dispensing did not result in major increases in medicine utilisation at the population level, although continued monitoring is warranted as policy uptake expands.