Price Disclosure Reductions for 2019 October Cycle

Page last updated: 16 August 2019

This summary only includes medicines taking a price disclosure reduction on 1 October 2019. The determined price disclosure outcomes for this cycle were calculated in accordance with the National Health Act 1953 (the Act) and National Health (Pharmaceutical Benefits) Regulations 2017 (the Regulations).

The outcomes below show percentage (%) price differences and ex‑manufacturer level prices. They do not include fees and mark-ups. Information about publication of prices including fees and mark-ups is set out below.

Flow-on Reductions for F2 Combination Items

Responsible persons with a brand of an F2 combination item should note that:

• if an F2 combination item is listed below, it has met the criteria for a direct reduction. However, this reduction may not take effect on 1 October 2019 if the price of a component ingredient is also reduced and flowing this component price on results in a lower price; or
• if an F2 combination item did not receive a direct price disclosure reduction, it may still receive a price reduction as a result of the flow-on of the price of a component ingredient that is taking a price disclosure reduction.

Calculations are currently being completed for flow-on price disclosure reductions to F2 combination items. Outcomes will be communicated to responsible persons with brands of affected drugs in late July 2019.

Legal Determination & Next Steps

The weighted average disclosed prices for each brand, including brands with a determination but no reduction, can be found in the legal determination on the Federal Register of Legislation website. Price disclosure reductions will apply to brands listed in Schedule 1 of the legal determination. Those brands in Schedule 2 of the determination will not take a price disclosure reduction because the percentage difference between their April 2019 PBS approved ex‑manufacturer price and the weighted average disclosed price was below 10% or 30% (as applicable and set out in the table below). Any new brands of existing pharmaceutical items with a determination in Schedule 1 that listed after 31 March 2019 will also take the reduction on 1 October 2019 under section 99ADHA of the Act.

An agreed process for responsible persons to raise any questions or concerns arising from an outcome mentioned above is set out in the Price Disclosure Dispute Resolution Administrative Process. The date for lodgement of disputes is 5 pm AEDT on 28 June 2019. 

Indicative prices for 1 October 2019 (including price to pharmacy, dispensed price for maximum quantity and price premiums) will be published by late July 2019. Subscribe to PBS News to receive notice when they become available.

Final prices for 1 October 2019 (including all price to pharmacy, dispensed price for maximum quantity/amount and price premiums) will be available from early September 2019.

Excel version of 2019 October Cycle Outcomes Summary (Excel 44KB)

Legal Instrument Drug (drugs marked with an * have a pharmaceutical item/s that met the 'no reduction' criteria)	Legal Instrument MoA	Legal Instrument Form	Average AEMP ($)	WAPD (%) across a drug/MoA	WADP - potential October '19 PBS Price (AEMP) ($) per pharmaceutical item	April '19 AEMP ($)	Percentage difference between April '19 and October '19  PBS prices (AEMP) (%) per pharmaceutical item	Calculations based on: OWAPD = all brand data GWAPD = originator brand data removed for at least one pharmaceutical item No originator brand determined Does not meet 30 month clock	Applicable Unadjusted Price Reduction 10% or 30%
			[Average AEMP minus WAPD = WADP]			[Difference between April '19 AEMP & WADP = % Difference]
Baclofen	Injection	Intrathecal injection 10 mg in 5 mL	124.63	23.13%	95.80	111.28	13.91%	GWAPD	10
Baclofen	Injection	Intrathecal injection 40 mg in 20 mL	498.40	23.13%	383.12	445.02	13.91%	GWAPD	10
Bosentan	Oral	Tablet 125 mg (as monohydrate)	1,536.56	27.56%	1,113.08	1,536.56	27.56%	Does not meet 30 month clock	10
Bosentan	Oral	Tablet 62.5 mg (as monohydrate)	1,536.56	27.56%	1,113.08	1,536.56	27.56%	Does not meet 30 month clock	10
Entecavir	Oral	Tablet 0.5 mg (as monohydrate)	210.81	31.46%	144.49	168.85	14.43%	Does not meet 30 month clock	10
Entecavir	Oral	Tablet 1 mg (as monohydrate)	342.84	31.46%	234.98	274.59	14.43%	Does not meet 30 month clock	10
Ezetimibe	Oral	Tablet 10 mg	29.44	29.15%	20.86	29.44	29.14%	Does not meet 30 month clock	10
Ezetimibe with simvastatin	Oral	Tablet 10 mg-10 mg	30.48	19.63%	24.50	30.48	19.62%	Does not meet 30 month clock	10
Ezetimibe with simvastatin	Oral	Tablet 10 mg-20 mg	30.95	19.63%	24.87	30.95	19.64%	Does not meet 30 month clock	10
Ezetimibe with simvastatin	Oral	Tablet 10 mg-40 mg	31.61	19.63%	25.40	31.61	19.65%	Does not meet 30 month clock	10
Ezetimibe with simvastatin	Oral	Tablet 10 mg-80 mg	32.54	19.63%	26.15	32.54	19.64%	Does not meet 30 month clock	10
Hyoscine	Injection	Injection containing hyoscine butylbromide 20 mg in 1 mL	11.48	12.62%	10.03	11.48	12.63%	Does not meet 30 month clock	10
Imatinib	Oral	Capsule 100 mg (as mesilate)	851.25	21.71%	666.44	851.25	21.71%	Does not meet 30 month clock	10
Imatinib	Oral	Capsule 400 mg (as mesilate)	1,702.50	21.71%	1,332.89	1,702.50	21.71%	Does not meet 30 month clock	10
Imatinib	Oral	Tablet 100 mg (as mesilate)	851.25	21.71%	666.44	851.25	21.71%	Does not meet 30 month clock	10
Imatinib	Oral	Tablet 400 mg (as mesilate)	1,702.50	21.71%	1,332.89	1,702.50	21.71%	Does not meet 30 month clock	10
Infliximab	Injection	Powder for I.V. infusion 100 mg	448.61	28.51%	320.71	448.61	28.51%	GWAPD	10
Lamivudine with zidovudine	Oral	Tablet 150 mg-300 mg	174.45	42.10%	101.01	174.45	42.10%	GWAPD	30
Lincomycin	Injection	Injection 600 mg (as hydrochloride monohydrate) in 2 mL	102.94	10.15%	92.49	102.94	10.15%	Does not meet 30 month clock	10
Modafinil	Oral	Tablet 100 mg	108.95	18.78%	88.49	108.95	18.78%	GWAPD	10
Pregabalin	Oral	Capsule 150 mg	31.47	23.67%	24.02	31.47	23.67%	Does not meet 30 month clock	10
Pregabalin	Oral	Capsule 25 mg	9.27	23.67%	7.08	9.27	23.62%	Does not meet 30 month clock	10
Pregabalin	Oral	Capsule 300 mg	46.95	23.67%	35.84	46.95	23.66%	Does not meet 30 month clock	10
Pregabalin	Oral	Capsule 75 mg	20.51	23.67%	15.66	20.51	23.65%	Does not meet 30 month clock	10
Tenofovir	Oral	Tablet containing tenofovir disoproxil fumarate 300 mg	385.52	11.97%	339.37	385.52	11.97%	Does not meet 30 month clock	10
Tenofovir	Oral	Tablet containing tenofovir disoproxil maleate 300 mg	385.52	11.97%	339.37	385.52	11.97%	Does not meet 30 month clock	10
Tenofovir	Oral	Tablet containing tenofovir disoproxil phosphate 291 mg	385.52	11.97%	339.37	385.52	11.97%	Does not meet 30 month clock	10
Valganciclovir	Oral	Tablet 450 mg (as hydrochloride)	1,506.30	40.10%	902.27	1,040.88	13.32%	Does not meet 30 month clock	10
Zoledronic acid	Injection	Injection concentrate for I.V. infusion 4 mg (as monohydrate) in 5 mL	173.89	23.88%	132.37	173.89	23.88%	GWAPD	10
Zoledronic acid	Injection	Injection concentrate for I.V. infusion 4 mg (as monohydrate) in 5 mL vial	197.50	23.88%	150.34	197.50	23.88%	GWAPD	10
Zoledronic acid	Injection	Solution for I.V. infusion 4 mg (as monohydrate) in 100 mL	173.89	23.88%	132.37	173.89	23.88%	GWAPD	10
Zoledronic acid	Injection	Solution for I.V. infusion 5 mg (as monohydrate) in 100 mL	232.81	23.88%	177.21	232.81	23.88%	GWAPD	10