The PBS and Prescription Medicines in Australia: How It Works and Who Benefits
Prescription medicines in Australia are not cheap if you have to pay the full market price. The Pharmaceutical Benefits Scheme (PBS) is a government program that significantly reduces the cost for those who are eligible. Understanding how it works helps you know whether you are entitled to help and how to make the most of it when buying medicine.
What the PBS is
The PBS is the Australian Government’s medicine subsidy program. Instead of paying the full price, eligible people pay only a fixed amount (called the patient contribution or co-payment), with the rest covered by the government and paid to the pharmacy.
The list of medicines subsidised through the PBS (the PBS list) includes thousands of common medicines, from antibiotics to medicines for heart disease, diabetes, asthma, mental health, cancer and many other chronic conditions. The list is updated periodically.
Who benefits from the PBS
To get the PBS price, you need:
- To be eligible for Medicare, and
- A prescription written by a doctor registered in Australia
If you do not have Medicare (for example, you are on a temporary visa that does not include Medicare), you can still buy prescription medicines in Australia, but you must pay the full price — often much higher.
The two co-payment rates
The PBS has two patient rates:
General rate: Applies to most people who have Medicare. You pay a fixed amount; the rest is subsidised by the government.
Concessional rate: Much lower, and applies to people who hold a concession card such as a Pensioner Concession Card, Health Care Card, or Commonwealth Seniors Health Card. These people pay considerably less for each prescription.
The exact amounts change each year (usually on 1 January) — check the current rate at pbs.gov.au before estimating your costs.
Safety net — when you use a lot of medicine
The PBS has a “safety net” mechanism: when the total cost of your (or your family’s) prescriptions during the year exceeds a certain threshold, further prescriptions that year are discounted or free.
This matters for people with chronic conditions who must take medicine long term. To make use of the safety net, you need to register at the pharmacy so your prescriptions are tracked and counted towards the total.
PBS medicines and non-PBS medicines
Not every prescription medicine is on the PBS. Some medicines — especially new ones, specialised ones, or some cancer treatments — are not yet on the PBS list, and you have to pay the full price. Some medicines are on the PBS but only at specific doses or for specific indications — if the doctor prescribes outside those conditions, you still pay the general price.
When you receive a prescription, ask the pharmacist: “Is this a PBS prescription?” — the pharmacist will tell you the expected cost straight away.
How to check the PBS list
The pbs.gov.au website lets you search by medicine name (generic name or brand name) to find out whether a medicine is on the PBS and what the co-payment is. This is the official, up-to-date source.
If you do not yet have Medicare, or you are on a temporary visa that does not include Medicare, check your Medicare eligibility at servicesaustralia.gov.au before estimating your long-term medicine costs.