Patient preferences for antihypertensive medication dispensing trade-offs in cardiovascular disease prevention: national survey in Australia

Objectives This study investigated predictors of consumer preferences for different antihypertensive dispensing policies in Australia. Design Cross-sectional survey. Setting An online national survey in Australia between 27 November 2024 and 20 December 2024. Participants 2054 adults taking antihypertensives completed the online survey experiment. Quota sampling was used to ensure sufficient diversity in age, gender and education groups. Primary and secondary outcome measures The primary outcome was participant preference between dispensing options. The survey included six forced choices between dispensing policy options that varied on (1) delivery method, (2) dispensing duration and (3) cost. For each choice set, participants chose 1 out of 2 dispensing options that either indicated a preference for pharmacy pickup over mail or longer over shorter dispensing duration. Analyses involved regression models for each forced-choice question. Results Overall, participants preferred delivery through pharmacies rather than post (range 75%–82% across two choice sets). When shown cheaper annual costs, they preferred longer dispensing of antihypertensives (range 69%–92% across four choice sets). Preference for shorter dispensing despite higher annual costs was predicted by access to government support for high medication costs. For non-concession card holders, this was a significant predictor (p<0.004) across 3/4 choice sets (OR range 1.3–4.1). For concession card holders, this was a significant predictor (p<0.002) across all four choice sets (OR range 2.3–4.3). Living in a major city, having a university education, not being female, being under 65 years of age and having a higher income predicted shorter dispensing preference in some but not all choice sets. Conclusions Government support for medication costs is a significant consideration when changing dispensing policy in Australia, which may differentially affect concession card holders. Implementing changes to antihypertensive dispensing requires clear communication about cost implications, including the impact on reaching government thresholds for financial assistance.