From 1 January 2023, the maximum cost of general prescriptions under the PBS has fallen for the first time in the 75-year history of the PBS.
As of the new year the most patients will pay for a listed medication is $30, down from $42.50.
This amount will be indexed on the first day of every new year, from 1 January 2024, and pharmacists will not be required to do anything to apply the changes, as their software systems will update automatically.
Minister for Health and Aged Care, Mr Mark Butler, said at a press conference in Adelaide on 1 January 2023, that this was the largest price cut ever to the PBS and would be of enormous benefit to as many as three and a half million patients across Australia.
“If you’re a family with three general patient scripts to fill every month, you may be saving as much as $500 every single year because of this cut to PBS medicine prices,” Minister Butler said.
“The ABS has told us that almost a million Australians every single year go without filling a script or the defer the filling of a script that their doctor has said is important for their health because they cannot afford to.
“Pharmacists have told us case after case of their customers coming into their pharmacy presenting them with several different scripts needed for their family and asked their advice about which ones they can go without because they cannot afford to fill them all.
“We know that general patients are often not on particularly substantial incomes, often on low to middle incomes, but fall on the wrong side of the concession cardholder income test and have been paying some of the highest prices for medicines for general patients in many countries to which we usually compare ourselves.
“This is a great measure at a time of unprecedented cost of living pressure on Australian households. But it is also something that is going to be good for Australia’s health.”
In addition to the $12.50 reduction, from 1 January 2023, pharmacists will be able to provide their own voluntary discounting for general patient medicines with a dispensed price between $30.00 and $45.60, with eligible medicines discounted to any price (including a price below $30.00) at the pharmacist’s discretion.
Pharmacists have already been able to voluntarily to discount the PBS patient co-payment amounts (concessional and/or general) by up to $1.00 since 1 January 2016, and this discount will continue in conjunction with the new arrangements.
The discounted amount charged to the patient will continue to contribute to their general patient PBS Safety Net threshold, and similarly, from 1 January 2023, the threshold will also be increased, up to $262.80 for those with a concession card and up to $1,563.50 for other eligible patients.
After reaching the threshold, general patients pay for further PBS prescriptions at the concessional co-payment rate and concession card holders are dispensed PBS prescriptions at no further charge for the remainder of that calendar year, with either the Safety Net Entitlement card or Safety Net Concession Card issued by their pharmacist.
The Pharmacy Guild of Australia’s National President, Professor Trent Twomey, welcomed the measures, stating that they will be a tremendous help to those who have been struggling to afford their medicines.
“In 2019-20 we learnt that 900,000 Australian patients did not get a script filled because they could not afford it,” Professor Twomey said.
“It’s a credit to our politicians that they listened to those concerns and gave a bi-partisan commitment to lower the maximum co-payment for PBS listed medicines after the election, January 1st marks a significant date as it will be the first time in the history of the PBS that the general co-payment for medicines has come down and not gone up.”
However, Professor Twomey also noted that the campaign to make medicines universally affordable for all Australians was far from over.
“We are now pushing to lower the maximum co-payment of PBS medicines even further: reducing the maximum co-payment to $19 will mean an additional 30% of PBS medicines are covered.”