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  • Dispensing FAQs
  • Programs FAQs
  • Policy FAQs

Dispensing FAQs

Will existing dispensing fees be increased under 8CPA?

Yes, the dispensing fee, Tier One Administration, Handling and Infrastructure (AHI) Fee, and the Dangerous Drug fee will all be increased from 1 July 2024. The dispensing fee will increase from $8.37 to $8.67, the Tier One AHI fee from $4.62 to $4.79, and the Dangerous Drug Fee from $5.18 to $5.37.

There will be two new dispensing fees payable on Section 85 PBS subsidised scripts which will increase the overall amount paid in dispensing through the 8CPA by $2.11 billion.  The two fees will jointly be referred to as the Additional Community Supply Support Payment. The first will be equivalent to a Tier One AHI fee that is paid on 60-day scripts that are priced above the patient co-payment. The second is a balancing fee paid on all scripts priced above the patient co-payment, whether they are for a standard maximum quantity or 60-days.

The additional Tier One AHI Fee will be indexed each year in line with the existing Tier One AHI fee, and the balancing fee will be set based on the value required to make sure the $2.11b is fully expended over the lifetime of the 8CPA, rather than being indexed by CPI.

These fees will be payable on each dispense of an eligible PBS subsidised medicine, including repeats.

No, the two new dispensing fees are only payable on scripts priced above the patient co-payment (PBS subsidised scripts). The 8CPA has retained the Additional Patient Charge (currently $3.45) and the Safety Net Recording Fee (currently $1.45 for Ready-Prepared Pharmaceutical Benefits and $1.87 for Extemporaneously Prepared Pharmaceutical Benefits) which can be applied to under co-payment scripts. Patients may not be charged a value above the maximum patient co-payment for PBS medicines priced under the maximum patient co-payment. The maximum patient charge and Additional Patient Charge will not be increased in line with the two new fees as these are payable on above co-payment scripts only.

No, the Additional Community Supply Support Payment is only payable on Section 85 medicines.

Payments will be based on your normal PBS claims process, and you will not need to do any additional work or submit additional data. The first payment will be made for the period from 1 April 2024 to 30 June 2024, and will be made in October 2024. Payments will then be made on a quarterly basis in arrears through Services Australia. From 1 July 2025, payments will be automated, with a frequency to be determined. The Guild will continue to advocate for this to be in line with your existing PBS payment timeframe. An estimated payment timeline is given below.

PeriodPayment Date
1 April 2024 – 30 June 2024October 2024
1 July 2024 – 30 September 2024January 2025
1 October 2024 – 31 December 2024April 2025
1 January 2025 – 31 March 2025July 2025
1 April 2025 – 30 June 2025 and ongoingAutomation – frequency TBD

Both components of the Additional Community Supply Support Payment will be back paid for scripts dispensed from 1 April 2024. This includes the $4.79 AHI fee payable on 60-day scripts priced above the patient co-payment as well as the balancing fee which is $0.78 in year 1 of 8CPA. Payments will start from 1 October 2024 and will be lump sum payments for all fees payable during the period.

The back payment will occur based on your normal PBS claiming process that occurred during the period from 1 April to 1 October 2024, so changes of ownership or PBS approval should not impact your receipt of these payments. If you are experiencing issues with back payments please contact the Guild for support at pbs.issues@guild.org.au.

The Guild is partnering with NostraData to provide a calculator tool for members to understand what 8CPA means for your pharmacy. More information on this will be available over coming days.

A change to the way remuneration under the 8CPA is evaluated and adjusted has been implemented through a strengthened payment adjustment mechanism. This will ensure the full commitment is realised even in the case of policy change or variation from volume forecasts.

The 7CPA saw the introduction for the first time of a risk share mechanism for pharmacy dispensing remuneration. However, 60-day dispensing demonstrated a need for a strengthened payment adjustment mechanism (PAM) for 8CPA. Adjustments have been increased in frequency from annual to six monthly, making it more responsive, and calculated on total volume rather than above co-payment. Volume can now grow by up to 10% before any adjustment is required, double the 5% under 7CPA, and any reduction in volume from forecasts will result in a positive adjustment.

The PAM will take into account both remuneration under the Commonwealth Price and through the Additional Community Supply Support Payment and balance outcomes between the two to ensure the full funding commitment from Government is met.

Any adjustments will be outside the Commonwealth Price on the new balancing fee in the first instance, to protect the integrity of the Commonwealth Price. Finally, a mid-8CPA assessment will be conducted to ensure the funding commitments made by Government under 8CPA are met.

Each year, the co-payment that a patient pays towards the cost of their medicines on the PBS is increased (or reduced) in line with the Consumer Price Index. Under the 8CPA, the co-payments will be frozen at the 2024 value until the total value of the indexation that would have otherwise applied reaches $1. So, for example, if the difference between the co-payment that was in place on 1 January 2024 and the co-payment if it had been indexed through to 1 January 2029 would have been $1, this would represent a reduction of $1.

At the first 1 January at which the total increase of the co-payment due to indexation would have been equal to or more than $1, indexation will resume. Because the general patient co-payment and the concessional co-payment have different values and therefore different indexation outcomes, the year in which the $1 will be achieved will be different for each patient type.

The Safety Net Recording Fee is an optional per-script fee chargeable to patients being dispensed a PBS medicine priced under the patient co-payment, in recognition of the work involved in recording information for the patient towards their Safety Net. The maximum value of the fee is currently $1.45 for ready-prepared PBS medicines and $1.87 for extemporaneously-prepared medicines. Pharmacies may charge any value for this fee up to the maximum amount, or choose not to charge it at all.

The Department of Health and Aged Care has a long-term digitalisation strategy which includes automating the PBS Safety Net. Should this system become fully automated over the term of the 8CPA and all work associated with recording of Safety Net information by pharmacies no longer be required, the Safety Net Recording Fee will no longer be applicable.

Programs FAQs

Who gets the increase in the Dose Administration Aid cap, and what do I need to do to claim at the increased level?

The Dose Administration Aid base cap will change from 60 per week to 90 per week from 1 July. This change will apply to any pharmacy with a current cap between 60 and 89 per week who will all move to a new cap of 90 per week. This change will apply from 1 July 2024 and pharmacies may simply begin claiming at the higher rate from this date. There will be no change to caps for any pharmacy with a special capping arrangement above 90 per week.

No. The existing program rules for Dose Administration Aids will continue to apply, which require eligible patients to live at home in a community setting. See Dose Administration Aids - Pharmacy Programs Administrator

All programs that were previously governed under 7CPA will continue as per the existing program rules, regardless of inclusion in 8CPA. These programs will all undergo an evaluation process which will conclude by 1 July 2026 and no changes to the program rules will be made before this time.

The current cap for MedsCheck, Diabetes MedsCheck, and Staged Supply will be retained. Growth in funding in these programs reflects a greater service level than at the beginning of 7CPA within these caps, with more pharmacies participating and more pharmacies using a greater proportion of their caps.

The 8CPA includes an additional funding commitment for the Regional Pharmacy Maintenance Allowance of $52 million over 5 years. Further details on the allocation of this funding will be available soon. The Regional Pharmacy Transition Allowance, which was a temporary program set to end on 30 June 2027, will now end on 30 June 2024 following other funding commitments under 8CPA.

The Department of Health and Aged Care will make alternative arrangements for the National Diabetes Services Scheme in future. The Guild encourages its members to consider all costs of delivering any service on behalf of a third party when setting fees and charges. More advice on this will be available for members in coming weeks.

Policy FAQs

What is the commitment to Doctor of Pharmacy?

The commitment from Government towards Doctor of Pharmacy is to support pharmacists graduating with an Australian Qualifications Framework Level 9 master’s degree (extended) in pharmacy to be treated by exemption as a level 10 qualification, similar to the treatment of other health professions covered under the National Registration and Accreditation Scheme. This means pharmacists graduating with this level of qualification will be able to use the honorific title of ‘Doctor of Pharmacy’.

Page last updated on: 05 June 2024