The Pharmaceutical Benefits Scheme (PBS) is part of Australia’s broader National Medicines Policy, a framework based on partnerships between governments, healthcare providers, the medicines industry and the media which focuses on consumer access to, and sensible use of, medicine. Along with Medicare, the PBS is a key component of Australian healthcare.
All medicines in Australia must be approved for sale by the Therapeutic Goods Administration (TGA). Manufacturers of prescription medicine can apply for the medicine to be subsidised under the PBS scheme.
Under the Pharmaceutical Benefits Scheme the government subsidises the cost of medicine for most medical conditions. Such medicines are typically dispensed by chemists and taken directly by patients.
Some medicines on the PBS are only subsidised for certain conditions. Where a medicine is not covered by the PBS, patients are required to pay the full price but part of the cost may be covered by the patient’s health fund.
Drugs which are designated as required to be administered under medical supervision, usually in a hospital, are the responsibility of the state or territory where the hospital or treatment facility is located.
The PBS began in a limited form in 1948 as a list of 139 free “life-saving and disease preventing” medicines. Today, the Pharmaceutical Benefits Scheme Schedule continues to be a list of all medicine available to be dispensed to patients at a subsidised price. The Schedule, now thousands of different drug brands, is available online as an A-Z medicine listing and is updated monthly.
The PBS is governed by the National Health Act 1953 and pharmaceutical benefits under the PBS may only be supplied by pharmacists and medical practitioners approved under the Act.
The Professional Services Review PSR is the body that helps to govern doctors who provide Medicare services or prescribe government subsidised medicines under the PBS scheme. In the event that these are misused, doctors have been required to repay their PBS benefits in the past.
Patients eligible for the PBS must either be Australian residents who hold a current Medicare card or be an overseas visitor from a country with which Australia has a Reciprocal Health Care Agreement (RHCA).
When lodging a prescription with a pharmacist, patients must either show their Medicare card or passport to prove eligibility in order to obtain the medication at a reduced cost. The pharmacist is then required to supply a valid Medicare number or special number (for patients covered by the RHCA for example) when they submit the prescription to the Department of Human Services in order to claim reimbursement.
The PBS is managed by the Department of Health and administered by the Department of Human Services. Those wanting to know more about can find detailed information via the Department of Health’s PBS website.
If you’re interested in the PBS scheme, make sure you read our post about doctors who have been forced to repay their PBS benefits.