No, the two new dispensing fees are only payable on scripts priced above the patient co-payment (PBS subsidised scripts). The 8CPA has retained the Additional Patient Charge (currently $3.45) and the Safety Net Recording Fee (currently $1.45 for Ready-Prepared Pharmaceutical Benefits and $1.87 for Extemporaneously Prepared Pharmaceutical Benefits) which can be applied to under co-payment scripts. Patients may not be charged a value above the maximum patient co-payment for PBS medicines priced under the maximum patient co-payment. The maximum patient charge and Additional Patient Charge will not be increased in line with the two new fees as these are payable on above co-payment scripts only.

No, the Additional Community Supply Support Payment is only payable on Section 85 medicines.

Payments will be based on your normal PBS claims process, and you will not need to do any additional work or submit additional data. The first payment will be made for the period from 1 April 2024 to 30 June 2024, and will be made in October 2024. Payments will then be made on a quarterly basis in arrears through Services Australia. From 1 July 2025, payments will be automated, with a frequency to be determined. The Guild will continue to advocate for this to be in line with your existing PBS payment timeframe. An estimated payment timeline is given below.

The Guild is partnering with NostraData to provide a calculator tool for members to understand what 8CPA means for your pharmacy. More information on this will be available over coming days.

A change to the way remuneration under the 8CPA is evaluated and adjusted has been implemented through a strengthened payment adjustment mechanism. This will ensure the full commitment is realised even in the case of policy change or variation from volume forecasts.

The 7CPA saw the introduction for the first time of a risk share mechanism for pharmacy dispensing remuneration. However, 60-day dispensing demonstrated a need for a strengthened payment adjustment mechanism (PAM) for 8CPA. Adjustments have been increased in frequency from annual to six monthly, making it more responsive, and calculated on total volume rather than above co-payment. Volume can now grow by up to 10% before any adjustment is required, double the 5% under 7CPA, and any reduction in volume from forecasts will result in a positive adjustment.

The PAM will take into account both remuneration under the Commonwealth Price and through the Additional Community Supply Support Payment and balance outcomes between the two to ensure the full funding commitment from Government is met.

Any adjustments will be outside the Commonwealth Price on the new balancing fee in the first instance, to protect the integrity of the Commonwealth Price. Finally, a mid-8CPA assessment will be conducted to ensure the funding commitments made by Government under 8CPA are met.

Each year, the co-payment that a patient pays towards the cost of their medicines on the PBS is increased (or reduced) in line with the Consumer Price Index. Under the 8CPA, the co-payments will be frozen at the 2024 value until the total value of the indexation that would have otherwise applied reaches $1. So, for example, if the difference between the co-payment that was in place on 1 January 2024 and the co-payment if it had been indexed through to 1 January 2029 would have been $1, this would represent a reduction of $1.

At the first 1 January at which the total increase of the co-payment due to indexation would have been equal to or more than $1, indexation will resume. Because the general patient co-payment and the concessional co-payment have different values and therefore different indexation outcomes, the year in which the $1 will be achieved will be different for each patient type.

The Safety Net Recording Fee is an optional per-script fee chargeable to patients being dispensed a PBS medicine priced under the patient co-payment, in recognition of the work involved in recording information for the patient towards their Safety Net. The maximum value of the fee is currently $1.45 for ready-prepared PBS medicines and $1.87 for extemporaneously-prepared medicines. Pharmacies may charge any value for this fee up to the maximum amount, or choose not to charge it at all.

The Department of Health and Aged Care has a long-term digitalisation strategy which includes automating the PBS Safety Net. Should this system become fully automated over the term of the 8CPA and all work associated with recording of Safety Net information by pharmacies no longer be required, the Safety Net Recording Fee will no longer be applicable.

No. The existing program rules for Dose Administration Aids will continue to apply, which require eligible patients to live at home in a community setting. See Dose Administration Aids - Pharmacy Programs Administrator

All programs that were previously governed under 7CPA will continue as per the existing program rules, regardless of inclusion in 8CPA. These programs will all undergo an evaluation process which will conclude by 1 July 2026 and no changes to the program rules will be made before this time.

The current cap for MedsCheck, Diabetes MedsCheck, and Staged Supply will be retained. Growth in funding in these programs reflects a greater service level than at the beginning of 7CPA within these caps, with more pharmacies participating and more pharmacies using a greater proportion of their caps.

The 8CPA includes an additional funding commitment for the Regional Pharmacy Maintenance Allowance of $52 million over 5 years. Further details on the allocation of this funding will be available soon. The Regional Pharmacy Transition Allowance, which was a temporary program set to end on 30 June 2027, will now end on 30 June 2024 following other funding commitments under 8CPA.

The Department of Health and Aged Care will make alternative arrangements for the National Diabetes Services Scheme in future. The Guild encourages its members to consider all costs of delivering any service on behalf of a third party when setting fees and charges. More advice on this will be available for members in coming weeks.