Pharmaceutical Benefits Scheme

The Pharmaceutical Benefits Scheme (PBS) is a scheme governed by the National Health Act 1953 whereby the Commonwealth Government provides benefits in relation to the supply of drugs or medicines. The scheme is similar to Medicare in that the Commonwealth covers most of the cost of the drug or medicine with a small out of pocket cost to the patient. The payment to the pharmacist by the patient under this scheme is set by the government and is called the co-payment.

The Minister for Health and Ageing is responsible for identifying the drugs or medicines whereby the benefit applies so not all medicines are included in the scheme. For those drugs prescribed under the scheme, WorkSafe reimburses the standard patient contribution charges. WorkSafe also reimburses PBS brand premiums, if the prescriber has indicated on the prescription that brand substitution is not permitted.

Note: Injured workers with a Medicare card are entitled to PBS prescribed medications.

Medications to be paid for should be prescribed under the PBS when clinically appropriate and available. For PBS prescribed medications, WorkSafe will reimburse all patient contribution charges set out in the PBS including brand and therapeutic premiums. Where a medical practitioner or dentist prescribes a dosage over the PBS limit for medications, an authority from Medicare Australia is required