Private vs PBS Prescription in Australia: Cost, Coverage, and How to Switch

Feature	PBS prescription	Private prescription
Government subsidy	Yes	No
Patient cost	Capped at $25.00 (general) or $7.70 (concession)	Full retail price (varies by pharmacy)
Counts toward Safety Net	Yes	No
Eligibility	Condition must meet PBS listing rules	Any condition the prescriber writes for

The PBS is run by the Department of Health and Aged Care under pbs.gov.au.

What a PBS prescription is

A PBS prescription is a script for a medicine that the federal government has listed on the Pharmaceutical Benefits Schedule. When your prescriber writes it as a PBS script, the PBS picks up most of the cost and you pay the standardised co-payment.

For 2026 the co-payments are:

• General patients: $25 per PBS item
• Concession card holders (Pensioner Concession Card, Health Care Card, Commonwealth Seniors Health Card, DVA): $7.70 per PBS item

That figure is the same whether the medicine costs $30 or $3,000 to the system. The PBS absorbs the gap.

Almost every common medicine for an ongoing chronic condition is on the PBS: medicines for blood pressure, cholesterol, type 2 diabetes, asthma, thyroid, common mental health conditions, and so on. The PBS list runs to several thousand items and is updated monthly.

For a PBS script, your prescriber writes "PBS" on a paper script or selects the PBS option in their eScript software.

What a private prescription is

A private prescription is a script for a medicine that is not being supplied under the PBS. You pay the pharmacy's full price for it, with no PBS subsidy.

Two important points:

• A private script is still a legal prescription. You still need it to obtain the medicine. The pharmacist dispenses it the same way as a PBS script.
• The pharmacy sets the price. Different pharmacies can charge different amounts for the same private prescription. It is worth phoning a few before you fill an expensive private script.

For a private script, your prescriber leaves the PBS box blank on a paper script or selects the private option in their eScript software.

Why your medicine might be private

Even when a medicine is on the PBS, your specific script can come out as private. The most common reasons:

• The medicine is not on the PBS list at all (newer medicines, lifestyle medicines, some travel medicines, some compounded preparations)
• The medicine is on the PBS list but only for specific indications, and your indication does not match
• The medicine requires Authority approval and the prescriber has not (yet) applied for it
• You are above the PBS quantity limit (for example, more than 30 days' supply on a non-60-day-eligible medicine)
• You are a visitor without Medicare access

Note: choosing a more expensive brand of a PBS-listed medicine does not turn a PBS script into a private script. It remains a PBS script; you simply pay the standard PBS co-payment plus a brand premium.

In each case the prescriber and pharmacist can usually explain why. If the explanation is "Authority not approved", your prescriber can apply for the authority and reissue the script as PBS.

How much each costs

Factor	PBS prescription	Private prescription
Price per fill (general)	$25 fixed	Pharmacy sets price
Price per fill (concession)	$7.70 fixed	Pharmacy sets price
Typical price range	Fixed co-pay	$20 to $80, specialty items higher
Pharmacy price variation	None	Yes, worth phoning around
Counts toward Safety Net	Yes	No

For the PBS side the numbers are fixed.

• General PBS co-payment in 2026: $25 per item
• Concession PBS co-payment in 2026: $7.70 per item
• Once you reach the PBS Safety Net threshold ($1,748.20 general or $277.20 concession in 2026), general patients pay the concessional rate and concession patients receive most PBS items at no charge for the rest of the calendar year

For the private side the numbers are not fixed.

• Common private scripts typically cost $20 to $80 per fill
• Newer specialty medicines can run to several hundred dollars per fill
• Compounded preparations are priced individually by the compounding pharmacy
• The same private script can be cheaper or more expensive depending on the pharmacy

The PBS Safety Net does not count private scripts. Money spent on a private prescription does not move you closer to the Safety Net threshold. If you are managing high prescription costs, the PBS items are what matters for Safety Net qualification.

For more on the Safety Net and how to track it, see our 60-day prescriptions guide.

When you can switch from private to PBS

If your medicine is on the PBS list and your situation matches a listed PBS indication, you can ask your prescriber to switch the next script to PBS. This is a one-minute task at your next consult.

Reasons it might switch successfully:

• Your indication moved onto the PBS list since your original script (the list updates monthly)
• Your prescriber missed that you qualify for an Authority code and can now apply for it
• A Streamlined Authority code is available that does not need phone approval
• You met an eligibility threshold (for example, a trial of first-line therapy that failed)

Reasons it might not switch:

• The medicine is not on the PBS list at all
• The PBS listing covers a different indication, dose, or patient group than yours
• You want a specific brand that is more expensive than the PBS-listed brand (you pay the brand premium)

If the switch is possible, the prescriber issues a new script as PBS. You discard the private one. You cannot have one script split across PBS and private supply.

For practical steps on changing scripts, see our transfer a prescription guide.

The Authority script side-track

Some PBS medicines require the prescriber to obtain an Authority before the pharmacy can dispense at the PBS price. An Authority is the PBS confirming, before the dispensing, that your situation meets the listed PBS indication.

Two flavours of Authority exist.

Streamlined Authority: the prescriber selects a four-digit code in their software. No phone call. Fast.

Phone or written Authority: the prescriber phones Services Australia, explains the situation, and receives an approval number. This can take a few minutes during the consult, or longer if the line is busy.

If a prescriber forgets the Authority, your pharmacy cannot dispense the script as PBS. They will offer to dispense it privately (full price) or ask you to wait while they phone the prescriber. The prescriber can usually fix this in a few minutes and reissue the script.

Authority does not apply to most PBS medicines. It is targeted at medicines where the PBS wants to confirm eligibility per patient.