07.Cutting medication costs
These are our top tips for cutting your medication costs.
- Buy generic medicines. They have the same active ingredients as the originally developed brand-name version but are usually cheaper.
- If it’s a prescription medicine you can ask your doctor to prescribe a less expensive brand, or ask your pharmacist if they can give you a cheaper equivalent (so long as the doctor hasn’t ticked the box marked ‘brand substitution not permitted’ on the prescription).
PBS safety net
If you spend over a certain amount on PBS medicine (prescription drugs covered by the government-subsidised Pharmaceutical Benefits Scheme) within one calendar year, you can get the rest of the year’s medication cheaper or free. Here’s an overview:
- If you and your family are general patients (Medicare card holders) and you spend more than $960.10 on PBS drugs in a calendar year, your subsequent PBS medications will cost $4.70 each.
- Concessional patients and their families (those with a Centrelink or DVA concession card) paying $4.70 per script can get free PBS medicine that year once they’ve spent over $253.80.
- If you think you’re likely to qualify, ask your pharmacist for a Prescription Record Form (PRF), on which they’ll record each PBS medication purchase. (The amount you need to spend equates to about a prescription a week, so not many people will qualify.)
- Once you’ve reached the threshold, ask your pharmacist for a Safety Net card to get your discounted or free PBS medicine.
Details you need to know
- You’re responsible for checking that information is recorded correctly, telling the pharmacist when you reach the threshold and storing the PRF (though if you use only one pharmacy, ask them to keep it there). If you use more than one pharmacy, this can be difficult to monitor, especially for people with cognitive difficulties.
- Pharmacists can charge a ‘recording fee’ of 97 cents or sometimes $1.38.
- If you get a more expensive version of the drug, the ‘brand premium’ or ‘therapeutic group premium’ — the difference in cost between it and a cheaper generic version — isn’t covered by the Safety Net. And if you’re prescribed a drug the manufacturer refuses to supply at the government’s PBS price, you have to pay the difference. Known as a ‘special patient contribution’, this difference also isn’t counted towards the Safety Net threshold.
- To avoid paying extra, ask your doctor not to tick the ‘brand substitution not permitted’ box on your prescription, so the pharmacist can give you the generic version if there’s one available.
- There’s the 20-day rule — if you need a repeat supply of some PBS drugs within 20 days, it can’t be counted towards the Safety Net threshold. Another detail you need to know if you think you’re eligible for the Safety net.