PBS Drug in Australia 2026
The Pharmaceutical Benefits Scheme (PBS) in Australia entered 2026 in the middle of its biggest affordability shake-up in more than two decades, and the latest verified government data confirms the scale of the shift. From 1 January 2026, the general patient co-payment for a PBS-subsidised prescription dropped to $25, down from $31.60 — the lowest general co-payment Australians have paid since 2004. That single change is expected to save Australians over $200 million annually, and it sits alongside a $1.8 billion federal investment in new and amended PBS listings, a fresh Pharmaceutical Wholesaler Agreement, and a wave of newly subsidised medicines spanning cancer, rare disease, women’s health, and chronic condition treatment.
This report brings together the newest verified PBS statistics for 2026, sourced directly from the Pharmaceutical Benefits Scheme (PBS.gov.au), the Australian Government Department of Health, Disability and Ageing, and the Australian Institute of Health and Welfare (AIHW). It covers the new $25 co-payment, the largest recent new-listing announcements, total PBS expenditure and prescription volumes, the Safety Net thresholds, and the concessional co-payment freeze that runs through to 2030. Every figure below comes exclusively from official Australian government publications and cross-checked release dates.
Interesting Facts: PBS Drug Statistics in Australia 2026
| Interesting Fact | Verified Statistic |
|---|---|
| General PBS co-payment (from 1 January 2026) | $25 per prescription, down from $31.60 |
| Lowest general co-payment since | 2004 — a more than 20% cut |
| Estimated annual patient savings from co-payment cut | Over $200 million per year |
| Federal budget for new/amended PBS listings | $1.8 billion |
| Total 2025–26 Budget investment in cheaper medicines | $3.2 billion |
| Funding for the Pharmaceutical Wholesaler Agreement | $564.1 million |
| Wholesaler funding increase under new agreement | 34% |
| Concessional co-payment (frozen through) | $7.70, frozen until 2030 |
| PBS Safety Net threshold (general, from 2026) | $1,748.20 per year |
| PBS Safety Net threshold (concession, from 2026) | $277.20 per year |
| PBS-subsidised prescriptions dispensed (2023–24) | Over 331 million (178.6M to females, 152.5M to males) |
| Government PBS expenditure (2023–24, over-copayment) | $9.0 billion+ |
| Medicines listed on the PBS Schedule (30 June 2024) | 930 different medicines in 5,164 brands |
| New and amended listings approved since July 2022 | 386 listings |
| Australians without a concession card benefiting from cut | 20 million |
Source: Pharmaceutical Benefits Scheme (PBS.gov.au); Australian Government Department of Health, Disability and Ageing, 2026.
Australia’s PBS statistics for 2026 point to the most consumer-friendly medicine-pricing reform the scheme has delivered in over twenty years. The drop to a $25 general co-payment does more than shave a few dollars off each script — it reverses a long-running affordability trend that, according to sector research, had left 21% of Australians (roughly 3.75 million people) skipping or delaying a prescription due to cost in the three years leading up to 2025. Layering the co-payment cut on top of 60-day dispensing (introduced from September 2023) and the concessional freeze at $7.70 until 2030 gives pensioners, concession-card holders, and general patients alike a multi-pronged affordability package rather than a single isolated saving.
The $1.8 billion allocated to new and amended PBS listings is equally significant because it funds the pipeline of medicines that keep the scheme clinically current — from cancer immunotherapies to rare-disease treatments that would otherwise cost patients hundreds of thousands of dollars a year. With 930 different medicines across 5,164 brands listed as of mid-2024 and 386 new or amended listings approved since July 2022 alone, the PBS continues to expand at a pace that keeps Australia’s subsidised medicines list among the most comprehensive in the world, even as the government simultaneously drives down what patients pay at the pharmacy counter.
PBS Co-Payment Reform in Australia 2026
PBS GENERAL CO-PAYMENT — HISTORICAL COMPARISON 2023-2026
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2023 (from Jan) ████████████████████████████████ $30.00
2024 (from Jan) █████████████████████████████████ $31.60
2026 (from 1 Jan) ██████████████████████ $25.00
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| Co-Payment Category | Amount |
|---|---|
| General patient co-payment, from 1 January 2026 | $25.00 |
| General patient co-payment, 2024–25 | $31.60 |
| General patient co-payment, from 1 January 2023 | $30.00 |
| Concessional co-payment, frozen through | $7.70 until 2030 |
| Cut in general co-payment (2024–25 to 2026) | $6.60 — over 20% |
| Estimated annual savings, non-concession patients | $689.1 million over four years |
| Total Budget cost of the co-payment reduction | $689.1 million |
Source: Australian Government Department of Health, Disability and Ageing, Cheaper Medicines, 2026.
The co-payment cut to $25 took effect on 1 January 2026 under legislation introduced to Parliament in July 2025, bringing the general PBS price below $30 for the first time since the co-payment was last this low back in 2004. For the roughly 20 million Australians without a concession card, this represents a saving of up to $6.60 on every prescription compared with the 2024–25 rate of $31.60, funded through a dedicated $689.1 million allocation in the 2025–26 Federal Budget.
Crucially, this reform did not happen in isolation. The concessional co-payment remains frozen at $7.70 until 2030, meaning pensioners and other concession-card holders are shielded from the annual CPI-linked increases that would otherwise apply, while general patients get the benefit of an outright reduction. Together, these two measures — a lower base price for general patients and a locked-in freeze for concession holders — form the core of what the government has described as its most significant medicines-affordability package since the PBS co-payment was last reduced two decades ago.
PBS Safety Net Thresholds in Australia 2026
PBS SAFETY NET THRESHOLDS — FROM 1 JANUARY 2026
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General patient threshold ████████████████████████████ $1,748.20
Concession/pension threshold ██ $277.20
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| Safety Net Category | Threshold (from 1 January 2026) |
|---|---|
| General patient annual Safety Net threshold | $1,748.20 |
| Pension/concession card annual Safety Net threshold | $277.20 |
| Cost per script after reaching Safety Net (general/Medicare card) | $7.70 (concessional rate) |
| Cost per script after reaching Safety Net (pension/concession card) | Free for the rest of the year |
| 60-day prescription patient savings (2023–24) | Approximately $54.4 million |
Source: Australian Government Department of Health, Disability and Ageing, PBS Safety Net and Cost Savings, 2026.
The PBS Safety Net exists to cap total annual medicine spending for individuals and families who need multiple prescriptions throughout the year, and the 2026 thresholds — $1,748.20 for general patients and just $277.20 for pension and concession card holders — determine when that protection kicks in. Once a family or individual crosses the relevant threshold, every further PBS medicine for the rest of the calendar year is either charged at the reduced concessional rate of $7.70 or supplied entirely free, depending on card type.
An important interaction the Department of Health flags for 2026 is that the lower general co-payment and the availability of 60-day prescriptions can actually change how quickly someone reaches the Safety Net. Because each script now costs less, it can take more prescriptions to reach the general threshold — but because total patient costs are lower across the board, most people still end up paying less overall by the end of the year, even if they cross into Safety Net territory slightly later than they would have under the previous $31.60 co-payment structure.
New PBS Medicine Listings in Australia 2026
| New/Expanded PBS Listing (2025–2026) | Condition Treated | Patient Impact |
|---|---|---|
| Lumasiran (Oxlumo®) | Primary hyperoxaluria type 1 (rare kidney disease) | Otherwise $392,000+/year; ~50 patients/year benefit |
| Ranibizumab (Lucentis®) | Diabetes-related eye disease | Saves patients over $9,000/year; ~500 patients/year |
| Blincyto | Acute lymphoblastic leukaemia (blood cancer) | Otherwise ~$230,000/course; ~110 patients/year |
| Calquence | First-line treatment for certain blood cancers | New tablet-form listing at PBS prices |
| Ocrelizumab (Ocrevus®), new form | Relapsing-remitting multiple sclerosis | Expanded access for adult MS patients |
| Yaz® and Yasmin® (oral contraceptives) | Women’s health / contraception | First new oral contraceptive types listed in decades |
| Adalimumab (expanded use) | Juvenile idiopathic arthritis | Expanded PBS access for young patients |
| Odevixibat (Bylvay®) | Progressive familial intrahepatic cholestasis | New listing for rare liver disease |
Source: Australian Government Department of Health, Disability and Ageing, media releases, 2025–2026.
The new PBS listings rolling out through 2025 and into 2026 illustrate how the scheme continues to bring extraordinarily expensive specialist medicines within reach of ordinary Australians. Lumasiran, which treats a rare genetic kidney condition and would otherwise cost more than $392,000 per year, now costs eligible patients no more than the standard PBS co-payment, while Blincyto, a leukaemia immunotherapy priced at roughly $230,000 per course without subsidy, became accessible to around 110 blood cancer patients annually from its PBS listing date. These are not marginal savings — they are the difference between a treatment being financially impossible for a family and being available at the same $25 (or $7.70 concessional) price as any other PBS medicine.
The women’s health listings — Yaz and Yasmin, described by the government as the first new types of oral contraceptive listed on the PBS in decades — signal a deliberate policy focus within the $1.8 billion new-listings budget on closing gaps in categories that had seen little PBS expansion in years. Combined with new or expanded listings for multiple sclerosis, juvenile arthritis, and rare liver disease, the 2025–2026 listing wave spans the full spectrum from ultra-rare genetic conditions affecting around 50 patients nationally to widely-used everyday medicines affecting millions of prescriptions per year — demonstrating the PBS’s dual role as both a safety net for catastrophic-cost conditions and a subsidiser of routine, high-volume healthcare needs.
Total PBS Expenditure and Prescription Volumes in Australia 2026
PBS EXPENDITURE & PRESCRIPTIONS — FY 2023-24
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Prescriptions to females ██████████████████████████ 178.6 million
Prescriptions to males ███████████████████████ 152.5 million
Government expenditure (over-copay) ███████████████████████ $9.0 billion+
Concessional patients' share of scripts ██████████████████ 88%
Concessional patients' share of spend █████████████████ 61%
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| Expenditure/Volume Metric (FY 2023–24) | Statistic |
|---|---|
| PBS prescriptions dispensed to females | 178.6 million |
| PBS prescriptions dispensed to males | 152.5 million |
| Government expenditure (over-copayment contributions) | $9.0 billion+ |
| Concessional patients’ share of all prescriptions | 88% |
| Concessional patients’ share of government expenditure | 61% |
| Average dispensed price per subsidised prescription (2022–23) | $81.73 |
| Average dispensed price per subsidised prescription (2021–22) | $74.67 |
| Different medicines listed on PBS Schedule (30 June 2023) | 928 medicines in 5,261 brands |
| PBS expenditure per person (2022–23, inflation-adjusted) | $641 — up 13% on 2021–22 |
| Average PBS-funded prescriptions per person (2023) | 13 prescriptions/year |
Source: Pharmaceutical Benefits Scheme (PBS.gov.au), Expenditure and Prescriptions Report, 2023–24; Australian Institute of Health and Welfare, PBS Prescriptions Over Time, 2026.
The scale of the PBS in 2023–24 is best captured by the sheer prescription volume: more than 331 million subsidised prescriptions were dispensed across the year, split fairly evenly by sex but heavily skewed by patient category. Concessional patients — pensioners, low-income earners, and other card holders — accounted for 88% of all prescriptions but only 61% of total government expenditure, a pattern that reflects the lower average cost of medicines commonly used by this group compared with the smaller volume of high-cost specialist medicines used more often by general patients.
The average dispensed price per subsidised prescription rose to $81.73 in 2022–23, up from $74.67 the year before — a trend the AIHW attributes partly to the growing share of expensive specialty and biologic medicines entering the Schedule. This is reflected in the per-person PBS expenditure rate, which reached $641 per Australian in 2022–23 after adjusting for inflation, a 13% increase on the prior year. With an average of 13 PBS-funded prescriptions dispensed per person annually — most commonly medicines for the cardiovascular system such as blood pressure and cholesterol treatments — the PBS remains one of the most heavily utilised universal health subsidy programs in the developed world, a scale that underscores why sponsors compare it favourably against schemes overseas, including in coverage discussions around Ozempic and Mounjaro in the US market, where no equivalent universal subsidy exists for the same class of medicines.
GLP-1 and Weight-Loss Medicine Access on the PBS in Australia 2026
GLP-1 MEDICINE PBS STATUS — AUSTRALIA 2026
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Ozempic — PBS listed? YES (type 2 diabetes only)
Wegovy — PBS listed for obesity? NOT YET (positive PBAC rec. Nov 2025)
Mounjaro/Zepbound — PBS listed? NO (TGA approved, private only)
PBAC eligibility criteria (if listed) Obesity + established CVD
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| GLP-1 Medicine / PBS Status | 2026 Detail |
|---|---|
| Ozempic (semaglutide) — PBS listing | Listed only for type 2 diabetes management |
| Wegovy (semaglutide) — PBS listing for obesity | Not yet listed; private prescription only as of 2026 |
| PBAC recommendation on Wegovy | Positive recommendation, November 2025 for patients with obesity and established cardiovascular disease |
| Conditions attached to the PBAC recommendation | Contingent on price reduction and risk-sharing arrangement |
| Mounjaro / Zepbound (tirzepatide) | TGA-approved; not PBS-subsidised for any indication |
| First-ever positive PBAC recommendation for an obesity therapy | Confirmed November 2025 |
Source: Pharmaceutical Benefits Scheme (PBS.gov.au), PBAC Advice on Equitable Access to GLP-1 Obesity Treatments, 2025–2026.
GLP-1 medicines remain one of the clearest gaps in current PBS coverage, even as the scheme expands rapidly elsewhere. Ozempic is PBS-subsidised strictly for type 2 diabetes, while Wegovy, the higher-dose obesity-specific formulation, has not yet been listed despite the Pharmaceutical Benefits Advisory Committee (PBAC) delivering a landmark positive recommendation in November 2025 — described by clinicians as the first-ever positive PBAC recommendation for an obesity therapy in the scheme’s history. That recommendation applies only to patients with obesity and established cardiovascular disease, and remains contingent on the manufacturer agreeing to a price reduction and risk-sharing arrangement with government.
For the millions of Australians who could clinically benefit from GLP-1 therapy for weight loss alone, this means private-pay pricing remains the only option through 2026, standing in contrast to the rapid PBS expansion seen in cancer, rare disease, and women’s health categories covered elsewhere on the Schedule this year. Whether the pending Wegovy listing proceeds before the end of 2026, and how narrowly its eligibility criteria are ultimately drawn, is likely to be one of the most closely watched PBS decisions of the year among both patients and health policy observers.
PBS Reform Timeline in Australia 2026
| Reform Milestone | Date |
|---|---|
| General co-payment lowered to $30.00 | 1 January 2023 |
| 60-day prescriptions introduced (eligible chronic conditions) | 1 September 2023 |
| General co-payment adjusted to $31.60 (CPI) | 1 January 2024 |
| General co-payment cut to $25.00 | 1 January 2026 |
| New Safety Net thresholds set | 1 January 2026 |
| Concessional co-payment freeze in effect through | 2030 |
| New and amended PBS listings approved since | July 2022 → 386 listings |
Source: Australian Government Department of Health, Disability and Ageing; Pharmaceutical Benefits Scheme (PBS.gov.au), 2026.
Viewed as a single continuous reform program rather than isolated announcements, the PBS affordability changes since 2022 form a deliberate, multi-year strategy. The 2023 co-payment cut, the 2023 introduction of 60-day dispensing, and the 2026 further reduction to $25 each targeted a different friction point in medicine affordability: upfront script cost, the frequency of pharmacy visits, and the total annual burden respectively. The 60-day dispensing change alone saved patients an estimated $54.4 million in 2023–24 by halving the number of dispensing fees paid for eligible long-term conditions.
Looking at what comes next, the concessional co-payment freeze locked in through 2030 gives pensioners and concession-card holders multi-year certainty against CPI-driven cost increases, while the 386 new and amended PBS listings approved since July 2022 show no sign of slowing as the government continues to expand access to expensive specialist medicines. For context on how PBS reform compares with broader healthcare financing debates in other markets, the ongoing US discussion around pharmacy benefit manager reform highlights just how differently structured Australia’s single-payer PBS model is from the multi-intermediary US system — a distinction that has become increasingly relevant as Australia weighs its own future decisions on GLP-1 and specialty medicine access. Readers researching broader Australian retirement and cost-of-living settings that interact with medicine affordability may also find the latest Australia superannuation statistics a useful companion, given how closely retirement income adequacy and out-of-pocket healthcare costs are linked for older Australians relying on the PBS.
Disclaimer: The data research report we present here is based on information found from various sources. We are not liable for any financial loss, errors, or damages of any kind that may result from the use of the information herein. We acknowledge that though we try to report accurately, we cannot verify the absolute facts of everything that has been represented.
