Pharmaceutical Benefits Scheme (PBS) & 60-Day Dispensing
Complete overview of Australia's PBS medication subsidies, concessional co-payments, the PBS Safety Net, and 60-day dispensing reforms.
What is the Pharmaceutical Benefits Scheme (PBS)?
The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that subsidises the cost of necessary prescription medicines for all Australian residents holding a current Medicare card. Without the PBS, life-saving modern pharmaceuticals—including biological therapies, targeted oncology agents, and novel inhalers—would cost hundreds or thousands of dollars per month.
Under the PBS, the Australian Government pays the remaining cost of the medicine directly to the community pharmacy, with the consumer contributing a statutory patient co-payment.
PBS Co-Payments & Concession Cards
Statutory co-payments are indexed on 1 January each year:
- General Patient Co-Payment: Capped at $31.60 per prescription (substantially reduced from historical highs). Pharmacies may discount this by up to $1.00 at their discretion.
- Concessional Patient Co-Payment: Capped at $7.70 per prescription for holders of a Pensioner Concession Card, Commonwealth Health Care Card, or DVA White/Gold Card.
- Closing the Gap (CTG) Co-Payment Measure: Helps Aboriginal and Torres Strait Islander people living with or at risk of chronic disease access cheaper PBS medicines, often reducing concessional co-payments to $0.00 and general co-payments to the concessional rate.
The PBS Safety Net: Annual Cost Protection
The PBS Safety Net helps patients and families who require high volumes of prescription medications. The scheme runs from 1 January to 31 December each calendar year:
- Concessional Safety Net: Once a concessional patient reaches the threshold (approx. 36 concessional scripts), all subsequent PBS prescriptions for the remainder of that calendar year are completely free of charge ($0.00).
- General Safety Net: Once general out-of-pocket prescription expenses cross the threshold (approx. $1,647.90), subsequent PBS medicines are supplied at the discounted concessional rate of $7.70 per script for the rest of the year.
- Pharmacy Safety Net Cards: Patients should keep a Safety Net prescription record card (Form PB240) or ensure their regular community pharmacy tracks their family total electronically.
PBS Prescription Categories: General, Authority & S100
Medications on the PBS schedule fall under three administrative categories:
- Unrestricted: Can be prescribed by a GP for any clinically indicated condition without government pre-approval.
- Restricted: Can only be prescribed as a subsidised PBS item when the patient meets specific clinical criteria defined by the Pharmaceutical Benefits Advisory Committee (PBAC).
- Authority Required: Requires the doctor to obtain prior telephone or electronic approval from Services Australia, or verify an electronic streamline code, confirming the patient satisfies stringent diagnostic or failure-of-prior-therapy criteria. Highly specialised drugs (Section 100) are funded under special arrangements.