Pharmaceutical Benefits Schedule Group Reports
NOTIFICATION: Please note that the figures for PBS have changed on 31st January 2017 for the PBS data in the month of December 2016. The December 2016 data which was published and available from the 25th January to 31st January has been updated with revised figures.
About Pharmaceutical Benefits Schedule Group Statistics Reports
These reports produce statistics on requested groups of Pharmaceutical items. PBS groups (ie. ATC & Patient Category) are defined in the footnotes below. Several report formats are available.
- Your report may take up to 2 minutes to be created and returned to you, depending on the work load of the server and the volume of traffic on the internet.
- Scheme - Statistics are supplied for both the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefit Scheme (RPBS, ie. items supplied to war veterans)
- Anatomical Therapeutic Chemical (ATC) Classification - this classification is defined by the World Health Organisation. Please see the website http://www.whocc.no/atcddd/ for more details.
- Patient category - The patient category refers to the patient's eligibility status at the time of supply of the benefit. The patient (or patient's family unit) may migrate to another category (safety net) after eligibility expenditure thresholds have been attained. The Patient Categories are:
- PBS - General - Ordinary
- PBS - General - Safety Net
- PBS - Concessional - Ordinary
- PBS - Concessional - Free Safety Net
- PBS - Other - Doctor's Bag Order Form (DBOF)
- RPBS - Ordinary
- RPBS - Free Safety Net
- Patient contributions - Under the PBS, there is a maximum cost for a pharmaceutical benefit item at a pharmacy for general patients and concessional patients†. The remainder is paid by the Government.
General patients who reached the Safety Net threshold and have a Safety Net concession card only pay the standard concessional patient contribution for PBS items.
Concessional patients who reach the Safety Net threshold and have a Safety Net entitlement card receive PBS items for free.† The concessional Safety Net threshold also applies to gold, white, or orange card holders under the RPBS.
The patient contribution rates are usually adjusted on 1 January each year. These rates are found in the current Schedule of Pharmaceutical Benefits. www.pbs.gov.au/html/home.
†except where a special patient contribution, a brand premium, or a therapeutic group premium applies.
- Only items contained in the Pharmaceutical Benefits Schedule appear in these statistics. Items supplied to general patients, costing less than the general patient contribution, do not receive a PBS benefit and are therefore not included. If you require statistics at a more detailed level (eg. broken down by patient age, gender etc.) please contact us detailing your request and supplying your phone and fax numbers. Medicare Australia charges on a cost recovery basis for providing more detailed statistics and their provision is subject to privacy considerations.
- The DHS figures are provided based on a point in time (2nd working day of each month), noting that Pharmacies may subsequently adjust their claims.
- The figures reported relate to the value (benefit) or volume (services) of PBS and RPBS services that have been processed by Medicare Australia. They refer only to paid services processed from claims presented by approved pharmacies. They do not include any adjustments made against pharmacists' claims, any manually paid claims or any benefits paid as a result of retrospective entitlement or refund of patient contributions.
- The figures contain some "Special Arrangements" items (eg Section 100 highly specialised drugs prescribed in Private Hospitals for out-patients). For more details on the items included in these figures, see the footnotes on the Normal Arrangements / Special Arrangements breakdown page (accessed via the hyperlinks in the requested tables)
- State/Territory is determined according to the address of the pharmacy supplying the item.
- Month is determined by the date the service was processed by Medicare Australia, not the date of prescribing or the date of supply by the pharmacy.
- Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc.
- A financial year is 1 July to 30 June.
- Instructions on how to download the statistics into a spreadsheet are contained in Downloading Statistical Information.
- This page is best printed in landscape mode.
The information and data contained in the reports and tables have been provided by Medicare Australia for general information purposes only. While Medicare Australia takes care in the compilation and provision of the information and data, it does not assume or accept any liability for the accuracy, quality, suitability and currency of the information or data, or for any reliance on the information or data. Medicare Australia recommends that users exercise their own care, skill and diligence with respect to the use and interpretation of the information and data.
Last updated: 24 March 2017