NSW s100 HSD Co-Payment Program
The Pharmacy Guild of Australia (The Guild) administers patient co-payment reimbursement on behalf of the NSW Government for s100 Highly Specialised Drugs (HSD) dispensed at NSW community pharmacies.
This program started in October 2015 to help ease the financial burden of purchasing medicines for patients with some chronic conditions.
Patients prescribed s100HSD Community Access scheduled drugs through NSW public hospitals or authorised NSW community prescribers will have their co-payments paid by the NSW Government after signing a 3 Year Patient Consent Form and presenting it at a NSW community pharmacy.
New to the program? View our program resources below.
S100 Portal
All claims are submitted through the s100 HSD Co-payment Program Claiming Portal
Program resources
New to the Program? Program resources covers the information you need to get started.
Below are the step-by-step instructions and resources on how to participate in the program.
| Step | Instructions | Video |
|---|---|---|
| 1. Create a user account in the portal | View | |
| 2. Register a new pharmacy or associate your account with an existing pharmacy | View | Watch |
| 3. Complete the claim template | View | Watch |
| 4. Submit your claim application online | View | Watch |
| 5. Re-submit your application if returned to 'Draft' status | View | Watch |
| 6. Download remittance advice | View | |
| 7. Update your pharmacy's account | View | Watch |
Claiming and payments
Claiming
To submit s100 co-payment claims and receive re-imbursement from NSW Health, Section 90 approved NSW community pharmacies must create a user account to access to the online claiming portal.
The pharmacy then uses the claiming portal to claim any waived co-payments when eligible patients present a completed 3 Year Patient Consent Form with their prescriptions.
Payments
In addition to the cost of the co-payment for eligible patients, pharmacies are paid a service fee for the work associated with submitting claims on behalf of patients.
The fees are $2.23 (incl GST) for each co-payment claimed and a one-off monthly administration fee of $13.42 (incl GST) for the first claim made each month.
Patient eligibility
To be eligible a patient must:
- be NSW residents who are patients of a NSW public hospital or a NSW authorised community prescriber
- be prescribed s100 HSD Community Access drugs for HIV antiretroviral therapy, Hepatitis B or clozapine maintenance therapy
- hold a valid 3 Year Patient Consent Form signed by both the prescriber and the patient
- present the 3 Year Consent Form at a NSW community pharmacy at every dispensing
Medicines eligibility
The NSW Government pays co-payments for a wide range of s100 drugs and medicines. However, the Program administered by the Guild pays only the co-payments of s100HSD Community Access scheduled drugs dispensed at NSW Community Pharmacies.
* Opioid dependence treatment medicines are not eligible for the NSW section 100 co-payment program.
The s100 HSD Community Access scheduled drugs include:
- HIV antiretroviral therapy
- Hepatitis B medicines
- Clozapine (maintenance therapy only)
Have a question?
We may have answered it in our FAQ.
If not, you can contact us on:
- Phone: (9am to 5pm AEDT) Monday to Friday
- Email: guild.solutions@guild.org.au
Page last updated on: 16 June 2024