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This page contains a summary of the various benefits and pensions available to people
living with HIV/AIDS and their carers. The information is based on the Department of
Social Security (DHSS) material, which was current as at January 1997.
If you receive a Disability Support Pension, you are entitled to ask to speak to a Disability Support Officer when dealing with the Department of
Social Security. Positive People Victoria maintains a list of these
officers within the regions, so ask for them by name. If you find the names have changed,
please let us know.
WARNING!! If
you are in receipt of any benefits and are planning overseas travel, check with the DHSS.
We know of some instances when people on Disability Support Pensions had payments cut for
failing to notify the Department and obtaining a Departure Certificate!!! Read the fine
print on your pension details notification.
- Who can claim:
- People who can't work full-time or be retrained for at least two years, because of a
physical, psychiatric or intellectual disability. Must have 10 years Australian residency,
unless inability to work occurred in Australia. Income/Assets test applied.
- Benefit:
- $346.40 per fortnight (adult, single, no dependents)
Plus $5.40 per fortnight Pharmaceutical Allowance
Entitled to Pensioner Concession Card.
- Telephone: 13 2300 to register intent to lodge claim.
- Who can claim:
- People who can't do their job or study because of a temporary illness or injury, have no
paid sick leave and have a job or study to return to. Income/Assets Test applied.
- Benefit:
- $320.20 per fortnight (adult, single, no dependents)
Plus $5.40 per fortnight Pharmaceutical Allowance
Entitled to Health Care Card.
- Telephone: 13 2468
- Who can claim:
- People who aged 16 or over who can't use public transport without substantial help, who
are doing at least 8 hours per week of work, training or voluntary work. Also payable to
people looking for work. No Income/Assets Test applied.
- Benefit:
- $56.50 per fortnight. Not payable if sales tax exemption on new motor
vehicle received in previous two years. If not on a pension, Health Care Card given.
- Telephone: 13 2300
- Who can claim:
- People caring full-time for a person who has a severe disability, is aged 16 and over,
and who gets a Social Security or Veteran's Affairs payment, or who meets Family Payment
income and assets test. Income/Assets test applied.
- Benefit:
- $346.40 per fortnight.
Also entitled to Pharmaceutical Allowance and Pensioner Concession Card.
- Telephone: 13 2300
How will changes to the Pharmaceutical Benefits
Scheme affect people with HIV/AIDS?
There was considerable public debate about changes
to the Pharmaceuticals Benfit Scheme (PBS) in the recent Federal budget. The following
article explores what the PBS is, how it works and what the announced changes mean.
So, what is the Pharmaceutical Benefits Scheme
(PBS)?
The PBS is a scheme whereby the Commonwealth
Government subsidises the cost of about 1700 medicines which are regarded as necessary
and/or life saving. Most of the medecines cost the Commonwealth Government more than the
price you pay at the chemist’s. Some cost hundreds of dollars. All Australians
benefit from this subsidy - the most you should be required to contribute for a PBS
prescription is $20 (although there may be a surcharge for more expensive brands).
What about Concession Card holders?
People with a concession card from the Department
of Social Security or a Department of Veteran’s Affairs treatment card are entitled
to additional subisidies for medicines listed on the PBS. The card must be presented each
time you take a prescription for a PBS medecine to the chemist. Concession Card holders
should only pay a maximum of $3.20 towards the cost of each PBS prescription, although
this may be more depending on which brand is used.
People or families with high needs for medications
are protected under this scheme. The Government sets a threshold for medication costs (see
below).Once you or your family have spent the amount of money set by the threshold on PBS
medicines, you apply for a Saftey Net Card. Any further PBS medicines that you need will,
for the remainder of the calendar year, be supplied cheaper or sometimes free. If you feel
you might qualify for the Safety Net, you will need to have recorded all your spending on
PBS drugs. A Prescription Record Form is available from most chemists to
help you record these expenses.
General Patient
Threshold |
Concession Card
Holder Threshold |
$612.60 per
individual/family* |
$166.40 per
individual/family* |
$3.20
for each further PBS prescription |
free
PBS medicines |
* family
includes spouse(or de facto),
children under 16 in your care, full-time dependent students under 25) |
The costs of pharmaceuticals are an issue for a
number of people with long-term chronic illnesses, such as HIV/AIDS, some of whom may have
to spend a large amount of money, but fail to reach the safety net. The health of some
people may also be put at risk by the current cost structure which requires full payment
for vital and prescribed medications for the early part of any one year before the safety
net is reached. The Consumer Health Forum has completed a survey of the costs of chronic
illness and will be suggesting to both major political parties appropriate changes to the
scheme, including a special "chronic illness card" to ensure that people have
ongoing access throughout the year to affordable drugs to meet their special needs.
Why has the Government made changes to the PBS?
The cost of the PBS has doubled in five years and
such an increase is unsustainable in the long term. Both the former Labour and the current
Liberal governments introduced measures designed to reduce the cost of the system, whilst
ensuring that people who needed medications receive them at an affordable cost.
According to the Federal Government, the most
recent changes announced in the last Federal Budget aim to
 | encourage the use of cheaper equivalents to high
cost brands of pharmaceuticals |
| educate health professionals and the general
community about the high costs of the PBS. |
As a result of these initiatives, the Government
has said that it will
| remove a number of drugs from the PBS. These drugs
are used to treat less serious conditions and most can be bought over the counter without
a prescription for between $2.45 and $9.95. The savings will amount to $112 million over
the next four years. |
| spend $22 million dollars on a National Prescriber
Service, commencing in March 1998, to assist doctors to prescribe appropriately. |
| provide funding to assist pharmacists, as the most
common point of distribution of medications, to advise the general communtiy about
cost-effective use of medicines, including the availability of cheaper, alternative
brands. It is expected that this will achieve savings of around $560 million over four
years. |
Why do I have to pay more for some drugs?
Often, different alternative brands of drugs are
listed on the PBS. For example, Amoxil, Moxacin, Alphamox, Ampexin, Fisamox and Cilamox
are all different brands of one antibiotic called ‘amoxycillin.’ Each of these
brands must have exactly the same antibiotic in exactly the same quantities and at exactly
the same quality. Each brand must work in exactly the same way in the body. The only
difference is that some brands are more expensive than others, according to the price
set by each manufacturer.
However, the Government will only subsidise a drug
to the level of the lowest-priced brand - this is called the benchmark price.
This is to curtail the ever increasing cost of the PBS to Government, and therefore to tax
payers. If there are no clinical implications, consumers are entitled to choose between
different brands, but if consumers choose a more expensive brand, then they will be
required to pay the difference between the brand price and the benchmark price. For
people on the Safety Net, only the benchmark price, is counted towards the
threshold
When a more expensive brand has been prescribed,
the consumer can request the chemist to give them a cheaper brand, if the PBS identifies
that the two brands are interchangeable. The pharmacist can also elect to substitute a
cheaper brand, providing that the consumer agrees and providing that the prescriber has
not specifically indicated on the prescription that such substitution is not not
permitted.
Are the cheaper "generic" drugs really
as good as the original brand names?
When a new drug is developed, it can be patented to
protect the revenue for its developers. There have often been significant costs in
research and development which the company seeks to recover. Once the patent expires,
however, other manufacturers can develop a "generic" equivalent. A generic drug
will only be listed on the PBS if manufacturers can ensure that the drug is clinically
equivalent and must undergo the same strict quality controls.
The generic drug is identical in the way it acts in
the body as the original brand.
There is current debate about whether this scheme
will have a negative effect on the research and development of new drugs in the future.
As of 23/09/98 this list is
currently being updated.
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