Pharmaceutical Benefits
Fees, Patient Contributions and Safety Net Thresholds
Page last updated: 1 July 2024
The following fees, patient contributions and Safety Net thresholds apply as at 1 January 2024 and are included, where applicable, in prices published in the Schedule of Pharmaceutical Benefits:
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Dispensing Fees: |
Ready-prepared |
$8.67 |
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Dangerous drug fee |
$5.37 |
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Extemporaneously-prepared |
$10.71 |
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Allowable additional patient charge* |
$3.45 |
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Wholesale Mark-Up (for Ready Prepared Pharmaceutical Benefits)*** |
When the Ex-Manufacturer Price is up to and including $5.50 |
$0.41 per dispense |
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Where the Ex-Manufacturer Price is over $5.50 and up to and including $720 |
7.52 per cent of the Ex-Manufacturer Price per dispense |
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Where the Ex-Manufacturer Price is over $720 |
$54.14 per dispense |
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Administration, Handling and Infrastructure Fee (AHI Fee) |
Tier One AHI Fee |
For a Listed Brand with a Price to Pharmacists for Maximum Quantity less than $100 |
$4.79 per dispense of Maximum Quantity |
|
Tier Two AHI Fee |
For a Listed Brand with a Price to Pharmacists for Maximum Quantity from $100 and up to and including $2,000 |
Tier One AHI Fee plus 5% of the amount by which the Price to Pharmacists for Maximum Quantity exceeds $100, per dispense of Maximum Quantity |
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Tier Three AHI Fee |
For a Listed Brand with a Price to Pharmacists for Maximum Quantity over $2,000 |
Tier One AHI Fee and $95 per dispense of Maximum Quantity. |
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Additional Fees (for Safety Net prices): |
Ready-prepared |
$1.45 |
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Extemporaneously-prepared |
$1.87 |
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Efficient Funding of Chemotherapy (EFC)** |
Preparation fee |
$90.13 |
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Distribution fee |
$30.05 |
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Diluent fee |
$5.95 |
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Patient Co-payment Amounts |
General |
$31.60 |
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Concessional |
$7.70 |
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Safety Net Thresholds |
General |
$1,647.90 |
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Concessional |
$277.20 |
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Safety Net Card Issue Fee |
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$12.04 |
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*The allowable additional patient charge is a discretionary charge to general patients if a pharmaceutical item has a dispensed price for maximum quantity less than the general patient co-payment amount. The pharmacist may charge general patients the allowable additional fee but the fee cannot take the cost of the prescription above the general patient co-payment amount for the medicine
**Public hospital pharmacies which are authorised to supply PBS-subsidised chemotherapy medicines are only eligible for the preparation fee (i.e. not the distribution or diluent fees)
***The wholesale mark-up for a Pack Quantity of a Listed Brand is calculated using the Relevant Quantity.
PBS Changes Explainer Table - January 2024 (PDF 181KB) - (Word 59KB)
The Real Cost of Medicines
Information on how much medicines really cost and gives examples of the amount the Commonwealth subsidises for some medicines.
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The Real Cost of Medicines |
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|---|---|---|---|---|---|---|---|
|
Condition/Medicine (chemical name) |
Actual Cost of Medicine* (dispensed price for maximum qty) |
General Patients* |
General Patients* |
General Patients after reaching PBS Safety Net/Concessional Patients* (Concession Card) |
General Patients after reaching PBS Safety Net/Concessional Patients* (Concession Card) |
Concessional Patients after reaching Safety Net |
Concessional Patients after reaching Safety Net |
|
Cost to patient |
Gov’t Subsidy |
Cost to patient |
Gov’t Subsidy |
Cost to patient |
Gov’t Subsidy |
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|
Asthma & Chronic Obstructive Pulmonary Disease Fluticasone propionate with salmeterol 250 mcg/25 mcg (pressurised inhalation) |
$56.54 |
$31.60 |
$24.94 |
$7.70 |
$48.84 |
Nil |
$56.54 |
|
Atrial fibrillation Dabigatran etexilate 150 mg |
$81.69 |
$31.60 |
$50.09 |
$7.70 |
$73.99 |
Nil |
$81.69 |
|
Prostate cancer Goserelin 3.6 mg and bicalutamide 50 mg |
$412.39 |
$31.60 |
$380.79 |
$7.70 |
$404.69 |
Nil |
$412.39 |
|
Multiple sclerosis Fingolimod 500 mcg |
$1,062.59 |
$31.60 |
$1,030.99 |
$7.70 |
$1,054.89 |
Nil |
$1,062.59 |
|
Chronic Myeloid Leukaemia Imatinib 400 mg |
$662.67 |
$31.60 |
$631.07 |
$7.70 |
$654.97 |
Nil |
$662.67 |
*Please note that some medicines on the PBS are only subsidised for certain conditions. Amounts current as of 1 January 2024.
Who Pays What?
Information on Commonwealth subsidies, patient co-payment amounts, and how manufacturers, pharmacies and wholesalers are paid.
|
Patient Co-payment Amount before Safety Net |
Patient Co-payment amount with Safety Net |
Safety Net Threshold |
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|---|---|---|---|
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General patient pays up to |
$31.60 |
$7.70 |
$1,647.90 |
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From 1 January 2024 for PBS prescriptions general patients (those without a concession card) can be charged up to $31.60. Pharmacists and other dispensers can charge the PBS dispensed price, plus an additional fee up to $1.40 for recording Safety Net expenditure on the Patient Record Form, plus an optional pharmacy charge of $3.45 or less, (such that the total of the afore-mentioned charges does not exceed the patient co-payment amount), plus any delivery or after hours fee, brand or therapeutic group premium, or special patient contribution that may be applicable. |
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Concessional patient pays up to |
$7.70 |
Nil |
$277.20 |
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plus any delivery or after hours fee, brand or therapeutic group premium, or special patient contribution that may be applicable. |
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Government pays |
any additional cost of drugs exceeding patient co-payment amounts up to the dispensed price, excluding any delivery or after hours fee, brand or therapeutic group premium, or special patient contribution that may be applicable. |
History of PBS Co-payment Amounts and Safety Net Thresholds
| Table outlining past and current Co-payment Amounts and Safety Net Thresholds | |||||
|---|---|---|---|---|---|
|
Date of Change |
Concessional Beneficiaries |
Concessional Beneficiaries |
Concessional Beneficiaries |
General Beneficiaries |
General Beneficiaries |
|
Co-payment Amount |
Co-payment Amount |
Safety Net Threshold $ |
Co-payment Amount $ |
Safety Net Threshold $ |
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Pensioners $ |
Others $ |
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1/3/1960 |
0.50 |
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1/11/1971 |
1.00 |
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1/9/1975 |
1.50 |
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1/3/1976 |
2.00 |
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1/7/1978 |
2.50 |
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1/9/1979 |
2.75 |
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1/11/1981 |
3.20 |
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1/1/1983 |
1 2.00 |
4.00 |
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1/7/1985 |
5.00 |
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1/11/1986 |
2.50 |
25 scripts |
10.00 |
25 scripts |
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1/7/1988 |
11.00 |
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1/11/1990 |
22.50 |
2.50 |
130.00 |
15.00 |
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1/1/1991 |
Introduction of |
1st tier .............. |
300.00 |
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1/8/1991 |
15.70 |
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1/10/1991 |
2.60 |
2.60 |
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1/1/1992 |
RPBS Co-payment Introduced 2.60 |
135.20 |
1st tier .............. |
309.90 |
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1/8/1992 |
15.90 |
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1/1/1993 |
1st tier .............. |
312.30 |
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1/8/1993 |
16.00 |
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1/1/1994 |
Discontinuance of |
1st tier .............. |
400.00 |
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1/8/1994 |
16.20 |
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1/1/1995 |
407.60 |
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1/8/1995 |
16.80 |
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1/1/1996 |
2.70 |
2.70 |
140.40 |
600.000 |
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1/8/1996 |
17.40 |
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1/1/1997 |
33.20 |
3.20 |
166.40 |
20.00 |
612.60 |
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1/1/1999 |
20.30 |
620.30 |
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1/1/2000 |
3.30 |
3.30 |
171.60 |
20.60 |
631.20 |
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1/7/2000 |
43.30 |
3.30 |
171.60 |
20.60 |
631.20 |
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1/1/2001 |
53.50 |
3.50 |
182.00 |
21.90 |
669.70 |
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1/1/2002 |
3.60 |
3.60 |
187.20 |
22.40 |
686.40 |
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1/1/2003 |
3.70 |
3.70 |
192.40 |
23.10 |
708.40 |
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1/1/2004 |
3.80 |
3.80 |
197.60 |
23.70 |
726.80 |
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1/1/2005 |
4.60 |
4.60 |
239.20 |
28.60 |
874.90 |
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1/1/2006 |
4.70 |
4.70 |
253.80 |
29.50 |
960.10 |
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1/1/2007 |
4.90 |
4.90 |
274.40 |
30.70 |
1,059.00 |
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1/1/2008 |
5.00 |
5.00 |
290.00 |
31.30 |
1,141.80 |
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1/1/2009 |
5.30 |
5.30 |
318.00 |
32.90 |
1,264.90 |
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1/1/2010 |
65.40 |
5.40 |
324.00 |
33.30 |
1,281.30 |
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1/1/2011 |
75.60 |
5.60 |
336.00 |
34.20 |
1,317.20 |
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1/1/2012 |
85.80 |
5.80 |
348.00 |
35.40 |
1,363.30 |
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1/1/2013 |
5.90 |
5.90 |
354.00 |
36.10 |
1,390.60 |
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1/1/2014 |
6.00 |
6.00 |
360.00 |
36.90 |
1,421.20 |
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1/1/2015 |
6.10 |
6.10 |
366.00 |
37.70 |
1,453.90 |
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1/1/2016 |
6.20 |
6.20 |
372.00 |
38.30 |
1,475.70 |
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1/1/2017 |
6.30 |
6.30 |
378.00 |
38.80 |
1,494.90 |
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1/1/2018 |
6.40 |
6.40 |
384.00 |
39.50 |
1,521.80 |
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1/1/2019 |
6.50 |
6.50 |
390.00 |
40.30 |
1,550.70 |
|
1/1/2020 |
6.60 |
6.60 |
9$316.80 |
41.00 |
101,486.80 |
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1/1/2021 |
6.60 |
6.60 |
316.80 |
41.30 |
1,497.20 |
|
1/1/2022 |
6.80 |
6.80 |
326.40 |
42.50 |
1,542.10 |
|
1/7/2022 |
6.80 |
6.80 |
11244.80 |
42.50 |
121,457.10 |
|
1/1/2023 |
7.30 |
7.30 |
262.80 |
1330.00 |
1,563.50 |
| 1/1/2024 | 14 7.70 | 147.70 | 277.20 | 1431.60 | 1,647.90 |
1. Previously paid general co-payment amount.
2. A compensating Pharmaceutical Allowance was introduced equal to co-payment amount x 52.
3. Pharmaceutical Allowance maintained at $2.70 per week paid fortnightly.
4. Pharmaceutical Allowance increased to $2.80 per week paid fortnightly.
5. Pharmaceutical Allowance increased to $2.90 per week paid fortnightly.
6. Pharmaceutical Allowance increased to $3.00 per week paid fortnightly.
7. Pharmaceutical Allowance is $3.00 per week paid fortnightly.
8. Pharmaceutical Allowance increased to $3.10 per week paid fortnightly.
9. The number of scripts for concessional beneficiaries to reach the Safety Net threshold was reduced from 60 to 48 scripts on 1 January 2020.
10. Amendments to the National Health Act 1953 lowered the general patient Safety Net threshold to $1,486.80 on 1 January 2020.
11. On 1 July 2022, the number of scripts to reach the Safety Net was lowered to 36 scripts due to enactment of the Treasury Laws Amendment (Cost of Living Support and Other Measures) Bill 2022.
12. Enactment of the Treasury Laws Amendment (Cost of Living Support and Other Measures) Bill 2022 changed the definition of the General Safety Net threshold to be $1,457.10 on 1 July 2022.
13. Enactment of National Health Amendment (General Co-payment) Bill 2022 defined the general patient co-payment amount to be $30.00 from 1 January 2023. This amount will be indexed annually from 1 January 2024.
14. On 1 January 2024, the PBS Safety Net threshold increased in alignment with the Consumer Price Index.
