Pharmaceutical Benefits Scheme (PBS)

The following information is supplied from www.pbs.gov.au/html/consumer/pbs/about#d201445e158 and www.medicare.gov.au/public/services/scripts/pbs.jsp

What is PBS?

The PBS Schedule lists all of the medicines available to be dispensed to patients at a Government-subsidised price. The Schedule is part of the wider Pharmaceutical Benefits Scheme managed by the Department of Health and Ageing and administered by Medicare Australia.

Who is eligible for the PBS?

The Scheme is available to all Australian residents who hold a current Medicare card. Overseas visitors from countries with which Australia has a Reciprocal Health Care Agreement (RHCA) are also eligible to access the Scheme. Only those eligible for the PBS will receive subsidised medication and every time you present your script to the pharmacist, you will need to provide your Medicare card. Eligible veterans may need to present their DVA card in addition to their Medicare card. With your consent, the pharmacist may (at their discretion) keep a record of your Medicare number so that you do not have to show the actual card every time you lodge a script.

Who is eligible for a concession?

To be eligible for a concessional benefit, you will have one of the following concession cards:

• Pensioner Concession Card;
• Australian Seniors Health Card;
• Health Care Card; or
• DVA White, Gold, or Orange Card.

Some State / Territory governments issue Seniors Cards. These are not considered concession cards for the purposes of the PBS.
Centrelink is responsible for the issue and administration of the Pensioner Concession Card, the Australian Seniors Health Card and Health Care Cards.
DVA are responsible for White, Gold and Orange Cards.
There is also a DVA Pension Card, which entitles holders to PBS medicines at the concessional rate (but not RPBS medicines).
General benefits apply if you do not have any of the above cards

What is the PBS Safety Net?

If you or your family need a lot of medicine in a calendar year, the PBS Safety Net helps you with the cost of your medicine. Once you or your family reach a Safety Net threshold, you can apply for a PBS Safety Net card - your PBS medicine will be less expensive or free† for the rest of the calendar year.
† If you choose a more expensive brand of medicine, or if your doctor prescribes one, the extra amount you pay won’t count towards your PBS Safety Net.

How much will I pay for my PBS medicine from 1 January 2009?

If you have a Department of Veterans’ Affairs (DVA) White Card for specific conditions and your medication is for those conditions you will pay $5.30, otherwise you pay the general amount.

† If you choose a more expensive brand of medicine, or if your doctor prescribes one, the extra amount you pay won’t count towards your PBS Safety Net.

What do I need to do?

You need to keep a record of your PBS medicine on a Prescription Record Form (PRF), which you can get from your pharmacy. Each time you have a PBS medicine supplied, hand your form to the pharmacist so it can be recorded. Your pharmacy might be able to keep a record for you on their computer, but if they can’t or if you visit different pharmacies, its best to keep your own records. If you have a family, ask your pharmacist about combining the amounts you spend for your Safety Net total.

What happens once I reach the Safety Net threshold?

When you are close to reaching the Safety Net threshold, ask your pharmacist about how you can apply for a Safety Net card. Once you have reached your relevant threshold and your pharmacist has issued your Safety Net card, medicine will be less expensive or free† for the rest of the calendar year.

† If you choose a more expensive brand of medicine, or if your doctor prescribes one, the extra amount you pay won’t count towards your PBS Safety Net.

PBS Safety Net thresholds from 1 January 2009

† If you choose a more expensive brand of medicine, or if your doctor prescribes one, the extra amount you pay won’t count towards your PBS Safety Net.

PBS Safety Net thresholds from 1 January 2009

If you get a PBS medicine within 20 days of a previous supply of the same medicine, the cost may not count towards your Safety Net threshold. Even if you have already reached the Safety Net you may have to pay your pre-safety net amount.

For further information about the PBS Safety Net 20 day rule or a list of PBS medicine types covered by the PBS Safety Net 20 day rule please visit Department of Health and Ageing.

Generic Medicines

This information is supplied by Alphapharm. For more information, visit www.alphapharm.com.au

What is a generic medicine?

A generic medicine is an alternative brand of a medicine that has been on the market for many years. For a generic medicine to be approved for sale, it must contain the same active ingredient; in the same dose and strength; have the same onset of action; stay in the body for the same amount of time; and work in the same way as its brand name equivalent.

The government, through the Therapeutic Goods Administration (TGA), applies the same strict regulatory criteria to the generic medicine as are applied to the originator brand, ensuring its safety, efficacy and quality is to high standards. Generic medicines are therefore considered to be interchangeable with the brand equivalent without compromising patient care.

Are there any differences in the quality of their ingredients?

All ingredients – active or inactive – in any medicine, be it expensive brand or generic, must be evaluated for quality, safety and efficacy, and approved for sale by the TGA before introduction into the market, and regularly thereafter.

Why are branded medicines more expensive than generic medicines?

When a medicine is discovered, the company that develops it may apply for a patent. The patent provides the company with a competition-free period of up to 25 years, to allow it to recover research and development costs and profit from the discovery. A generic medicine can enter the market when this patent has expired. Generic medicines are less expensive because the manufacturers don't have the initial investment costs of the developing company.

Further, when generic medicines enter the market, there is greater competition, which can bring prices down. The government also subsidises medicines through the Pharmaceutical Benefits Scheme (PBS).

Where can I find more information?

General information:
PBS information on health.gov.au site

PBS and Medicare Australia:
PBS information on medicareaustralia.gov.au site

The Safety Net:
Safety Net information on medicareaustralia.gov.au site