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Pharmaceutical Benefits Scheme — not always cost effective for the chronically ill

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Chronically ill patients without concession cards may save money through non-PBS bulk prescriptions

The Pharmaceutical Benefits Scheme (PBS) has been in operation for almost 60 years, with some benefits first being made available in 1948. It has evolved from supplying a limited number of “life-saving and disease-preventing drugs” free of charge to the community, into a broader, subsidised scheme. In its current form, the PBS was introduced in 1960 and included the introduction of a patient contribution (or co-payment) of 5 shillings to provide some control on volumes and expenditure.1

Government PBS expenditure on an accrual accounting basis for the year ending 30 June 2014 totalled $9148.5 million. The total PBS volume was 209.8 million prescriptions. Government expenditure amounted to 82.5% of the total cost of PBS prescriptions. The remainder comprised patient contributions that amounted to $1545.1 million. Most government expenditure on PBS prescriptions was directed towards concessional cardholders ($5708.0 million, 78.1% of the total).2

Australia has an ageing population. Many of the post-War baby boomers, born between 1946 and 1961, are either already, or soon will be, self-funded retirees. From the point of view of the PBS, this could mean a growing percentage of the population that will be classified as non-concessional despite…