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Cost Recovery Implementation Statement (2018-2019)

Page last updated: 5 July 2018

PBS and NIP Cost Recovery – Annual Indexation of Fees

The recovery of fees associated with the evaluation and listing of medicines, vaccines and other products or services on the Pharmaceutical Benefits Scheme (PBS) and National Immunisation Program (NIP) commenced on 1 January 2010.

The prescribing regulations that underpin PBS and NIP cost recovery are the National Health (Pharmaceutical and Vaccines—Cost Recovery) Regulations 2009.  Part 4.7 of the regulations provides for the annual indexation of PBS and NIP cost recovery fees based on annual increases in the Consumer Price Index. 

The seventh CPI indexation of PBS and NIP cost recovery fees took place on 1 July 2018 with a 1.9% increase being applied. An updated Cost Recovery Implementation Statement (CRIS) for 2018-2019 has been published to reflect the indexation. The CRIS does not alter the cost recovery arrangements that have been in place since 1 January 2010.

Information about the current cost recovery fees is available from the PBS website.

During the term of the 2017 Strategic Agreement the Commonwealth and Medicines Australia have agreed to work to improve the transparency and efficiency in PBS listing processes from initial applications and Pharmaceutical Benefits Advisory Committee (PBAC) submissions through to delisting. This work will include revising the PBAC costing model to better reflect the real costs of activity associated with PBS/NIP listings. It will also canvass expanding the scope of cost recovery activities to include post listing and list management activities to ensure consistency with the Australian Government Cost Recovery Guidelines.

Work is underway in partnership with the pharmaceutical industry through the Access to Medicines Working Group to consider options to improve the transparency and efficiency in PBS listing processes. Consultations are also ongoing with representatives from Medicines Australia and the Generic and Biosimilar Medicines Association through a joint subgroup of the Access to Medicines Working Group and the Generic Medicines Working Group, the Transparency and Efficiencies subgroup, about future cost recovery arrangements.

Should a decision be made by Government to change the current cost-recovery arrangements, the details of the proposed charging framework will be the subject of further consultation.