Millions of Australians are struggling to afford essential medicines, and it’s not just about the price tag. While the recent $25 script price cap under Australia’s Pharmaceutical Benefits Scheme (PBS) has been a welcome relief for many, a shocking number of everyday medications are slipping through the cracks, leaving patients to foot the bill. From ear drops to painkillers, eczema creams to hormone replacement therapy, these drugs are often deemed 'private scripts,' meaning they don’t qualify for PBS subsidies. But here’s where it gets controversial: it’s not always because they don’t meet the scientific standards. Many drug manufacturers simply choose not to apply for PBS listing, citing high costs and a small market.
The PBS, designed to ensure access to life-saving and preventive medicines, covers over 900 medicines across 5,000 brands. Yet, health advocates argue that the system is failing some of the most vulnerable. For pensioners and disadvantaged groups, the lack of PBS subsidy means paying full price—often $20 to $100 per script—with no relief from the PBS Safety Net for long-term use. And this is the part most people miss: the financial burden can be overwhelming, especially for those with chronic illnesses who need multiple medications.
Take incontinence medicines, for example. With up to one in three Australians over 15 affected, there are only six drugs available, and just one—oxybutynin—is PBS-funded. But oxybutynin comes with a troubling side effect: an increased risk of dementia, making it unsuitable for many aging women. Is it fair to force patients to choose between financial strain and potential health risks?
Even when drugs are PBS-listed, restrictions can render them inaccessible. Cardiologists report that medicines like Repatha and Eliquis are often prescribed as private scripts due to stringent subsidy conditions. Why are these life-improving treatments out of reach for so many?
The issue boils down to a flawed system. The PBS relies on manufacturers to apply for funding, but the process is costly and time-consuming. For some companies, it’s simply not worth it—they can charge higher prices without PBS involvement. Is this a failure of regulation, or a necessary evil in a global pharmaceutical market?
Medicines Australia argues that the PBS funding process is outdated, using old comparators that don’t reflect scientific advancements. They’re calling for faster reforms, but even then, companies aren’t obligated to submit their drugs for consideration. What more can be done to ensure equitable access to essential medicines?
The government is trialing new approaches, but change is slow. Health Minister Mark Butler highlights recent additions to the PBS, including women’s health treatments, but advocates say it’s not enough. Are we doing enough to prioritize patient needs over commercial interests?
This isn’t just a policy debate—it’s a matter of health, dignity, and fairness. What do you think? Should the government take a stronger stance, or is the current system the best we can hope for? Let’s start the conversation.
