About Australia’s Pharmaceutical Benefits Scheme
Australia’s Pharmaceutical Benefits Scheme (PBS) is a cornerstone of our health system – sitting hand in hand with Medicare. Through the PBS, the Australian Government subsidises the cost of medicines to make them affordable for Australians. This means Australians with a Medicare card can access over 5,200 essential medicines without paying full price for them.
Our PBS is a unique partnership between Australian Governments, the innovative medicines industry and Australians. We work together to deliver these safe and effective medicines to Australians when and where they need them.
The PBS ensures medicines are affordable
Rather than paying the full price of the medicine, the PBS enables Australians to access the medicines they need for $30 or $7.30 if you hold a concession card.
All Australians with a Medicare Card can access the PBS and it is also available to visitors from 11 nations with which Australia holds a Reciprocal Health Care Agreement.
Currently, more than 5,200 medicines are funded through the PBS, and every day more than 800,000 prescriptions are filled for Australians across the country.
How are medicines put on the PBS?
All medicines available on the PBS have been carefully considered and evaluated as safe and effective by Australia’s Therapeutic Goods Administration (TGA). The process is rigorous as the TGA works through considerable evidence. No medicine can be sold in Australia without TGA approval.
Once approved, a medicine is evaluated by an independent committee of clinical experts – the Pharmaceutical Benefits Advisory Committee. They evaluate considerable evidence to work out two key things – that a medicine does what it says it will do compared to alternatives, and for a price that delivers value to the Australian community. It is the PBAC’s responsibility to recommend to the Australian Government that a medicine should be made available.
Once a medicine is recommended, the Australian Government decides what medicines are made available and when.
The History of the PBS
In 1948, after World War Two, the PBS was created to provide a new wave of antibiotic drugs to all Australians – not just those who could afford them. At this time, it offered free medicines for Australian pensioners and 139 medicines free of charge to the community. It took another 12 years to become the comprehensive program that we know today.
Today, our PBS makes over 5,200 medicines available to Australians.
Steps towards PBS reforms
The Albanese Government has publicly committed to PBS reforms and work is under way to design a new system for how medicines are assessed and made available to patients through the PBS.
PBS Review
In 2023 Mark Butler announced a review into the way in medicines and health technologies are assessed for inclusion on the PBS.
This review is known as the Health Technology Assessment (HTA) policy and methods review. It is the first time in more than 30 years this system has been comprehensively reviewed and during this time science and innovation has come a long way.
Many innovative products have become available that fall outside of the current assessment framework, which is leading to excessive delays after a medicine has been approved for use in Australia by the Therapeutic Goods Administration (TGA).
More than 300 organisations and individuals have provided input into this review so far. Patient advocacy groups, patients, doctors, embassies, health groups such as the Australian Medical Association have all called for reform to speed up access to medicines in Australia.
From here, we hope the Government will commit to reforms and commence a co-design process to develop new policies and legislation that will give patients faster access to new and emerging medicines and health technologies. This will also require further investment by the Government in the medicines that Australians need for a healthy society.
For more information about the review visit: Health Technology Assessment Policy and Methods Review | Australian Government Department of Health and Aged Care