Treatment for both hepatitis C and B is regulated under the Pharmaceutical Benefits Scheme. The medications are listed as highly specialised drugs under Section 100 of the National Health Act and, as such, can only be prescribed by approved specialist medical practitioners and dispensed through pharmacies (usually within hospitals) participating in the Highly Specialised Drug Program. A brief explanation of the PBS and anticipated expenses is given below.
A GP referral is required to a Liver Clinic (Royal Perth Hospital, Sir Charles Gairdner Hospital and Fiona Stanley Hospital), or a liver specialist (Gastroenterologist or Hepatologist). Once linked in with the clinic or specialist, additional blood tests and an ultrasound of the liver will be organised to determine the person’s liver health. If appropriate, treatment will then be discussed and, if agreed, arrangements will be made to commence the treatment. Generally, the medications will be dispensed through a hospital pharmacy and only a dispensing fee will be paid by the patient (see below).
For people living in rural and remote locations a number of options are available to reduce the necessity to travel to Perth. Some regions have a Viral Hepatitis Nurse who can act as a link between the Liver Clinic, the individual and their GP. Some regions may have a liver specialist available and, in other cases, TeleHealth may be available. Your GP should be able to find out this and other information about Share Care for you.
What is the PBS?
The PBS came into being in 1948 and comes under the National Health Act 1953 (Commonwealth). The PBS Schedule, part of the Pharmaceutical Benefits Scheme, lists the medicines available for dispensing at a Government-subsidised price. This Schedule is managed by the Department of Health and Ageing and administered by Medicare Australia.
Who is eligible for the PBS?
Australian residents who hold a current Medicare card are able to access the PBS.
Australia currently has Reciprocal Health Care Agreements with Italy, New Zealand, the Republic of Ireland, Finland, Malta, the Netherlands, Sweden, Norway, the United Kingdom and Belgium. Visitors from these countries are also eligible to access the Scheme. Proof of eligibility is required when putting in a prescription. This may be through showing their passport or through a Reciprocal Health Care Agreement Card available from Medicare. Some overseas visitors may not be eligible for this card.
Current patient fees and charges
Patient co-payment is the amount a patient contributes towards the cost of a PBS medicine. Many PBS medicines cost much more than is charged in the co-payment. From 1 January 2010, most PBS medicines cost up to $33.30 or $5.40 on a concession card. The Federal Government pays the balance. Co-payments are adjusted on the 1st January each year as per the CPI (Consumer Price Index).
Hepatitis C Education and Prevention Initiative (2008). National Hepatitis C Resource Manual 2nd Edition. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/Content/phd-hepc-manual-toc.
The Commonwealth of Australia as presented by the Department of Health and Ageing (2010). About the PBS. Retrieved from http://www.pbs.gov.au/html/consumer/pbs/about.
Page last updated: Thursday 19 February, 2015