Community pharmacy operates in a highly regulated environment to provide the highest quality of care in delivering cost-efficient, safely dispensed pharmaceuticals under the Pharmaceutical Benefits Scheme (PBS).
Community pharmacies are central to the effective operation of the PBS. Australia’s 5000 pharmacies are well-distributed throughout metropolitan, suburban and rural regions providing convenient access to the community. Patients, in even the most remote locations, can be assured of receiving the medications they need within 24 hours (at most) of ordering thanks to the efficiency of the drug distribution network which includes manufacturers, wholesalers and pharmacists.
While sponsors of RPBS-listed products are obliged to honour the listed RPBS price as part of the contractual arrangements with DVA, price changes may occur without notification or prior to acceptance and/or implementation by DVA.
The objectives of the Location Rules, as set out in the Fourth Community Pharmacy Agreement, are to ensure:
While the majority of PBS medicines are distributed through community and hospital pharmacies under Section 85 (S85) of the National Health Act (Cth), there are a number of PBS medicines for which alternative arrangements are in place under Section 100 (S100) of the National Health Act (Cth).
Different ordering and PBS remuneration arrangements apply to S100 Program medicines, and some PBS prescriptions cannot be dispensed by a community pharmacy. S100 medicines are not included as part of the CSO, and medicines sponsors may have special ordering arrangements. Certain medicines may be dual listed items (both S85 and S100) and are usually invoiced at the S85 price, inclusive of wholesaler mark-up.
It is important to contact either your wholesaler or the medicine sponsor to ensure that you can order at the correct price. Dispensary staff should be vigilant in monitoring and responding to any PBS Online alerts when dispensing S100 medicines as well as other high cost medicines to avoid claim rejections.
Members can find further information regarding S100 arrangements here:
The Australian Government Department of Health is committed to preventing the occurrence of fraud against health related programs.
Should you have concerns about a potential breach of the Conditions of Approval for approved pharmacists, or any other compliance matter, you can report your concerns to the Health Provider Compliance Tip-off Line by calling 1800 314 808 or submitting the details to the Department online by completing the Tip-off form.
Please note that the Department is not able to provide complainants with updates due to legislated privacy and secrecy provisions.
Further information is available at the Department of Health website.