PBS Changes and Your Medication

Genea PBS Medicare changes 2015The Australian Federal Government recently announced changes to the existing IVF/GIFT program that manages access to fertility medicines for eligible Medicare card holders.

In the past, the Pharmaceutical Benefits Scheme (PBS) absorbed the full cost of certain fertility medicines. From 1 July 2015 the PBS will now require patients to make a contribution towards the cost of their subsidised medicines.

Below are some frequently asked questions which help explain what you will need to do:

1. What are the changes starting 1 July 2015?

The current supply process of IVF medications will cease on 30 June 2015. From 1 July medications will no longer be able to be supplied by IVF clinics. Your IVF specialist doctor will be required to write a special PBS prescription for you to be able to receive your medications.

2. Where can I get my IVF prescription dispensed?

Your IVF prescription will need to be dispensed by a pharmacist.

3. Will all pharmacies stock IVF medications?

Any community pharmacy can theoretically dispense medicines under the new prescription supply process. Patients are free to choose any pharmacy to have their IVF medicines dispensed.

In practice, due to the volume of stock required and the cold chain requirements, only a few specialist pharmacies are likely to keep supply on hand.

Genea is working with pharmacies closely located to their clinics to ensure medications are conveniently available to patients.

For patients seeking treatment in Kent Street Sydney CBD, an independent pharmacy is now co-located on Level 2, to allow convenient collection of the medication. Payment will be required to the pharmacy at point of collection.

4. How will I pay for my prescription?

Pharmacies dispensing IVF prescriptions will require payment to be made before you take the medicines home. You will be asked to pay at the pharmacy.

5. Are there maximum quantities allowed for each drug?

Yes. Each drug will have its own maximum PBS quantity. If it is decided you require additional medication above the maximum PBS quantity your doctor will need to write another prescription.

6. Will there be repeats allowed on these prescriptions?

No. There are no repeats allowed on the IVF streamlined authority medications. If it is decided you require additional medication above the maximum PBS quantity your doctor will need to write another prescription.

7. Will there be a cost to me under the new system?

Under the new system patients will be required to pay the PBS co-payment for each prescription. The PBS general co-payment for 2015 is $37.70 per prescription. We estimate the majority of patients will need to pay a co-payment for at least 4 drugs.  The PBS co-payment will also count towards a patient’s Safety Net entitlement.

8. If I am using an egg donor, will these changes affect my egg donor costs in the same way?

Yes, donors will be impacted by these changes.

9. Is there any change to the supply of non-PBS (non-subsidised) medicines?

There will be no change for medicines that are ineligible or do not qualify for PBS subsidy, in that patients will continue to pay full price.

10. Will the change affect my IVF cycle starting instructions?

Yes. We ask that all patients ring their nursing team at least 2 weeks before they expect to start on their cycle so all treatment plans and medication prescriptions can be arranged by your doctor in advance. This includes both IVF stimulation cycles and cryo (frozen embryo) cycles.

Posted: 1/07/2015 12:09:50 PM by Karen Sivieng | with 0 comments
Filed under: Fertility, Information, Medicare
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