AIHW's first count: 1.9 million Australians on five-plus medicines

There is a version of polypharmacy that is good medicine: a person with type 2 diabetes, hypertension, dyslipidaemia, and a history of atrial fibrillation taking seven medicines because each one is managing a real condition with clear evidence and regular review. That version exists. It is, in a meaningful sense, the intended outcome of treating complex chronic disease well.

There is another version that is an accretion: medicines added over years by different prescribers, never fully reconciled, some whose original indications no longer apply, and no one appointment in recent memory where the whole list was examined from first principles. That version also exists, and until this week Australia had no national picture of how common it is.

The Australian Institute of Health and Welfare has published its first-ever national polypharmacy report, drawing on 2025 Pharmaceutical Benefits Scheme and Repatriation PBS data. The headline number: about 1.9 million Australians — 7% of the population — are regularly dispensed five or more medicines. As RACGP newsGP reports, roughly one in nine of those people is receiving ten or more medicines regularly.

What the data shows — and what it misses

The AIHW figure is almost certainly an undercount. The report draws only on PBS and RPBS-dispensed medicines; private prescriptions, complementary medicines, over-the-counter purchases, and anything obtained outside the subsidised system are excluded. For a population where supplements, sleep aids, and anti-inflammatory analgesics are widely used without prescription, that is a meaningful gap.

The age pattern is steep: about 20% of people aged 65–74 are in the polypharmacy category, rising to 40% of those 75 and over. Prevalence is nearly identical in men and women — the AIHW attributes this primarily to age and chronic disease burden rather than sex. Younger Australians who do appear in the polypharmacy cohort are more likely to be prescribed antidepressants, antipsychotics, and psychostimulants. Older Australians’ profiles skew toward diabetes, cardiovascular, dyslipidaemia, and gastro-oesophageal reflux medicines. Antidepressants appear across most age groups — a reflection of their expanding indication set and long prescribing duration once started.

Both-and: the clinical tension at the centre of this

More medicines can mean better-managed disease. The cardiovascular and metabolic mortality improvements over the past three decades are partly attributable to people staying on statins, antihypertensives, and antiplatelet therapy long-term. Removing a medicine without good reason carries its own risks.

And: drug interactions, falls risk, cognitive effects, and the cumulative side-effect burden of a large medicine list are real. Anticholinergic burden in older people — which accrues across multiple medicines, not just the obvious ones — is independently associated with cognitive decline and falls. A medicine introduced for a side effect of another medicine is a pattern that can self-replicate if no one steps back to review the whole picture.

Dr Xisco Reus, a GP with an aged care focus, recommends an annual review of every medication, with particular attention at transitions of care — hospital discharge, aged care admission, significant changes in functional status. These are the points at which medicines are most frequently lost, duplicated, or continued past their indication. The RACGP-endorsed deprescribing guidelines provide evidence-based support for the conversation about stopping medicines that are no longer earning their place.

2 cents

If you or someone close to you is on five or more regular medicines, a medication review appointment with a GP is a reasonable next step — not to reduce the number for its own sake, but to confirm each one still has the right indication at the right dose. A home medication review by a pharmacist, arranged through a GP referral, is a practical option for anyone finding it hard to track a complex regime.

For GPs: this report provides population-level backing for the conversation that deprescribing guidelines already support. The 1.9 million figure will grow as the population ages — and the capacity to manage that well sits disproportionately in general practice.

Verdict: yes — Australia’s first national count of polypharmacy is a useful baseline, and the patterns it shows — especially around transitions of care and older patients — are directly actionable in general practice.

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Sources cited

1. Polypharmacy among almost two million Australians — RACGP newsGP
2. Polypharmacy in Australia in 2025 — AIHW
3. Deprescribing guidelines for older people — deprescribing.com