War of words over PBS reform

Medicines underspend is helping prop up our budget surplus, says pharmacist MP as parties take potshots over PBS bill

There was acrimonious debate in Federal Parliament last week over proposed amendments to the PBS safety net thresholds.

After a week in which both major sides trumpeted their own successes when in office and lambasted apparent failings by the other side when they were having their turn at the wheel, the National Health Amendment (Safety Net Thresholds) Bill 2019 remains unsigned, and further debate is planned during the current sitting of Parliament.

Speaking during the opening debate, Queensland Liberal MP, Julian Simmonds, said this government has been “the best friend that the PBS has ever had”, listing over 2000 new and amended drugs on the scheme.

“As part of our election commitment to the Australian people, we promised to reduce the safety net thresholds that apply to the Pharmaceutical Benefits Scheme,” he said.

“It’s the people that matter. Ninety-one per cent of scripts dispensed every year—the equivalent of $186 million—are to concession card holders, including seniors. As the son of two pharmacists myself, having grown up working behind the counter in pharmacies, I know firsthand the difference that quality, cost-effective medicines can make, particularly to older Australians”.

The bill will reduce the PBS safety net threshold amounts for both concessional and general patients and their from 1 January 2020.

The number of scripts needed to reach the safety net threshold will be reduced by 12 for concessional patients, down from 60 scripts to 48 scripts. The safety net threshold for general patients will reduce from the 2019 level of $1,550.70 to $1,486.80. 

The debate featured a passionate address from pharmacists, turned ALP MP Emma McBride, who related some of her experiences of dealing with patients who couldn’t afford to pay for their required medicines.   

She said there were now 60 medicines approved by the Pharmaceutical Benefits Advisory Committee that had not yet been PBS listed by the government.  

“For many years, I was a specialist mental health pharmacist and chief pharmacist at Wyong hospital in my electorate on the New South Wales Central Coast,” Ms McBride said.

“I’ve been there in an outpatient clinic when a patient living with a major mental health condition has said to me, ‘Which medication can I do without?’, these are real people with major health concerns who need proper support, and they are having to make this decision which no-one should have to make: ‘Which one can I skip? Which one can I delay?’

People are sometimes taking medications every second day, or they might get one prescription filled this month and an alternative prescription filled next month. And we know what happens when people skip their medications,” she said. “They get worse, not better”.

The government shouldn’t be propping up its budget surplus by underspending on the PBS, she said.

“This government does like to pat itself on the back about having a budget surplus, but the reality is that
the surplus is built on underspends like this one, and like the $1.6 billion underspend on the National Disability Insurance Scheme.

The latest health spending data from the Australian Institute of Health and Welfare show that out-of-pocket costs are the highest they have ever been, she said, standing at a “record” $30 billion a year for their own out-of-pocket costs for health care – an increase of $920 million over the financial year—up three per cent.

“The minister can spruik listing PBS drugs, but if people can’t afford them, then some will delay or avoid filling a prescription—particularly the most vulnerable in our communities, such as those living with major mental health conditions”.

Ms McBride called for a House motion that criticised the Government for delaying Pharmaceutical Benefits Scheme listings; and trying to increase PBS co-payments for all Australians.

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  1. Geoffrey Timbs

    Great start, 20% fewer scripts needed by concession card holders to reach safety net but only 4% reduced target for non-conc’n eg working families with children. Presumably script copayment will still rise by CPI increase on January 1st so really does nothing to make medications more affordable for anyone who doesn’t reach a safety net target- great start but smoke and mirrors for many.

  2. Jim Tsaoucis

    Medicines underspend is really code for we have ripped off pharmacy so much that there is no real incentive to own a pharmacy anymore running it as a health destination business unless you have a raft of other more profitable areas to prop up the Dispensary. The bureaucrats will sprook that the PBS is a remuneration system which by definition is a cost recovery exercise in their eyes. Sorry but there has to be some profit incentive. I say let the Govt. take over the PBS at the shopfront level and deal with the distribution, storage, out of stocks, cleaning, staffing, rostering, out of dates, seeing reps, dealing with customers good, bad and indifferent, doing budgets, seeing bankers and other advisors, Accreditation obligations, telling the wife and kids that I won’t be home till late tonight because of what ever reason and I can’t get a locum ( because of the current lack of pharmacists ) etc etc etc. Let see a public servant do aaaalllllll this for nothing!!!

  3. Tim Hewitt

    For those with a long memory.. when the safety net was started, ie when Pensioners started having to pay for scripts (that had up until then been FREE under PBS), the ‘deal’ was that pensioners would pay $2.50 per script, they would also get an extra $2.50 in their weekly pension to cover the cost, up to 52 per year (that’s one a week for those in the Government who aren’t much good at sums), after which the safety net would kick in. It was supposed to be a disincentive to ‘hoard drugs’ and to also send a ‘price signal’ .. and if a pensioner used less than 52 scripts per year.. they came out in front! woo hoo!.. I’m not sure if the extra $ in the pension was indexed to keep up with co-payment increases.. i think not, but over time I think pensioners have been duped by successive Governments who conveniently forgot about a ‘deal’ that not many of us are old enough and still alive, to remember..

    • Jim Tsaoucis

      another “past deal” was the pharmacy buy out to rationalise the numbers of pharmacies and make it more efficient through efficiencies of scale…..but who paid for this…..all the pharmacies that remained via a script levy. Now with the talk of a farm buy out due to the drought situation lets see who is going to fund this, the tax payer or the rest of the farm owners left??
      Just because it quacks like a duck doesn’t mean it is a duck…

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