Around 1.9 million Australians were regularly dispensed five or more medicines at the same time in 2025, according to the first report on polypharmacy ever published by the Australian Institute of Health and Welfare (AIHW).
Polypharmacy in Australia in 2025, released today (7 October), found 7% of Australians experienced polypharmacy, based on medicines dispensed through the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS).
Around one in nine people experiencing polypharmacy (219,000 Australians) or 1% of the population – were regularly dispensed 10 or more different medicines, defined as hyperpolypharmacy.
But the extent of the issue is likely far greater. The PSA National Board Director Brooke Shelly FPS said the report gives the profession a national baseline – but only a baseline.
‘The AIHW figures are compelling, but they’re also inherently conservative,’ she said. ‘PBS and RPBS data can tell us what has been dispensed through those systems; they can’t tell us everything sitting on a patient’s kitchen bench.’
Older Australians carry the heaviest load
Polypharmacy increased sharply with age, the report found. In 2025, around 910,000 people aged 75 years and over were dispensed five or more PBS/RPBS medicines, representing 40% of this age group.
This fell to 20% among people aged 65–74 and 9.5% among those aged 55–64.
Speaking to AAP, PSA National President Professor Mark Naunton MPS urged older Australians to be alert to the risks.
‘How the body gets rid of the medicines can change with age, so the risk of adverse events or adverse drug reactions is typically higher in the older people because the drugs aren’t cleared as easily,’ he said.
Prof Naunton told AAP that adverse side effects could easily be reduced through medicine review schemes such as Home Medicines Reviews (HMRs).
In 2025/26, HMRs were delivered to around 180,915 patients – a long way shy of the 1.9 million Australians experiencing polypharmacy.
Polypharmacy looks different across the lifespan
Polypharmacy isn’t confined to older Australians, with the report finding it occurred across all age groups, including among 0.2% of people aged 15–24.
The medicines involved also reflected different health needs across the life span. Among younger people, polypharmacy was more often driven by mental health and neurological medicines, particularly antidepressants, antipsychotics and psychostimulants.
In older adults, the pattern shifted towards medicines for chronic conditions such as diabetes, cardiovascular disease, dyslipidaemia and GORD, reflecting the greater burden of chronic disease and multimorbidity with age. Antidepressants, however, remained common across most age groups, including older adults.
The pattern also differed between females and males across age groups. Females had higher rates of polypharmacy from 15–54 years, when mental health and neurological medicines featured prominently. From age 55, males overtook females, coinciding with a shift towards medicines for chronic conditions.
The full medicines picture is more complicated
For a medicine to be counted as a ‘regular’ in the AIHW analysis, it had to be dispensed on four or more occasions over the year. This threshold was designed to capture ongoing medicine use rather than treatments generally used for short-term acute conditions, such as antibiotics.
The data also doesn’t show why a medicine was prescribed, or its specific dose or duration of use. Private prescriptions, over-the-counter medicines and most medicines supplied to public hospital inpatients, were also excluded.
Ms Shelly said the gap between the dispensing record and what patients actually take is familiar territory for credentialed pharmacists.
‘Private prescriptions, medicinal cannabis, weight-loss medicines, over-the-counter and complementary medicines are only part of the picture. Sometimes it’s also, “My neighbour takes this and thought it might work for me too”,’ she said.
In Ms Shelly’s view this doesn’t diminish the AIHW data; it makes it even more important.
‘What we now have is a national picture of the minimum scale of medicines complexity we’re responding to,’ she said. ‘The real-world medicines burden is almost certainly greater, and that has significant implications for how we should invest in medicines safety.’
Why HMRs matter more than ever
The risk of adverse drug reactions, drug–drug interactions and not taking medicines as prescribed all rise with the number of medicines a person takes, the report noted.
‘Medication-related harm can reduce quality of life, contribute to avoidable healthcare use and lead to poorer health outcomes,’ it said.
Ms Shelly said Home Medicines Reviews (HMRs) address these risks without overriding patient choice.
‘Patient autonomy and medicines safety aren’t competing ideas,’ she said.
‘Australians should be empowered to make choices about their health and self-care, but informed choice requires access to expertise that can identify risk across the whole medicines picture. That is precisely the value of an HMR’
While population-level data explains where the risk sits, HMR identifies what that risk looks like for an individual patient – in the context of their health, medicines and what matters to them.
‘That’s where a credentialed pharmacist can turn medicines complexity into safer, more effective care,’ Ms Shelly added.
More action needed
The report is first in a new AIHW series exploring polypharmacy in Australia, with future reports set to track trends over time and geographic variation, including by remoteness.
But shifting the needle on polypharmacy requires more than data.
‘There’s also a certain irony in the report noting that the WHO [World Health Organization] identified polypharmacy as a medication safety priority in 2019, because 2019 was also the last time HMR remuneration was indexed,’ she said.
‘If polypharmacy is a priority, then so too must be ensuring we have the credentialed pharmacist workforce to respond to it.
Annual indexation is hardly a radical proposition. It is a simple, reasonable mechanism to help retain experienced credentialed pharmacists and ensure this remains a viable career pathway for the next generation of the workforce.’
Through its Uncap Care campaign, PSA is calling for annual indexation of HMR fees with catch-up adjustments, and removal of the monthly cap of 30 HMRs per pharmacist.
‘We’re getting closer to finalising the 1PPA [First Pharmacy Programs Agreement] and we’re confident the government now understands both the scale of the medicines safety challenge and the importance of investing in the workforce required to address it,’ Ms Shelly said.
‘For PSA, sustainable remuneration, including ongoing indexation, remains a red-line issue in these negotiations.
‘We can keep paying for medicine-related harm once it reaches our hospitals, or we can invest in preventing it in the first place. We already know the cost of getting it wrong; the 1PPA is our chance to properly invest in getting it right.’
