Australia

Coverage and out-of-pocket costs

Under the PBS, general patients and concession card holders pay different copayment amounts, and the PBS Safety Net lowers or removes copayments once a family's annual spending passes a threshold. Medicines not listed on the PBS are paid in full by the patient. The government sets copayment caps by regulation and adjusts them periodically, so current amounts should be checked on the official PBS site.

Medicine names and availability

The Therapeutic Goods Administration (TGA) regulates medicines. Australian generic names follow international conventions. Pharmacists may substitute a bioequivalent generic brand unless the prescriber marks the prescription as brand substitution not permitted.

Questions for your pharmacist or plan

• Is this exact active ingredient, strength and formulation approved and available locally?
• Is my prescription covered, and do any authorisation or eligibility conditions apply?
• Which official programme or plan document explains my current costs?

Authoritative sources

• Therapeutic Goods Administration (TGA)
• Pharmaceutical Benefits Scheme (PBS)
• Services Australia — Medicare