Pharmaceutical Benefits Scheme (PBS) - Patient Category Report

Brief description

The Pharmaceutical Benefits Scheme (PBS) began in 1948, and continues to provide timely, reliable and affordable access to necessary medicines for Australians today. The PBS is managed by the Department of Health and administered by the Department of Human Services.


The Repatriation Pharmaceutical Benefits Scheme (RPBS) is subsidised by the [Department of Veterans' Affairs (DVA)] (http://www.dva.gov.au/), and can be used by veterans who have a DVA White, Gold or Orange Card.

Under the PBS, which includes the RPBS, the Australian government subsidises the cost of medicine for most medical conditions. Most of the listed medicines are dispensed by pharmacists, and used by patients at home. Some medicines are administered in hospital. Read more [about the PBS](http://www.pbs.gov.au/info/about-the-pbs) on their website.



The [PBS Schedule](http://www.pbs.gov.au/browse/medicine-listing) is part of the wider Pharmaceutical Benefits Scheme and lists all of the medicines available to be dispensed to patients at a Government-subsidised price. The Schedule is updated monthly.

**The Patient Category Report:** this report contains the number and total benefit amount of PBS and RPBS services by patient category. The patient category determines how much the patient contributes to the cost of their medicine and refers to the patient's eligibility status at the time of supply of the benefit. Patient categories are listed in the file's metadata. Current and historical patient co-payment amounts and safety net thresholds can be found on the [PBS website] (http://www.pbs.gov.au/pbs/home).

Statistics are supplied for both the PBS and RPBS, and are provided in the following formats:


**Excel:** The human readable data for the current year is located in an individual excel file. Historical data (1992-2014) may be found in the relevant zipped excel file.
**CSV:** The machine readable data for the current year is provided in an individual csv file. Historical data (1992-2014) may be found in the relevant zipped csv file.

Additional [Medicare statistics](http://www.humanservices.gov.au/corporate/statistical-information-and-data/medicare-statistics) may be found on the Department of Human Services website and data.gov.au.

Disclaimer: The information and data contained in the reports and tables have been provided by Medicare Australia for general information purposes only. While Medicare Australia takes care in the compilation and provision of the information and data, it does not assume or accept any liability for the accuracy, quality, suitability and currency of the information or data, or for any reliance on the information or data. Medicare Australia recommends that users exercise their own care, skill and diligence with respect to the use and interpretation of the information and data.

Full description

Excel PBS Patient Category Report 2016 YTD - * This report is updated monthly and contains year to date figures up to **31 July 2016 only.**\r\n \r\n\r\n* Statistics are supplied for both the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefit Scheme (RPBS, ie. items supplied to war veterans).\r\n\r\n\r\n\r\n* The figures reported relate to the value (benefit) or volume (services) of PBS and RPBS services that have been processed by Medicare Australia. They refer only to paid services processed from claims presented by approved pharmacies. They do not include any adjustments made against pharmacists' claims, any manually paid claims or any benefits paid as a result of retrospective entitlement or refund of patient contributions. \r\n \r\n* The patient category determines how much the patient contributes to the cost of their medicine and refers to the patient's eligibility status at the time of supply of the benefit. The patient (or the patient's family unit) may migrate to another category (safety net) after eligibility expenditure thresholds have been attained. The Patient Categories are: \r\nPBS General- Ordinary \r\nPBS General- Safety Net \r\nPBS Concessional - Ordinary \r\nPBS Concessional- Safety Net \r\nPBS Other- Doctor's Bag Order Form \r\nRPBS- Ordinary \r\nRPBS- Safety Net \r\n \r\n* The figures contain "Special Arrangements" items, which refers to items that are supplied to patients via an alternative method when supply through a community pharmacy is not appropriate or efficient for the patient. Read more about Special Arrangements on the PBS website.\r\n\r\n\r\n\r\n\r\n* State/Territory is determined according to the address of the pharmacy supplying the item. \r\n \r\n* Further information about patient contributions under the PBS may be found in the attached metadata. Patient contribution rates are usually adjusted on 1 January each year. These rates are found in the current Schedule of Pharmaceutical Benefits.\r\n\r\n\r\n\r\n* Only items contained in the Pharmaceutical Benefits Schedule appear in these statistics. Items supplied to general patients, costing less than the general patient contribution, do not receive a PBS benefit and are therefore not included. \r\n \r\n* Month is determined by the date the service was processed by Medicare Australia, not the date of prescribing or the date of supply by the pharmacy. Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc. \r\n
CSV PBS Patient Category Report 2016 YTD - * This report is updated monthly and contains year to date figures up to **31 July 2016 only.**\r\n \r\n\r\n* Statistics are supplied for both the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefit Scheme (RPBS, ie. items supplied to war veterans).\r\n\r\n\r\n\r\n* The figures reported relate to the value (benefit) or volume (services) of PBS and RPBS services that have been processed by Medicare Australia. They refer only to paid services processed from claims presented by approved pharmacies. They do not include any adjustments made against pharmacists' claims, any manually paid claims or any benefits paid as a result of retrospective entitlement or refund of patient contributions. \r\n \r\n* The patient category determines how much the patient contributes to the cost of their medicine and refers to the patient's eligibility status at the time of supply of the benefit. The patient (or the patient's family unit) may migrate to another category (safety net) after eligibility expenditure thresholds have been attained. The Patient Categories are: \r\nPBS General- Ordinary \r\nPBS General- Safety Net \r\nPBS Concessional - Ordinary \r\nPBS Concessional- Safety Net \r\nPBS Other- Doctor's Bag Order Form \r\nRPBS- Ordinary \r\nRPBS- Safety Net \r\n \r\n* The figures contain "Special Arrangements" items, which refers to items that are supplied to patients via an alternative method when supply through a community pharmacy is not appropriate or efficient for the patient. Read more about Special Arrangements on the PBS website.\r\n\r\n\r\n\r\n\r\n* State/Territory is determined according to the address of the pharmacy supplying the item. \r\n \r\n* Further information about patient contributions under the PBS may be found in the attached metadata. Patient contribution rates are usually adjusted on 1 January each year. These rates are found in the current Schedule of Pharmaceutical Benefits.\r\n\r\n\r\n\r\n* Only items contained in the Pharmaceutical Benefits Schedule appear in these statistics. Items supplied to general patients, costing less than the general patient contribution, do not receive a PBS benefit and are therefore not included. \r\n \r\n* Month is determined by the date the service was processed by Medicare Australia, not the date of prescribing or the date of supply by the pharmacy. Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc. \r\n\r\n
Excel PBS Patient Category Report 2015 - * This report covers the 2015 calendar year only.\r\n\r\n\r\n\r\n* Statistics are supplied for both the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefit Scheme (RPBS, ie. items supplied to war veterans).\r\n\r\n\r\n\r\n* The figures reported relate to the value (benefit) or volume (services) of PBS and RPBS services that have been processed by Medicare Australia. They refer only to paid services processed from claims presented by approved pharmacies. They do not include any adjustments made against pharmacists' claims, any manually paid claims or any benefits paid as a result of retrospective entitlement or refund of patient contributions. \r\n \r\n* The patient category determines how much the patient contributes to the cost of their medicine and refers to the patient's eligibility status at the time of supply of the benefit. The patient (or the patient's family unit) may migrate to another category (safety net) after eligibility expenditure thresholds have been attained. The Patient Categories are: \r\nPBS General- Ordinary \r\nPBS General- Safety Net \r\nPBS Concessional - Ordinary \r\nPBS Concessional- Safety Net \r\nPBS Other- Doctor's Bag Order Form \r\nRPBS- Ordinary \r\nRPBS- Safety Net \r\n \r\n* The figures contain "Special Arrangements" items, which refers to items that are supplied to patients via an alternative method when supply through a community pharmacy is not appropriate or efficient for the patient. Read more about Special Arrangements on the PBS website. \r\n \r\n\r\n\r\n\r\n\r\n* State/Territory is determined according to the address of the pharmacy supplying the item.\r\n\r\n\r\n\r\n* Further information about patient contributions under the PBS may be found in the attached metadata. Patient contribution rates are usually adjusted on 1 January each year. These rates are found in the current Schedule of Pharmaceutical Benefits.\r\n\r\n\r\n\r\n* Only items contained in the Pharmaceutical Benefits Schedule appear in these statistics. Items supplied to general patients, costing less than the general patient contribution, do not receive a PBS benefit and are therefore not included. \r\n \r\n* Month is determined by the date the service was processed by Medicare Australia, not the date of prescribing or the date of supply by the pharmacy. Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc. \r\n\r\n
CSV PBS Patient Category Report 2015 - * This report covers the 2015 calendar year only.\r\n \r\n* Statistics are supplied for both the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefit Scheme (RPBS, ie. items supplied to war veterans).\r\n\r\n\r\n\r\n* The figures reported relate to the value (benefit) or volume (services) of PBS and RPBS services that have been processed by Medicare Australia. They refer only to paid services processed from claims presented by approved pharmacies. They do not include any adjustments made against pharmacists' claims, any manually paid claims or any benefits paid as a result of retrospective entitlement or refund of patient contributions. \r\n \r\n* The patient category determines how much the patient contributes to the cost of their medicine and refers to the patient's eligibility status at the time of supply of the benefit. The patient (or the patient's family unit) may migrate to another category (safety net) after eligibility expenditure thresholds have been attained. The Patient Categories are: \r\nPBS General- Ordinary \r\nPBS General- Safety Net \r\nPBS Concessional - Ordinary \r\nPBS Concessional- Safety Net \r\nPBS Other- Doctor's Bag Order Form \r\nRPBS- Ordinary \r\nRPBS- Safety Net \r\n \r\n* The figures contain "Special Arrangements" items, which refers to items that are supplied to patients via an alternative method when supply through a community pharmacy is not appropriate or efficient for the patient. Read more about Special Arrangements on the PBS website.\r\n\r\n\r\n\r\n\r\n* State/Territory is determined according to the address of the pharmacy supplying the item. \r\n \r\n* Further information about patient contributions under the PBS may be found in the attached metadata. Patient contribution rates are usually adjusted on 1 January each year. These rates are found in the current Schedule of Pharmaceutical Benefits.\r\n\r\n\r\n\r\n* Only items contained in the Pharmaceutical Benefits Schedule appear in these statistics. Items supplied to general patients, costing less than the general patient contribution, do not receive a PBS benefit and are therefore not included. \r\n \r\n* Month is determined by the date the service was processed by Medicare Australia, not the date of prescribing or the date of supply by the pharmacy. Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc. \r\n\r\n
Excel PBS Patient Category Report Historical 1992-2014 - * This report contains historical data for the period 1992-2014.\r\n\r\n* Statistics are supplied for both the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefit Scheme (RPBS, ie. items supplied to war veterans). \r\n\r\n\r\n* The figures reported relate to the value (benefit) or volume (services) of PBS and RPBS services that have been processed by Medicare Australia. They refer only to paid services processed from claims presented by approved pharmacies. They do not include any adjustments made against pharmacists' claims, any manually paid claims or any benefits paid as a result of retrospective entitlement or refund of patient contributions.\r\n\r\n\r\n\r\n* The patient category determines how much the patient contributes to the cost of their medicine and refers to the patient's eligibility status at the time of supply of the benefit. The patient (or the patient's family unit) may migrate to another category (safety net) after eligibility expenditure thresholds have been attained. The Patient Categories are: \r\nPBS General- Ordinary \r\n PBS General- Safety Net \r\n PBS Concessional - Ordinary \r\n PBS Concessional- Safety Net \r\n PBS Other- Doctor's Bag Order Form \r\n RPBS- Ordinary \r\n RPBS- Safety Net\r\n\r\n\r\n\r\n* The figures contain "Special Arrangements" items, which refers to items that are supplied to patients via an alternative method when supply through a community pharmacy is not appropriate or efficient for the patient. Read more about Special Arrangements on the PBS website. \r\n\r\n\r\n* State/Territory is determined according to the address of the pharmacy supplying the item. \r\n\r\n\r\n* Further information about patient contributions under the PBS may be found in the attached metadata. Patient contribution rates are usually adjusted on 1 January each year. These rates are found in the current Schedule of Pharmaceutical Benefits. \r\n\r\n\r\n* Only items contained in the Pharmaceutical Benefits Schedule appear in these statistics. Items supplied to general patients, costing less than the general patient contribution, do not receive a PBS benefit and are therefore not included.\r\n\r\n\r\n\r\n* Month is determined by the date the service was processed by Medicare Australia, not the date of prescribing or the date of supply by the pharmacy. Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc. \r\n\r\n
CSV PBS Patient Category Report Historical 1992-2014 - * This report contains historical data for the period 1992-2014.\r\n\r\n* Statistics are supplied for both the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefit Scheme (RPBS, ie. items supplied to war veterans). \r\n\r\n\r\n* The figures reported relate to the value (benefit) or volume (services) of PBS and RPBS services that have been processed by Medicare Australia. They refer only to paid services processed from claims presented by approved pharmacies. They do not include any adjustments made against pharmacists' claims, any manually paid claims or any benefits paid as a result of retrospective entitlement or refund of patient contributions.\r\n\r\n\r\n\r\n* The patient category determines how much the patient contributes to the cost of their medicine and refers to the patient's eligibility status at the time of supply of the benefit. The patient (or the patient's family unit) may migrate to another category (safety net) after eligibility expenditure thresholds have been attained. The Patient Categories are: \r\nPBS General- Ordinary \r\nPBS General- Safety Net \r\nPBS Concessional - Ordinary \r\nPBS Concessional- Safety Net \r\nPBS Other- Doctor's Bag Order Form \r\nRPBS- Ordinary \r\nRPBS- Safety Net\r\n\r\n\r\n\r\n* The figures contain "Special Arrangements" items, which refers to items that are supplied to patients via an alternative method when supply through a community pharmacy is not appropriate or efficient for the patient. Read more about Special Arrangements on the PBS website. \r\n\r\n\r\n* State/Territory is determined according to the address of the pharmacy supplying the item. \r\n\r\n\r\n* Further information about patient contributions under the PBS may be found in the attached metadata. Patient contribution rates are usually adjusted on 1 January each year. These rates are found in the current Schedule of Pharmaceutical Benefits. \r\n\r\n\r\n* Only items contained in the Pharmaceutical Benefits Schedule appear in these statistics. Items supplied to general patients, costing less than the general patient contribution, do not receive a PBS benefit and are therefore not included.\r\n\r\n\r\n\r\n* Month is determined by the date the service was processed by Medicare Australia, not the date of prescribing or the date of supply by the pharmacy. Monthly figures may vary due to the varying number of processing days in a month, which depends on the number of days in the month, public holidays, overtime worked etc. \r\n\r\n\r\n\r\n\r\n