The prescriber bag supply order form must be completed in triplicate and signed by the prescriber. The original and duplicate is to be given to the approved supplier and retained by the approved supplier of the pharmaceutical benefit. Each form is valid for the month indicated on the form.
Prescribers may order the maximum quantity of an item provided they do not already have the maximum quantity on hand. Additionally, where there is more than one item in a group in the Prescriber Bag Determination Schedule, prescribers may only order the maximum quantity of an item if they do not already have the maximum quantity on hand for the other items within that group. The items can only be obtained once a month. Prescribers may also ask for a particular brand of a pharmaceutical benefit. If it is unavailable, they must specify another listed brand, and initial the alteration.
Further information and examples can be found in the Explanatory Statement to the National Health (Pharmaceutical Benefits) Amendment (2024 Measures No. 1) Regulations 2024.
A receipt must be signed by the prescriber, or by an authorised representative, when supplies are received.
Eligible prescribers can order a Prescriber Bag Supply Order Book from Services Australia using their Health Professional Online Services (HPOS) account. Refer to the Services Australia website for more information on linking and ordering. If you have no access to a computer or the internet, please contact Services Australia.
| Prescriber code | PBS Item code | Name, manner of administration and form & strength | Max qty packs |
Max qty units |
Dispensed price for max qty | Brands |
|---|---|---|---|---|---|---|
|
|
Adrenaline (epinephrine)adrenaline (epinephrine) 1 in 1000 (1 mg/mL) injection, 5 x 1 mL ampoules
|
1 | 5 | $21.43 | Link Medical Products Pty Ltd |
|
|
|
atropine sulfateatropine sulfate monohydrate 600 microgram/mL injection, 10 x 1 mL ampoules
|
1 | 10 | $29.78 | Atropine Injection (Bridgewest) |
|
|
|
Benzathine benzylpenicillinbenzathine benzylpenicillin tetrahydrate 1.2 million units (1016.6 mg)/2.3 mL injection,
10 x 2.3 mL syringes
|
1 | 10 | $336.31 | Bicillin L-A |
|
| OR | OR | |||||
|
|
Benzathine benzylpenicillinbenzathine benzylpenicillin 1.2 million units powder for injection [1 vial] (&) inert
substance diluent [4 mL ampoule], 1 pack
|
10 | 10 | $504.68 | Lentocilin S 1200 (Portugal) |
|
|
|
Benzatropinebenzatropine mesilate 2 mg/2 mL injection, 5 x 2 mL vials
|
1 | 5 | $118.94 | Benzatropine Injection |
|
|
|
Benzylpenicillinbenzylpenicillin 600 mg injection, 1 vial
|
5 | 5 | $43.48 | BenPen |
|
|
|
Benzylpenicillinbenzylpenicillin 3 g injection, 1 vial
|
1 | 1 | $23.37 | BenPen |
|
|
|
Ceftriaxoneceftriaxone 2 g injection, 5 vials
|
1 | 5 | $27.61 | Ceftriaxone Viatris |
|
| OR | OR | |||||
|
|
Ceftriaxoneceftriaxone 2 g injection, 10 vials
|
0.5 | 5 | $32.91 | Ceftriaxone Viatris |
|
|
|
Chlorpromazinechlorpromazine hydrochloride 50 mg/2 mL injection, 10 x 2 mL ampoules
|
1 | 10 | $34.78 | Largactil |
|
| OR | OR | |||||
|
|
Haloperidolhaloperidol 5 mg/mL injection, 10 x 1 mL ampoules
|
1 | 10 | $24.99 | HALOPERIDOL MEDSURGE Serenace |
|
|
|
Clonazepamclonazepam 2.5 mg/mL (0.1 mg/drop) oral liquid, 10 mL
|
1 | 1 | $17.55 | Rivotril |
|
|
|
diphtheria + tetanus vaccinediphtheria 2 units + tetanus 20 units vaccine injection, 5 x 0.5 mL syringes
|
2 | 10 | $178.86 | ADT Booster |
|
|
|
Furosemidefurosemide 20 mg/2 mL injection, 5 x 2 mL ampoules
|
1 | 5 | $17.07 | Lasix |
|
|
|
Furosemidefurosemide 20 mg tablet, 50
|
1 | 50 | $16.48 | Frusemix-M UREMIDE 20 |
|
|
|
glucagon hydrochlorideglucagon hydrochloride 1 mg injection [1 vial] (&) inert substance diluent [1 mL syringe],
1 pack
|
1 | 1 | $51.43 | GlucaGen Hypokit |
|
|
|
Glyceryl trinitrateglyceryl trinitrate 400 microgram/actuation spray, 200 actuations
|
1 | 1 | $26.42 | Nitrolingual Pumpspray |
|
|
|
hydrocortisone sodium succinatehydrocortisone (as sodium succinate) 100 mg injection [1 chamber] (&) inert substance
diluent [2 mL chamber], 1 dual chamber vial
|
2 | 2 | $24.74 | Solu-Cortef |
|
| OR | OR | |||||
|
|
hydrocortisone sodium succinatehydrocortisone (as sodium succinate) 250 mg injection [1 chamber] (&) inert substance
diluent [2 mL chamber], 1 dual chamber vial
|
1 | 1 | $23.38 | Solu-Cortef |
|
|
|
hyoscine butylbromidehyoscine butylbromide 20 mg/mL injection, 5 x 1 mL ampoules
|
1 | 5 | $20.85 | Buscopan HYOSCINE BUTYLBROMIDE MEDSURGE HYOSCINE BUTYLBROMIDE SXP HYOSCINE BUTYLBROMIDE-AFT |
|
|
|
Lidocainelidocaine hydrochloride monohydrate 1% (50 mg/5 mL) injection, 5 x 5 mL ampoules
|
1 | 5 | $51.23 | LIGNOCAINE INJECTION (BRIDGEWEST) |
|
|
|
Methoxyfluranemethoxyflurane 99.9% (999 mg/g) inhalation solution, 3 mL bottle
|
1 | 1 | $67.55 | Penthrox (Combination Pack) |
|
|
|
Metoclopramidemetoclopramide hydrochloride 10 mg/2 mL injection, 10 x 2 mL ampoules
|
1 | 10 | $21.42 | METOCLOPRAMIDE INJECTION BP Metoclopramide HCl Medsurge |
|
| OR | OR | |||||
|
|
Prochlorperazineprochlorperazine mesilate 12.5 mg/mL injection, 10 x 1 mL ampoules
|
1 | 10 | $30.63 | Stemetil |
|
|
|
Midazolammidazolam 5 mg/mL injection, 10 x 1 mL ampoules
|
1 | 10 | $40.18 | Pfizer Australia Pty Ltd |
|
|
|
Morphinemorphine hydrochloride trihydrate 10 mg/mL injection, 5 x 1 mL ampoules
|
1 | 5 | $23.43 | Morphine Juno |
|
| OR | OR | |||||
|
|
Morphinemorphine hydrochloride trihydrate 20 mg/mL injection, 5 x 1 mL ampoules
|
1 | 5 | $25.62 | Morphine Juno |
|
| OR | OR | |||||
|
|
Morphinemorphine sulfate pentahydrate 15 mg/mL injection, 5 x 1 mL ampoules
|
1 | 5 | $27.01 | MORPHINE SULFATE 15 mg/1 mL MEDSURGE |
|
| OR | OR | |||||
|
|
Morphinemorphine sulfate pentahydrate 30 mg/mL injection, 5 x 1 mL ampoules
|
1 | 5 | $29.11 | MORPHINE SULFATE 30 mg/1 mL MEDSURGE |
|
|
|
Naloxonenaloxone hydrochloride 400 microgram/mL injection, 5 x 1 mL ampoules
|
2 | 10 | $48.68 | NALOXONE SXP Naloxone Hydrochloride (DBL) Naloxone Juno |
|
| OR | OR | |||||
|
|
Naloxonenaloxone hydrochloride 400 microgram/mL injection, 10 x 1 mL ampoules
|
1 | 10 | $48.67 | NARCAN |
|
|
|
Phytomenadionephytomenadione 10 mg/mL injection, 5 x 1 mL ampoules
|
1 | 5 | $25.96 | Konakion MM |
|
|
|
Salbutamolsalbutamol 2.5 mg/2.5 mL inhalation solution, 20 x 2.5 mL ampoules
|
1 | 1 | $18.67 | Ventolin Nebules |
|
| OR | OR | |||||
|
|
Salbutamolsalbutamol 100 microgram/actuation inhalation, 200 actuations
|
1 | 1 | $19.62 | Zempreon CFC-Free with dose counter |
|
| $20.08 | Asmol CFC-Free with dose counter |
|||||
| $22.62 | Ventolin CFC-Free with dose counter |
|||||
|
|
Salbutamolsalbutamol 5 mg/2.5 mL inhalation solution, 20 x 2.5 mL ampoules
|
1 | 1 | $67.36 | Salbutamol (as sulfate) (Accord, UK) |
|
| OR | OR | |||||
|
|
Salbutamolsalbutamol 5 mg/2.5 mL inhalation solution, 20 x 2.5 mL ampoules
|
1 | 1 | $18.80 | Ventolin Nebules |
|
| OR | OR | |||||
|
|
Salbutamolsalbutamol 5 mg/2.5 mL inhalation solution, 30 x 2.5 mL ampoules
|
1 | 1 | $19.16 | Salbutamol Cipla |
|
|
|
Tramadoltramadol hydrochloride 100 mg/2 mL injection, 5 x 2 mL ampoules
|
1 | 5 | $17.35 | Tramadol AN Tramadol Sandoz Tramal 100 |