PBS Changes Make IVF Medicines Available At Private Pharmacies

pharmacist writing prescription

From 1 July 2015, the way the government scheme known as the Pharmaceutical Benefits Scheme (PBS) subsidises In Vitro Fertilisation medicines and how they are prescribed, dispensed, and accessed will change so as to come in line with all other PBS subsidised medicines.

The new arrangement streamlines processes for patients and IVF specialist prescribers and enables patients to access IVF medicines at a hospital or community pharmacy.

Like other PBS subsidised medicines, patients will contribute a PBS patient co-payment.  The PBS patient co-payment will count towards a patient’s PBS Safety Net.

A full list of the current medicines and PBS eligibility criteria is available at: http://www.pbs.gov.au/browse/section100-if.

PBS Frequently Asked Questions

What is changing for patients?

Under the new arrangements, patient eligibility requirements will remain the same.  Patients will visit their specialist medical practitioner for assessment and to obtain a prescription for IVF medicines

From 1 July 2015, Fertility Solutions and Affordable IVF patients will be able to access IVF medicines through a private pharmacy, rather than receiving IVF medicines from their clinics.

To better align with other PBS medicines patients will pay a co-payment for each dispensing of IVF/GIFT.  In 2015, the PBS general patient co-payment is up to $37.70 or $6.10 if the patient has a concession card.  Each PBS patient co-payment will count towards the patient’s PBS Safety Net record.

I am having treatment with Fertility Solutions or Affordable IVF so where can I get my medications?

The following pharmacies have fertility/IVF medications in stock:

Sunshine Coast:

Maroochy Day n Night Pharmacy

107-109 Aerodrome Rd Maroochydore QLD 4558

T (07) 5443 6070 F (07) 5443 6255

Opening hours: 8am – 10pm 365 Days

Bundaberg:

Friendly Society Pharmacy

19-23 Bingera Street, Bundaberg West QLD 4670, Australia T (07) 4331 1699 F (07) 4331 1698

Opening Hours: Mon – Fri: 8.30am – 5.30pm: Sat: 9.00am – 12.00 noon 

Why is the Government making changes to the IVF Programme?

The changes better align the prescribing, dispensing and access arrangements for medicines with other Authority Required (STREAMLINED) PBS-subsidised medicines while still retaining current patient eligibility criteria.

Will patients be charged for my PBS-subsidised IVF medicines?

All eligible patients must pay the co-payment for each dispensing of a PBS IVF item similar to other PBS-subsidised medicines.

Will the PBS patient co-payment contribute to patients PBS Safety Nets?

Yes.  Each PBS patient co-payment will add to patients PBS Safety Net records.

How much is the PBS patient co-payment?

In 2015, the PBS general patient co-payment is up to $37.70 and the PBS concessional patient co-payment is $6.10.

Patients will be required to pay the PBS patient co-payment for each PBS item on the prescription.  The PBS co-payment amount is indexed on 1 January each year in line with the Consumer Price Index (CPI).

What is the PBS Safety Net?

The PBS Safety Net provides further assistance to those Australians who require a very large number of PBS prescriptions over a calendar year.

After reaching the Safety Net threshold, general patients pay for further PBS prescriptions at the concessional co-payment rate and concession card holders are dispensed PBS prescriptions at no further charge for the remainder of that calendar year.

In order to access the Safety Net arrangements, patients need to maintain records of their PBS expenditure on a Prescription Record Form. These are available from all pharmacies.  A Safety Net Entitlement card or Safety Net Concession Card can be issued by the pharmacist once the threshold is reached.  More information about the PBS patient
co-payment and PBS Safety Net is available at: http://www.pbs.gov.au/info/about-the-pbs.

What is the PBS Safety Net threshold?

In 2015, the general patient PBS Safety Net threshold is $1,453.90 and the concessional patient PBS Safety Net threshold is $366.00.  The PBS Safety Net threshold is indexed on 1 January each year in line with the CPI.

Will patients have to pay the patient co-payment for a prescription that was written
prior to 1 July 2015?

From 1 July 2015 onwards, all patients will be required to pay the co-payment for each original and repeat prescription dispensed for PBS-subsidised IVF/GIFT medicines.

Each co-payment will accrue to your PBS Safety Net record.  No co-payment will apply for medicines dispensed prior to 1 July 2015. 

Where can patients pick up their PBS IVF prescription?

Your IVF specialist prescriber will write the prescription for your medicines.

Patients will then take this script to a pharmacy that stocks the medications in advance as in some instances stock may need to be ordered as some pharmacies may not always keep stock on hand.

What is the PBS IVF/GIFT Programme?

The PBS IVF/GIFT Programme (the Programme) provides Australian couples with an alternative to natural reproduction, where previous attempts to conceive naturally have been unsuccessful.  The Programme is subsidised by the Australian Government through PBS special arrangements made under section 100 of the National Health Act 1953.

The Programme provides for the supply of certain PBS medicines to eligible patients who are receiving IVF/GIFT treatment under Medical Benefit Scheme (MBS) item codes 13200, 13201, 13202 and 13203.

Further details about the eligibility criteria, including the full list of PBS IVF/GIFT medicines, are available from the Department website at:

http://www.pbs.gov.au/browse/section100-if.

If you would like further information on this new system please contact Fertility Solutions on 1300 FERTILITY.