Pharmaceutical Charges Explained
When you pick up your prescription from a pharmacy, you will probably have to pay at least some of the cost, depending on a number of factors including whether the drug is fully subsidised or partly subsidised, and on whether you hold a community services card or a high user health card. This section explains what charges you can expect to pay, and why.
1. Government prescription charge
Most medicines listed on the Pharmaceutical Schedule are fully subsidised. For these the only charge to you will be the full cost of the medicine or the Government prescription charge (usually the lower of the two), with the Government picking up the rest of the cost of the medicine.
The Government prescription charge, or co-payment, for a fully subsidised medicine ranges up to $15, but might be less depending on what the prescription is for, the age of the patient (children under six are free), and whether you hold a Community Services Card, a High User Health Card, or a Prescription Subsidy Card. The following table details how much you should expect to pay for your prescription:
| Patient's Health Card | Qualifier | Charge |
|---|---|---|
| No card | Adult | $15 |
| Child 6 - 17 | $10 | |
| Child under 6 | $0 | |
| Contraceptives | $3 | |
| PHO enrolee or Care Plus patient | No other card | $3 |
| Community Services Card (CSC) | No other card | $3 |
| High User Health Card (HUHC) | No other card | $3 |
| Prescription Subsidy card (For families after the first 20 charged prescriptions since the previous February) | No other card | $2 |
| With High User Health Card (HUHC) only | $2 | |
| With Community Services Card (CSC) | $0 | |
| PHO enrolee or Care Plus patient | $0 |
2. Manufacturer’s surcharge on partly-subsidised medicines
Some medicines are not fully subsidised and for these you might be charged more than the maximum $15 co-payment, depending on the cost of the medicine. In addition to the co-payment, you might also have to pay the Manufacturer’s Surcharge, which is made up of the difference between the agreed level of Government subsidy and the manufacturer’s price, plus a pharmacy mark-up.
For partly-subsidised medicines, the final price you pay depends on the difference between the subsidy and the manufacturer’s price, and the size of the mark-up the dispensing pharmacy charges. Some pharmacies charge a higher mark-up on the drugs they dispense than others. This means that the final price you pay for a prescription medicine that is not fully-subsidised may vary between pharmacies. However, pharmacies are required to provide you with a receipt detailing the cost of the drug and the final cost to you. If you have any queries regarding the amount you are required to pay, ask the pharmacist to explain to you how the final cost is calculated. If you are not satisfied, you can always phone another pharmacy to compare costs.
Page updated on 09 Apr 2008
