10 numbers to know on PBS scripts and spending

Did government spending go up? How many scripts did community pharmacies discount? Here are 10 key numbers

The Department of Health has released the latest data on PBS expenditure and prescriptions for the 2017-18 financial year.

PBS expenditure includes the following patient categories:

  • General – Non-Safety Net (Ordinary)
  • General – Safety Net
  • Concessional – Non-Safety Net (Ordinary)
  • Concessional – Safety Net
  • Doctor’s Bag.

Here are some of the most interesting numbers on the PBS:

1. Total PBS government expenditure decreased 3% – from $12,058 million in 2016-17 down to $11,690 million (excluding revenue) for the 2017-2018 financial year.

2. Total 2017-18 PBS subsidised prescription volumes increased by 0.8% – to a total of 204.1 million, compared to 202.4 million for the 2016-17 financial year.

43281150 - medicines with money inside

3. In 2017-18, PBS Government expenditure (Section 85 and Section 100) was $11,602.9 million (excluding rebates) which is 88.9% of the total cost of PBS prescriptions. The remainder was patient contributions that amounted to $1,455.5 million.

4. Average dispensed price (Patient payment plus Government benefit) per prescription of PBS subsidised medicines decreased to $64.04 in 2017-18, compared to $66.09 in 2016-17.

5. Top 5 PBS drugs by highest total prescription volume in 2017-18 were rosuvastatin (11,024,852 scripts); atorvastatin (10,601,264 scripts); esomeprazole (9,172,273 scripts); pantoprazole (6,892,698 scripts); and perindopril (6,319,736).

6. Top 5 PBS drugs by highest government cost in 2017-18 were: sofosbuvir/velpatasvir ($695,021,028); adalimumab ($320,374,082); aflibercept ($304,212,258); ledipasvir/sofosbuvir ($244,606,914); and nivolumab ($208,068,092).

pharmacy vector7. The number of community pharmacies across Australia sits at 5,723 as of 30 June 2018. There are only 11 dispensing doctors across the country.

8. Of PBS/RPBS prescriptions dispensed by community pharmacies in 2017-18, 28% (58,155,090) were discounted while 72% (150,924,505) were not discounted. The majority (96.9%) of discounts were at the $1 mark.

9. Price to pharmacists of PBS and RPBS
prescriptions expenses (ex-manufacturer price and wholesale mark-up) went down 4.3%, from $7,813,770,027 in 2016-17 to $7,479,463,909 in 2017-18. Meanwhile the Administration, Handling and Infrastructure (AHI) fee went up 10.4%, from $857,995,456 in 2016-17 to $947,411,407 in 2017-18. The Electronic Prescription Fee also increased by 29.8%.

10. Pharmacy remuneration as part of the 6CPA for 2017-18 was $2,598,494,464, with a further $182,019,950 provided to the Pharmacy Guild towards professional programs. Of this, $7,649,772 was provided to the Guild as administration fees.

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  1. Of PBS/RPBS prescriptions dispensed by community pharmacies in 2017-18, 28% (58,155,090) were discounted “. This report does not point to anything other than PBS/RPBS when discussing prescriptions. Of the 3% drop in PBS/RPBS costs (approx $368M) which impacts on us because we share the burden of those reductions as we are part of the costs, we also voluntarily gave up roughly $58M in patient contributions (at $1 a pop) AND we have to bear the consequences of that drop in revenue/remuneration also. We are discounting a hell of a lot more non-PBS or below patient contribution threshold prescriptions and private prescriptions to patients and that further greatly damages our viability. If this report was an annual blood test it would show that we have a worsening chronic disease with a poor prognosis.
    The discounting has to stop! We are a professional service provider for the Government and for our patients (both payers in the scheme) and we are forced to accept lower payment for our professional service from one payer and asked to do it by the other. Why? Because both payers believe we sell consumables and that is all we do. We let them think that is true because we discount without question and we call our patients “customers”. Getting the picture?
    What about the drug manufacturer and the “Drug Company” or “Big Pharma” if you like. Do their profits trend down year after year? Do their revenues decline year after year? I doubt it! Do they constantly provide a professional service to the end user (payer) or are THEY only selling consumables?
    There is another way.
    The Government should own the dispensary stock and fight for discounts from the manufacturers – a fight they would win. We should dispense for a professional fee ONLY which is commensurate with our worth to the health outcomes of the Patients we serve and get out from being the meat in the sandwich which we are while we are linked to the inventory costs of the drugs we supply. Those costs of the medicines which make up the inventory which we pay for are what the Government seeks to gouge to our detriment over and over again. It’s time to get out of the ring and let someone else be the punching bag.
    I have written further about all of this on my Brangan Medical Website. link “pharmacy” look for article.

    • Paul Sapardanis

      Tony in metropolitan areas most pharmacies make less on general non claimable prescriptions than they do on claimable prescriptions even if the $1 discount is applied. There needs to be a minimum dispe nbse fee applied on everything dispensed.

      • Yes Paul that is absolutely correct. I would refer you to my article on my web site Brangan Medical – Pharmacy – scroll down for article – in which I make the same suggestion.

  2. Gavin Mingay

    The Guild is raking it in…

  3. Peter Allen

    I notice the amazing expenditure on -MAB drugs: 90% of all PBS expenditure. More are bound to appear. Until we had these, what went onto the PBS was treated like all expenditure — cost / benefit. It could have been valued as say “$50,000 to prolong one useful year of life.”
    I see new ethical and economic difficult decisions ahead.

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