The maximum cost of a PBS prescription for general patients will reduce from $42.50 to $30 from 1 January 2023. This is a 29% reduction.
This is the first time in 75 years the general co-payment under the PBS has fallen. This change will help ease cost-of-living pressures for Australians.
Facts for pharmacists
Costs and discounts
- The maximum cost of the general co-payment for PBS prescriptions will reduce by $12.50, from $42.50 to $30.
- Pharmacists will be able to provide an increased discount to general patients on prescriptions with a Commonwealth price between $30 and $45.60.
Safety Net, Closing the Gap and concessional patients
- When the new discretionary discount is applied, the amount paid by the patient will still count towards their PBS Safety Net. This ensures no-one will be worse off by the changed co-payment. Pharmacists will not be eligible to claim PBS benefits if the discretionary discount is applied.
- These changes won’t affect the amount concession card holders pay. This includes concession card holders in the Closing the Gap (CTG) PBS co‑payment program. However, from 1 January 2023 the concessional co‑payment amount will change in line with the CPI.
- Concessional patients are already receiving benefits from reductions to the PBS Safety Net. On 1 July 2022 the Safety Net reduced by $81.60 to $244.80.
- Patients who are part of the CTG program won’t be disadvantaged by a reduced co-payment when reaching the general PBS Safety Net threshold.
- CTG prescriptions priced at or above the general co-payment ($30 in 2023, then indexed annually) will continue to count toward the PBS Safety Net at the current amount of $42.50.
- The Australian Government has worked with software providers to make relevant updates.
- Pharmacists won’t have to do anything to implement the changes. Software systems will automatically update.
- Services Australia administers the PBS.
- This includes processing pharmaceutical benefits and Safety Net claims, authority applications and supply of PBS stationery used by health professionals.
- For more information call 132 290 or visit the Services Australia website.
For more information and downloadable patient resources, see the PBS website.