General versus concessional pricing
The PBS has two co-payment tiers: a general co-payment (the standard maximum patients pay) and a concessional co-payment (a lower maximum for concession-card holders including Pension, Health Care Card, and DVA cards). Both amounts are set annually and are current on pbs.gov.au. For most PBS-listed antidepressants, the actual medication cost is well above the co-payment, so both amounts represent substantial subsidy.
The PBS Safety Net
The PBS Safety Net reduces or eliminates co-payments once your annual out-of-pocket spending on PBS medications reaches a defined threshold. General patients drop to concessional pricing after reaching their threshold; concessional patients pay nothing after reaching theirs. The current thresholds are on pbs.gov.au. Keep receipts or ask the pharmacist to track your Safety Net progress.
Non-PBS medications and higher-tier prescriptions
A small number of newer or specialist antidepressants are not on the PBS or are only PBS-listed under specific authority requirements. These may cost significantly more. Your GP or psychiatrist can advise whether a specific medication qualifies for PBS listing for your situation. If cost is a barrier, discuss with your prescriber — often an alternative that is PBS-subsidised works well for the same clinical purpose.
What to flag to your prescriber
- Cost affecting treatment adherence.
- Any prescription that seems more expensive than expected.
- Confusion about whether you have reached the Safety Net threshold.
- Situations where a non-PBS medication is being suggested but cost is a barrier.
Related reading: Medicare Rebates for Mental Health Appointments and How to Prepare for Your Antidepressant Follow-Up Appointment.
Frequently asked questions
How much do antidepressants cost on the PBS?
The co-payment is capped at the standard or concessional rate set annually. Check pbs.gov.au for current amounts.
What is the PBS Safety Net?
After your annual out-of-pocket PBS spending reaches a threshold, further prescriptions are cheaper (concessional rate) or free (for concession card holders).
Are all antidepressants on the PBS?
Most commonly-prescribed antidepressants are PBS-listed. A small number of newer or specialist medications may not be.
Evidence and sources referenced
- NICE Guideline NG222 — Depression in adults: treatment and management (United Kingdom).
- Royal Australian and New Zealand College of Psychiatrists (RANZCP) — Clinical Practice Guidelines for Mood Disorders.
- NPS MedicineWise — patient and prescriber resources on antidepressants (Australia).
- Royal College of Psychiatrists — patient information on antidepressants.
- TGA and FDA — product information for SSRI and SNRI classes.
- Maudsley Prescribing Guidelines in Psychiatry.
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