Preface

As with previous versions of the Manual of resource items and their associated costs (the manual), the sources for most of the unit costs are provided so that frequent revisions to the manual will not be necessary. Where available, an internet site that contains the sources of costs is provided to ensure that readers use the most up-to-date unit costs. These sites are hyperlinked in the electronic version of the manual on the Pharmaceutical Benefits Scheme website, and the URLs of the sites are listed in Appendix 1.

Sponsors are advised to consult the latest version of the manual and the source documents before finalising a submission to the Pharmaceutical Benefits Advisory Committee.

Version 5.0 of the manual includes several changes and updates to the previous version.

Section 4 ‘Medicines, medicinal preparations or vaccines’ has been updated to give advice on calculating prices for various settings, including public and private hospitals, various s100 programs, and the National Immunisation Program. Subsection 4.5 ‘Medicine administration costs’ has been simplified to a preference for using only the relevant Medicare Benefits Schedule (MBS) fee if the medicine or medicinal preparation is administered by infusion.

Section 5 ‘Medical services, including investigative, diagnostic and allied health services’ has been updated to include professional services provided by a qualified medical practitioner, as well as other health care practitioners. This change follows the availability of MBS data for selected nonmedical health professionals. Section 5 also includes the information on diagnostic and investigational services that was previously found in Section 7.

Section 6 ‘Hospital services’ now separates nonadmitted hospital care from emergency department services, because they are different concepts and each has a different classification.

Section 7 is now titled ‘Community-based services’, following the relocation of information on diagnostic and investigational unit costs to Section 5. Subsection 7.2 ‘Home care’ has been added in Version 5.0 to include the current cost of providing complex care to older people living in their own homes.

Subsection 8.2 ‘Calculating the financial unit cost of medical services from the perspective of the MBS’ is new to Version 5.0 and clarifies the Medicare rebate amount to be used as the unit cost.