Benefits and cost savings
Patients with a 60-day prescription for a Pharmaceutical Benefits Scheme (PBS) medicine may save up to:
- $180 a year per medicine for Medicare card holders who do not have a concession card
- $43.80 a year per medicine for concession cardholders.
Patients buying PBS medicines will save more than $1.6 billion over the next 4 years from 60-day prescriptions.
Patients taking only 60-day prescription medicines may halve their doctor and pharmacy trips to renew and fill their scripts, freeing up millions of GP visits.
For an eligible patient who pays the $30 general co-payment for their PBS medicines, they will receive 60 days’ worth of medication for the cost of 30 days.
The saving will be less where:
- the cost of the medication is below the maximum $30 PBS general co-payment amount
- additional manufacturer surcharges are applicable.
The maximum 60-day prescription cost is:
- not the same as for a one-month supply
- less than the maximum PBS cost for 2 one-month prescriptions.
Patients will pay only one dispensing fee for a 60-day prescription, rather than 2 fees for 2 one-month supplies.
A brand premium may apply to some PBS medicines, including those available for 60-day prescriptions. A brand premium is an additional payment that you pay to the PBS medicine brand supplier. Pharmaceutical companies who supply the medicine impose and keep brand premiums fees, not the Australian Government. The additional supplier's charge does not mean there is any difference in quality between brands.
It is a legal requirement for pharmacists to charge brand premiums for the supplier. The brand premium does not count towards your Safety Net threshold.
Brand premiums are only permitted when a pharmacist can substitute an available PBS medicine that is:
- an alternative
- premium free
- a Therapeutic Goods Administration (TGA) registered brand.
Patients with 60-day prescriptions:
- will still need to pay any applicable brand premiums
- should speak to their pharmacist to discuss dispensing of premium-free alternatives.
Pharmacists can substitute any of the available brands when dispensing a PBS medicine, provided that the prescriber has not ticked the box on the prescription indicating that the brand may not be substituted. This can ensure greater savings for patients.
PBS Safety Net
The PBS Safety Net continues to support Medicare card holders who do not have a concession card and spend more than $1,563.50 on PBS medicines in 2023. Concession cardholders reach the safety net when they spend more than $262.80.
With a 60-day prescription, patients may save so much on their medicines that they won’t need the safety net. Others will reach the safety net later in the year, spreading their medicine costs out over a longer period. If patients hit the threshold later in the year, it means they have saved money throughout the year.
Medicines are cheaper for all patients on 60-day prescriptions.
The safety net threshold for concession cardholders is the same as before, $262.80 for 2023. After reaching this threshold concession cardholders will receive the rest of their prescriptions for free for the rest of the year.
Brand premiums and special patient contributions will still apply. Even if a concession cardholder reaches the threshold, they:
- won’t have to wait until they hit the threshold to save money on medicine
- will get help with their cost of living sooner.
Medicare cardholders who do not have a concession card
Medicare cardholders who do not have a concession card will pay for fewer prescriptions each year if they are eligible for 60-day prescriptions. If they reach the PBS Safety Net ($1,563.50 in 2023), they pay the concessional rate for any remaining PBS prescriptions for the year.