Expenditure and Prescriptions twelve months to 30 June 2018

Page last updated: 11 January 2018

Summary of Pharmaceutical Benefits Scheme 2017-2018

Total Pharmaceutical Benefits Scheme (PBS) government expenditure (both Section 85 and Section 100) on an accrual accounting basis for the 2017-2018 financial year was $11,690 million (excluding revenue), compared with $12,058 million for the previous year. This is a decrease of 3.0%.

The majority of the Expenditure and Prescriptions report refers to PBS Section 85 and Section 100 data reported by date of supply financial year, however a few tables refer to Section 85 only and there are some tables that report pharmacy program expenditure.

Total 2017-18 PBS subsidised prescription volumes increased by 0.8% to a total of 204.1 million, compared to 202.4 million for the 2016-17 financial year.

In 2017-18, PBS Government expenditure (Section 85 and Section 100) was $11,602.9 million (excluding rebates) which is 88.9% of the total cost of PBS prescriptions. The remainder was patient contributions that amounted to $1,455.5 million.

The majority of government expenditure in 2017-18 on PBS Section 85 and Section 100 prescriptions was directed towards concessional cardholders ($7,866.1 million, 67.8% of the total), compared to concessional cardholders expenditure for 2016-17 ($8,121.4 million, 67.9% of the total).

The average dispensed price (Patient payment plus Government benefit) per prescription of PBS subsidised medicines decreased to $64.04 in 2017-18, compared to $66.09 in 2016-17.

Note: From 2016-17 this publication is based on the date that a prescription medicine was supplied to a patient. Previous publications were based on the date that a claim was processed (and the payment finalised) by the Department of Human Services. The historical data from 1948-49 to 2015-16 on pages 26 to 31 remains by date of processing.

Important Information

Please direct enquiries about this publication or requests for complimentary copies via:

Surface mail:   Director
PBS Information Management Section
Pricing and PBS Policy Branch, MDP 900
Department of Health
GPO Box 9848 Canberra ACT 2601

E-mail: pbsstats@health.gov.au

Unless otherwise indicated this publication has been produced using data provided to the Department of Health by the Department of Human Services. The figures reported in this publication relate to the value (benefit) or volume of PBS prescriptions that have been processed by the Department of Human Services. They refer only to paid services processed for prescriptions submitted and claimed via the PBS Online claiming system by the approved suppliers. They do not include any manually paid claims.

PBS Expenditure includes the following patient categories:

  • General - Non-Safety Net (Ordinary)
  • General - Safety Net
  • Concessional - Non-Safety Net (Ordinary)
  • Concessional - Safety Net
  • Doctor's Bag

The patient category refers to the patient's eligibility status at the time of supply of the benefit. General patients hold a Medicare card, Concessional patients hold a Medicare card and one of the following cards from Centrelink:

  • Pension Concession Card
  • Commonwealth Seniors Health Card
  • Health Care Card

There are two safety net thresholds – one for General patients and the other for Concessional patients.

From 1 January 2018, the general patient safety net threshold was $1,521.80. When patients and/or their families reached this amount, they could apply for a Safety Net Card and pay only $6.40 per prescription for the rest of the calendar year. The concessional safety net threshold was $384.00. Once patients and/or their families reached this amount, they could apply for a Safety Net Entitlement Card and receive items free of charge for the rest of the calendar year.

The Patient Contribution, Total Cost and Average Price amounts do not include brand or therapeutic premiums.

Caution should be exercised in referring to the breakdown by patient category in Table 21(a) on pages 26 to 27 and Table 21(b) on pages 28 to 31, because of a past problem in data supplied by the Department of Human Services whereby a number of General Safety Net scripts were wrongly allocated to Concessional Non-Safety Net. This problem was fixed for 2008-09, but the 2006-07 and 2007-08 allocations of scripts and expenditure by patient category were inaccurate and not strictly comparable to the corresponding 2008-09 and later years’ numbers.

While Section 100 data has been included in the majority of tables for the first time in this report, this data does not include supplies to Aboriginal Health Services.

The Department of Health has taken every care to ensure the data supplied is accurate but does not warrant that the data is error free and does not accept any liability for errors or omissions in the data.