What pharmacists need to know about the PBS reduction

From 1 January 2023, the maximum cost of a PBS prescription for general patients will reduce from $42.50 to $30.00.

The 29% reduction will help ease the cost-of-living pressures for many Australians.

Here’s what pharmacies need to know to support their customers.

Costs and discounts

The maximum cost of the general co-payment for PBS prescriptions will reduce by $12.50, from $42.50 to $30.00.
Pharmacists will be able to provide an increased discount to general patients on prescriptions with a Commonwealth price between $30.00 and $45.60.

Safety Net, Closing the Gap and concessional patients

When the increased discount is applied, the amount paid by the patient will still count towards their PBS Safety Net. This ensures no one will be worse off by the changed co-payment. Pharmacists will not be eligible to claim PBS benefits if the increased discount is applied.
These changes won’t affect the amount concession card holders pay. This includes concession card holders in the Closing the Gap (CTG) PBS co‑payment program. However, from 1 January 2023, the concessional co‑payment amount will change in line with the CPI.
Concessional patients are already receiving benefits from reductions to the PBS Safety Net. On 1 July 2022, the Safety Net was reduced by $81.60 to $244.80.
Patients who are part of the CTG program won’t be disadvantaged by a reduced co-payment when reaching the general PBS Safety Net threshold.
CTG prescriptions priced at or above the general co-payment ($30.00 in 2023, then indexed annually) will continue to count toward the PBS Safety Net at the current amount of $42.50.

Software updates

The Australian Government has worked with software providers to make relevant updates.
Pharmacists won’t have to do anything to implement the changes. Software systems will automatically update.

Services Australia

Services Australia administers the PBS.
This includes processing pharmaceutical benefits and Safety Net claims, authority applications and supply of PBS stationery used by health professionals.
For more information call 132 290 or visit the Services Australia website.