The Closing the Gap (CTG) - PBS Co-payment Program

Page last updated: 1 November 2022

The CTG PBS Co-payment program was established in July 2010 to improve access to affordable PBS medicines for Aboriginal and Torres Strait Islander people living with, or at risk of, chronic disease, and who in their doctor’s opinion would experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine and would be unlikely to adhere to their medicines regimen without assistance through the program.

When obtaining PBS General Schedule medicines at their local pharmacy, eligible general patients who would normally pay the full PBS co-payment will pay the concessional rate and those eligible patients who would normally pay the concessional rate receive their PBS medicines without being required to pay a PBS co‑payment. 

Complementing this Program, and recognising that there may not be pharmacies available to dispense in some remote areas, the Remote Area Aboriginal Health Services (RAAHS) Program allows clients of approved RAAHS to receive medicines from their RAAHS, without the need for a normal PBS prescription form, and without charge. For more information, please visit the Services Australia or the Department of Health and Aged Care

In June 2020, it was announced through the Seventh Community Pharmacy Agreement, that changes would be made to enhance the CTG PBS Co-payment Program in a number of ways, including:

• expanding the range of health professionals who are able to register eligible Aboriginal and Torres Strait Islander people for the program;
• enabling any eligible Aboriginal and Torres Strait Islander person to be registered for the Program, regardless of their chronic disease status and no matter where they live in Australia;
• removing the need for prescriptions for an eligible PBS medicines for Aboriginal and Torres Strait Islander people who are registered for the program to be annotated with CTG by the prescriber; and
• enabling prescriptions for eligible PBS medicines issued by PBS prescribers within public hospitals to be eligible when they are dispensed by a community pharmacy or Section 94 Approved Private Hospital pharmacy. 

The Closing the Gap PBS Co-payment Program, which reduces or removes the PBS Co-payment for eligible Aboriginal and Torres Strait Islander people, will apply to medicines supplied under Continued Dispensing from 1 July 2022, where the medicines are eligible for supply under Continued Dispensing arrangements.

Patient Eligibility

The Closing the Gap PBS Co-payment Program is available to Aboriginal and Torres Strait Islander people of any age who are registered with Medicare, and in the opinion of a prescriber or Aboriginal Health Practitioner (AHP):

• would experience setbacks in the prevention or ongoing management of a condition if the person did not take the prescribed medicine; and
• are unlikely to adhere to their medicines regimen without assistance through the program.

Registering for the CTG – PBS Co-payment Program

Aboriginal and Torres Strait Islander people who are already registered for the Program as at 30 June 2021, do not need to be re-registered for the Program.

From 1 July 2021, any PBS prescriber or eligible AHP can register eligible Aboriginal and Torres Strait Islander people for the Program. Registration of eligible Aboriginal and Torres Strait Islander people will be via the Services Australia Health Professional Online Services (HPOS) portal and is a one-off registration.

Once an Aboriginal and Torres Strait Islander person has been assessed as being eligible for the program, the PBS prescriber or eligible AHP can authorise a HPOS delegate to act on their behalf to enter the registration details into HPOS. Before they can link their delegate to the HPOS account they will need to register for their own PRODA account.

If a patient is unsure whether they are registered for the program, their Practitioner or the Pharmacist will be able to check via HPOS for them.

In remote areas with limited internet access, a health service or clinic can phone Services Australia on 132 290 to register the patient for the program.

Questions in regards to registering as a Medicare Provider or use of HPOS need to be directed to Services Australia. Contact details can be found at Health professionals contact information – Services Australia.

Eligible PBS medicines and Approved Suppliers

The Program applies to prescriptions for PBS General Schedule medicines only.

CTG prescriptions can only be dispensed at community pharmacies or Section 94 Approved Private Hospital pharmacies.

If a person is registered for the program at the time eligible PBS medicines are dispensed, the co-payment reduction will apply even if the prescription does not have a CTG annotation.

Where brand premiums apply to a PBS medicine covered under this program, Aboriginal and Torres Strait Islander people will need to pay the brand premium at the time of dispensing.

Further information?

Questions from pharmacists regarding changes to the dispensing software should be directed to the respective software vendor and questions in relation to PBS claiming can be directed to Services Australia on 132 290.

• CTG PBS Co-payment Program Frequently Asked Questions (PDF 695KB) - (Word 3.3MB)
• Factsheet for Aboriginal and Torres Strait Islander People (PDF 556KB) - (Word 3.3MB)
• Factsheet for Community Pharmacies (PDF 737KB) - (Word 3.3MB)
• Factsheet for Hospital Pharmacies (PDF 562KB) - (Word 3.3MB)
• Factsheet for Prescribers (PDF 684KB) - (Word 3.3MB)

Data and Expenditure Information

Total Expenditure for Medicines and Number of PBS Items Supplied 2010-11

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$2,500,029	$540,774	$117,740	$1,628,786	$447,923	$609,787	$108,311	$116,239	$6,069,589
PBS Items Supplied	343,817	80,911	13,979	212,513	63,600	80,691	14,768	13,304	823,583

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2011-12

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$5,457,662	$1,236,246	$408,712	$3,667,974	$1,012,893	$1,579,836	$273,085	$252,889	$13,889,297
PBS Items Supplied	763,210	175,244	45,930	481,083	148,972	207,855	39,615	29,916	1,891,825

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2012-13

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$7,438,131	$1,516,325	$646,572	$5,248,183	$1,371,726	$2,203,288	$425,045	$338,910	$19,188,179
PBS Items Supplied	1,051,636	216,394	73,149	698,536	200,102	290,006	62,003	41,025	2,632,851

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2013-14

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$9,816,430	$1,683,014	$935,121	$6,827,129	$1,723,315	$3,123,573	$619,307	$428,452	$25,156,341
PBS Items Supplied	1,382,756	247,954	110,735	925,306	254,347	414,799	92,416	53,200	3,481,513

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2014-15

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$11,741,443	$2,029,457	$859,690	$8,074,056	$2,202,649	$3,383,061	$774,318	$292,947	$29,357,621
PBS Items Supplied	1,702,570	304,988	108,442	1,138,348	328,891	471,576	120,340	37,333	4,212,488

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2015-16

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$13,867,432	$2,540,274	$1,068,012	$9,720,552	$2,305,376	$4,006,622	$956,170	$368,797	$34,833,236
PBS Items Supplied	1,935,642	365,310	132,271	1,325,848	337,071	545,248	144,177	45,228	4,830,795

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2016-17

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$14,983,300	$2,779,150	$1,170,832	$10,494,782	$2,496,609	$4,248,077	$1,126,455	$418,742	$37,717,947
PBS Items Supplied	2,075,118	394,522	146,773	1,437,985	361,888	579,473	167,102	50,892	5,213,753

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2017-18

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$17,387,065	$3,103,991	$1,359,882	$12,603,143	$2,886,053	$4,847,492	$1,346,824	$417,527	$43,951,977
PBS Items Supplied	2,388,535	432,330	168,712	1,712,128	414,504	654,970	198,529	48,072	6,017,780

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2018-19

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$19,180,412	$3,410,127	$1,522,390	$14,204,722	$3,147,669	$5,334,076	$1,559,996	$463,877	$48,823,270
PBS Items Supplied	2,592,734	461,951	184,162	1,890,807	444,189	711,969	227,421	51,678	6,564,911

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2019-20

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$21,221,975	$3,907,605	$1,679,021	$16,022,113	$3,423,650	$5,931,343	$1,806,147	$515,827	$54,507,681
PBS Items Supplied	2,834,645	523,357	200,151	2,098,529	473,958	775,910	262,496	56,640	7,225,686

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2020-21

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$21,642,040	$4,133,441	$1,739,736	$16,445,334	$3,434,822	$5,946,101	$1,912,211	$569,635	$55,823,320
PBS Items Supplied	2,955,476	564,807	207,666	2,207,032	489,848	784,205	285,258	63,554	7,557,846

 

Total Expenditure for Medicines and Number of PBS Items Supplied 2021-22

	NSW	VIC	NT	QLD	SA	WA	TAS	ACT	TOTAL
TOTAL ($)	$25,524,865	$5,057,830	$1,979,263	$20,611,209	$3,919,986	$7,125,239	$2,466,846	$693,991	$67,379,232
PBS Items Supplied	3,349,181	665,509	230,059	2,659,964	536,225	903,063	349,207	74,613	8,767,821

Requests for any additional data or further breakdowns should be directed to Services Australia.  Services Australia will evaluate your request in line with their data release policies, and respond accordingly.

Requests to Services Australia for statistical data must be made in writing and clearly state:

• how the information contributes to improving Australia's health;
• the type of information required;
• what the information will be used for; and
• to whom the information will be disclosed.

Written requests can be sent to:
Health MI Section
Health Support and Performance Branch
Services Australia
PO Box 7788
Canberra BC ACT 2610
or email:  statistics@servicesaustralia.gov.au