What is the PBS?

The Pharmaceutical Benefits Scheme (PBS) lets Australians get necessary prescribed medicines without paying full price.

The PBS is part of the Australian Government’s National Medicines Policy. The PBS started in 1948. The National Medicines Policy aims to balance good health results with the cost of the medicines.

The government subsidises the cost of medicine for most medical conditions, through the PBS.

Can I use the PBS?

The PBS can be used by all Australians who hold a current Medicare card.

Overseas visitors from countries that have a reciprocal health care agreement with Australia can also get medicines through the PBS.

This covers visitors from:

• Belgium
• Finland
• Ireland
• Italy
• Malta
• The Netherlands
• New Zealand
• Norway
• Slovenia
• Sweden
• United Kingdom

People from these countries must show their passports when having a prescription filled.

How much will I pay for PBS medicines?

Most of the cost of PBS medicines is covered by the government. However, you will also need to make a co-payment.

What is a co-payment?

A co-payment is the money that you pay towards the cost of the medicine. This is a set fee for all PBS medicines.

The co-payment amount changes on 1 January each year. You can check the current patient co-payment amounts.

You can find the cost of your medicine by searching on pbs.gov.au. Many PBS medicines cost much more than the co-payment.

If you hold a concession card, your co-payment will be lower.

Can I get a concession card?

To get the reduced co-payment you must hold one of the following cards:

• Commonwealth Seniors Health Card
• Department of Veterans Affairs White, Gold, or Orange Card
• Health Care Card
• Pensioner Concession Card

Brand premiums

Some medicines might have a price premium or brand premium. This is an extra payment that you pay to the supplier of the medicine, not to the government.

The brand premium is a cost in addition to your co-payment. It does not count towards your PBS Safety Net threshold.

When more than one brand of the same medicine is available, the Government subsidises each brand to the same amount. If you are taking a more expensive brand, the price difference is paid by you.

The extra charge does not mean there is any difference in quality between brands.

You can ask your pharmacist to give you a less expensive brand. These are often called generic medicines.

Your doctor must agree that you can have a different brand of medicine to the one they prescribed. In some cases, your doctor may want you to have a specific brand.

If you have any concerns, you should talk to your doctor or pharmacist.

What is the PBS safety net?

If you spend a lot of money on medicines, the Australian Government gives you more support. This support is called the PBS Safety Net.

The cost of your medicines is reduced once you reach the Safety Net threshold. When you reach the threshold:

• general patients only pay the concessional co-payment for PBS prescriptions for the rest of the calendar year
• concession card holders get PBS prescriptions at no cost for the rest of the calendar year

The Safety Net is applied to a family unit. A family unit can be:

• a person
• a couple
• a family with children

How do I show what I’ve spent on medicines?

To access the Safety Net, you need to maintain a record of what you spend on PBS medicines. This is done on a Prescription Record Form. You can get these forms from:

• Services Australia
• a pharmacy

Once you reach the Safety Net threshold, you can apply for a Safety Net Card.

This lets you get your medicines at a lower cost for the rest of the calendar year.

You can check the current Safety Net thresholds.

What are 60-day prescriptions?

Some PBS medicines are available on a 60-day prescription. By September 2024, this will cover over 300 medicines.

This means you may be able to get twice the amount of medicine for the price of one prescription.

To qualify for a 60-day prescription you must:

• live with an ongoing health condition
• be assessed as being stable on your current medicine
• have talked about your medicine with your doctor
• have been given a new 60-day prescription

Your doctor will decide whether you get a 30- or 60-day prescription.

You can view the list of medicines that you can get on a 60-day prescription.

Payments for these medicines will still count towards your PBS Safety Net. However, you may reach the PBS Safety Net threshold later in the year. This is because you can buy 2 months’ worth of medicine for the cost of a single prescription.

Resources and support

Healthdirect’s medicines section allows you to search for medicines by brand name or active ingredient.

It gives useful information about medicines such as:

• their use
• whether they are on the PBS
• product recalls

You can browse the PBS online:

• to look at all drugs listed on the PBS
• to learn more about the prescribing of PBS medicines
• for detailed patient information on medicines prescribed by your doctor or dentist
• to find out what you can expect to pay for medicines

To learn more about 60-day prescriptions visit 60dayscripts.com.au.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.