2015 Pharmaceutical Benefits Scheme co-payment and safety net information

Patient Co-payments:	General	$37.70
	Concessional	$6.10
Safety Net Thresholds:	General	$1453.90
	Concessional	$366.00

 

2014 Budget information on the Pharmaceutical Benefits Scheme

13 May 2014

The 2014 Budget information on the Pharmaceutical Benefits Scheme is available on the Department of Health website.

Why are these changes being made?

• The Government needs to ensure that the PBS is managed in a fiscally responsible way, so that the Australian community can continue to have access to new, innovative and affordable medicines now and into the future. 
• Over the past decade the cost of the PBS has increased by 80 per cent. Long-term PBS expenditure is expected to grow by 4-5 per cent per annum.
• To put the PBS on a more sustainable footing, the Government is asking Australians to take more personal responsibility for their health, through modest additional contributions to the costs of their care. 

What will these changes mean for me?

• If you are a general patient, you will pay $5 more per subsidised PBS prescription. 
• If you are a concessional patient, including pensioners and veterans, you will pay 80 cents more per PBS prescription.
• The PBS safety net will still be there for both concessional and general patients to protect high medicine users. However, the safety net threshold will also be adjusted.
• The safety net for general patients will increase by 10 per cent above CPI each year over four years from the current $1421.20.

Table 1: Estimated General Safety Net Amounts

Table 1: Estimated General Safety Net Amounts

YEAR	From	To	Increase per year
2015	$1,452.50*	$1,597.80*	$145.30
2016	$1,485.90*	$1,798.00*	$312.10
2017	$1,524.50*	$2,029.20*	$504.70
2018	$1,562.60*	$2,287.90*	$725.30

*Estimate amounts only subject to actual September 2014 CPI

• The safety net threshold for concessional patients will increase by two prescriptions each year over four years from the current 60 prescriptions to 62 in 2015 and up to 68 in 2018.

Table 2: Estimated Concessional Safety Net Amounts

YEAR	From	To	Increase per Year
2015	$366.00 (60 prescriptions)	$427.80 (62 prescriptions)	$61.80
2016	$372.00 (60 prescriptions)	$454.40 (64 prescriptions)	$82.40
2017	$384.00 (60 prescriptions)	$481.80 (66 prescriptions)	$97.80
2018	$396.00 (60 prescriptions)	$510.00 (68 prescriptions)	$114.00

*Estimate amounts only subject to actual September 2014 CPI

Table 3: Changes to PBS co-payments and safety net thresholds in 2015

	General			Concessional
	Co-payment	Safety Net Threshold	Post Safety Net co-payment	Co-payment	Safety Net Threshold	Post Safety Net co-payment
Patient contribution in 2015 (status quo - with CPI)	$37.70*	$1,452.50*	$6.10*	$6.10*	$366.00*	Nil
New Patient contribution in 2015	$42.70*	$1,597.80*	$6.90*	$6.90*	$427.80*	Nil
Difference [Increase($)]	$5.00	$145.30	$0.80	$0.80	$61.80	Nil

*Estimate amounts only subject to actual September 2014 CPI

• General patients use on average 2 subsidised PBS scripts per year and should expect to pay $10 more in contributions per year.
• Concessional patients – who use 17 PBS scripts per year on average – will pay $13.60 more per year.
• General patients who are high medicine users will pay $145.30 more in 2015 before reaching the PBS safety net.
• Concessional patients who are high medicine users will pay an additional $61.80 in 2015 before reaching the PBS safety net.
• For some PBS medicines which are priced below the general co-payment, there will be no change to the price that consumers will pay.
• Consumers are encouraged to discuss the price of PBS medicines with their pharmacist.

When will these changes come into effect?

• These changes to patient contributions will take effect from 1 January 2015.
• For more information please call the PBS Information Line: Free Call 1800 020 613