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This page of our website is dedicated to educating and informing our customers about some of the important and pertinent topics and issues in pharmacy. Hopefully you will have a better understanding of how the Pharmaceutical Benefit Scheme (PBS) works and what the Pharmacy Safety Net is and if it applies to you. You may also be interested in Generic Medicines and Brand Substitution and why does the same medicine sometimes cost differently.

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What is the Pharmaceutical Benefits Scheme (PBS)?

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The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that benefits you and all Australians by subsidising medicines to make them more affordable. This means you can get access to lifesaving medicines when you need them most.

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So who is eligible to receive benefits under the PBS?

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If you are an Australian Resident and you hold a current Medicare card then you are eligible to receive benefits under the PBS. The Australian Government has also set up a Reciprocal Health Care Agreement (RHCA) with certain countries designed to give visitors from particular countries the benefits of the PBS.

Australia currently has RHCAs with New Zealand, the United Kingdom, the Republic of Ireland, the Netherlands, Finland, Sweden, Norway, Malta, and Italy. 

If you are a visitor from any of the countries listed above simply show you passport when filling your prescriptions at a pharmacy.

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What is the PBS Safety Net and Threshold?

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The PBS Safety Net protects patients and their families requiring a large number of PBS or RPBS items. 

The Safety Net threshold must be reached first before a Safety Net Card can be issued. The Safety Net threshold is reached by purchasing, hence accumulating eligible PBS medicines supplied through community pharmacies and private hospitals and for out-patient medication supplied by public hospitals.

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There are two Safety Net thresholds. The general patient Safety Net threshold for 2023 is $1,563.50 and the concessional Safety Net threshold is $262.80. PBS Safety Net operates according to the calendar year.

Once you have reached the threshold the pharmacist will issue you with either a Safety Net Entitlement Card or a Safety Net Concessional Card depending if you were originally a concessional customer or a general customer.

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Safety Net Entitlement Cards - are issued to concessional customers. If you are a recipient of such card then you may receive PBS medicines and items free of charge (except for any applicable premium that are applied for example to some originator brands of a medicine) for the rest of that calendar year.

 

Safety Net Concessional Cards - are issued to general customers. If you are a recipient of such

card then you the pay concessional co-payment amount of $7.30 plus any applicable premium

for pharmaceutical benefits for the rest of that calendar year. 

 

                                                        Note: Pharmacy software can only keep a record of your 

                                                            Safety Net for the PBS medicines and items you

                                                            purchased at that particular pharmacy. If you shop at

                                                            multiple pharmacies then you will have to keep a record

                                                           of your Safety Net yourself using a Safety Net Record Form which the pharmacy                                                                      will give you upon request. (See picture to the left)

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                                                            Generic Medicines and Brand Price Premium

                                                       

                                                            Manufacturers can develop generic equivalents of a particular drug and in doing so

gives rise to what we know as Generic or Alternative Brands. These brands contain the same active drug and are clinically  equivalent and must undergo the same strict quality controls as the originator brand. Generic medicines are designed to act on the body in exactly the same way, however they are usually cheaper than the originator brands.

The extra cost of originator brands (depending on the drug and brand) is referred to as the Brand Price Premium.

This is how the PBS works in Australia and this is the reason why some brands (generally Originator Brands) cost more than $6.60 for concessional customers and more than $41.00 for general customers. 

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In Australia you can be sure that Generic Brands are of high quality as it is regulated by the Therapeutic Goods Administration (TGA).

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It is a legal requirement that a pharmacist must ask for your permission first and you must agree before substituting your medicines for another brand. It is not a requirement to contact the prescribing doctor as long as the doctor has not indicated on the prescription form that substitution is not to occur. 

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We will never substitute your medicines for another brand without your verbal consent.