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About the PBS

The following links provide information about the Pharmaceutical Benefit Scheme.

Pharmaceutical Benefit Scheme (PBS)

What is the PBS?

The PBS Schedule lists all of the medicines available to be dispensed to patients at a Government-subsidised price. The Schedule is part of the wider Pharmaceutical Benefits Scheme managed by the Department of Health and Ageing and administered by Medicare Australia.

This schedule is now on-line and updated on a monthly basis. This on-line searchable version contains:

  • All of the drugs listed on the PBS
  • Information on the conditions of use for the prescribing of PBS medicines
  • Detailed consumer information for medicines that have been prescribed by your doctor or dentist;
  • What you can expect to pay for medicines.

The PBS has been in existence since 1948 and is governed by the National Health Act 1953 (Commonwealth).

Who is eligible for the PBS?

The Scheme is available to all Australian residents who hold a current Medicare card.

Overseas visitors from countries with which Australia has a Reciprocal Health Care Agreement (RHCA) are also eligible to access the Scheme. Australia currently has RHCAs with: Italy, New Zealand, the Republic of Ireland, Finland, Malta, the Netherlands, Sweden, Norway and the United Kingdom.

Residents of these countries must show their passports when lodging a prescription to prove their eligibility or they can contact Medicare and get a Reciprocal Health Care Agreement Card to prove their eligibility. Some overseas visitors may not be eligible for this card.

Only those eligible for the PBS will receive subsidised medication and every time you present your script to the pharmacist, you will need to provide your Medicare card.

Eligible veterans may need to present their DVA card in addition to their Medicare card.

With your consent, the pharmacist may (at their discretion) keep a record of your Medicare number so that you do not have to show the actual card every time you lodge a script.

What is the RPBS?

The Repatriation Pharmaceutical Benefits Scheme (RPBS) is subsidised by the Department of Veterans’ Affairs, and can be used by veterans who have DVA White, Gold or Orange Card.

If you hold one of these cards then you are eligible for all PBS medicines, and other medicines listed on the RPBS, depending on your DVA entitlement. All medicines supplied under the RPBS are dispensed at the concessional rate (or free if the patient has reached their Safety Net threshold).

DVA white card entitles you to RPBS and PBS medicines at the concessional rate for a specific medical condition (which is at your doctor’s discretion). You can receive all other PBS medicines at the general rate.

DVA gold and orange cards entitle you to all RPBS and PBS medicines at the concessional rate.

What is the Dental Schedule?

Dentists are not able to prescribe general PBS items, but have a separate Dental Schedule from which they can prescribe dental care medicines for their patients.

What is the Optometrical Schedule?

Optometrists are not able to prescribe general PBS items, but have a separate Optometrical Schedule from which they can prescribe eye care medicines for their patients.

Who is eligible for a concession?

To be eligible for a concessional benefit, you will have one of the following concession cards:

  • Pensioner Concession Card;
  • Australian Seniors Health Card;
  • Health Care Card; or
  • DVA White, Gold, or Orange Card.

Some State / Territory governments issue Seniors Cards. These are not considered concession cards for the purposes of the PBS.

Centrelink is responsible for the issue and administration of the Pensioner Concession Card, the Australian Seniors Health Card and Health Care Cards.

DVA are responsible for White, Gold and Orange Cards.

There is also a DVA Pension Card which entitles holders to PBS medicines at the concessional rate (but not RPBS medicines).

General benefits apply if you do not have any of the above cards.

What are the current patient fees and charges?

Patient co-payments

The co-payment is the amount you pay towards the cost of your PBS medicine. Many PBS medicines cost a lot more than you actually pay as a co-payment.

From 1 January 2008, you pay up to $31.30 for most PBS medicines or $5.00 if you have a concession card. The Australian Government pays the remaining cost.

The amount of co-payment is adjusted on 1 January each year in line with the Consumer Price Index (CPI).

Items that are priced below the general patient co-payment

For general patients, an allowable additional patient charge can apply.  The allowable additional patient charge is a discretionary charge to general patients if a pharmaceutical item has a dispensed price for maximum quantity less than the general patient co-payment. The pharmacist may charge general patients the allowable additional fee but the fee cannot take the cost of the prescription above the general patient co-payment for the medicine.

The maximum fee is currently $3.63 and is adjusted on January 1 each year. This fee does not count towards your Safety Net threshold.

Additional fee for ready prepared items

In addition, if a medicine has a ‘dispensed price for maximum quantity’ less than the general co-payment a safety net recording fee may be charged by your pharmacist. This fee may not take the cost of your script above the co-payment.

Concessional patients do not pay this fee.

This fee is currently $1.03 and is adjusted on 1 August each year. The amount of this fee does count towards your Safety Net threshold.

What is a Price premium?

A price premium or brand premium, may apply to some medicines.

Where there are two or more brands of the same drug on the Schedule, the Government subsidises each brand to the same amount - up to the cost of the lowest priced brand.

If you are taking a more expensive brand the price difference is paid by you as a brand premium. This cost is in addition to your co-payment.

At your request, the pharmacist may be able to substitute a less expensive brand where your doctor has allowed this. If you have any concerns, you should talk to your doctor or pharmacist.

Pharmacists are legally required to charge brand premiums. The brand premium does not count towards the safety net threshold.

Where can I find more information?

PBS contacts

General information:
PBS information on health.gov.au site

PBS and Medicare Australia:
PBS information on medicareaustralia.gov.au site

The Safety Net:
Safety Net information on medicareaustralia.gov.au site

Safety net info on the Department of Health and Ageing site