Medications
Australia
Medication costs and prescriptions
Understand medication costs for children with Crohn’s disease or ulcerative colitis in Australia. Learn about PBS prescription prices, concession cards, the PBS Safety Net, specialist treatments and practical ways to manage ongoing medication expenses.
Managing Crohn’s disease or ulcerative colitis often means regular prescriptions, ongoing medication and sometimes several different treatments. For families, the cost of medicines can add up, especially when a child needs long-term treatment.
The good news is that the Australian healthcare system offers several ways to reduce prescription costs. Understanding the Pharmaceutical Benefits Scheme (PBS), keeping track of your family’s medicine spending and asking the right questions can help you plan ahead.
💙 What is the Pharmaceutical Benefits Scheme (PBS)?
The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that subsidises the cost of many prescription medicines. Instead of paying the full price of an eligible medicine, you pay a contribution and the government covers the remaining subsidised amount.
Many medicines used to treat IBD may be available through the PBS, but eligibility depends on the specific medicine, the condition being treated and the prescribing requirements.
Some medicines have restrictions, such as needing approval from a specialist or meeting particular clinical criteria. Not every medicine is subsidised, and some treatments may have additional costs.
You can search for medicines and check current PBS information on the official PBS website.
💰 How much do PBS prescriptions cost?
From 1 January 2026, the maximum patient contribution for most PBS medicines is:
Up to $25 per prescription for general patients with a Medicare card.
Up to $7.70 per prescription for eligible concession card holders.
These are maximum co-payments for eligible PBS medicines, not guaranteed prices for every medicine. The amount you pay may be lower, and additional charges can apply in some circumstances.
You may pay more if a medicine is not listed on the PBS, if you choose a brand with an additional brand premium, or if other special charges apply.
If your child takes several medicines, ask your pharmacist to explain the cost of each prescription and whether a less expensive equivalent brand is available.
🧾 What is the PBS Safety Net?
The PBS Safety Net helps reduce medicine costs when you or your family spend a certain amount on eligible prescriptions during a calendar year.
For 2026, the thresholds are:
General patients: $1,748.20 in eligible medicine costs.
Concession card holders: $277.20 in eligible medicine costs.
Once your family reaches the applicable threshold, general patients can pay the concessional rate of up to $7.70 per PBS prescription for the rest of the calendar year.
Eligible concession card holders can receive PBS medicines at no further charge for the remainder of that year. Additional charges, such as some brand premiums, may still apply.
An important tip for families: Eligible family members can combine their PBS medicine spending to reach the Safety Net sooner. Ask your pharmacist how to register your family’s spending and keep a record of prescriptions, particularly if you use more than one pharmacy.
Find out more through Services Australia’s PBS Safety Net information.
🪪 Can a concession card reduce medication costs?
If your family has an eligible concession card, you may pay a lower co-payment for PBS medicines.
Eligibility for concession cards depends on your circumstances and the relevant government rules. If you are unsure whether your family qualifies, check with Services Australia or ask a social worker at your child’s hospital for guidance.
Even if you do not have a concession card, the PBS Safety Net may help reduce costs if your family spends enough on eligible prescriptions.
🩺 What if your child needs specialist medication?
Some IBD treatments, including certain biologic medicines, have specific PBS eligibility and prescribing requirements. These treatments may be provided through a hospital or specialist service rather than collected like a routine prescription from a community pharmacy.
Depending on the medicine and where it is supplied, the costs and arrangements can differ.
If your child’s gastroenterologist recommends a new treatment, ask:
Is this medicine subsidised through the PBS?
Does it require special approval or authority?
Will it be supplied through the hospital or a community pharmacy?
Are there any costs for the medicine, administration or associated appointments?
Who should we contact if we have difficulty affording treatment?
If a medicine is not covered by the PBS, ask the treating team whether another suitable subsidised option or a hospital supply arrangement is available. Never stop or change your child’s medication because of cost without speaking to their treating team.
📋 What about medicines that are not covered by the PBS?
Some medicines are not subsidised for a particular condition, may be prescribed outside PBS restrictions, or may not be listed on the PBS at all. In these situations, you may need to pay more of the cost yourself.
Before filling an expensive prescription, ask your pharmacist or specialist to confirm the expected price and whether any subsidy or alternative is available.
You can also ask the hospital’s social worker or patient support team whether there are local assistance programs that may be relevant to your family.
💡 Practical ways to manage medication costs
A few simple habits can make it easier to manage ongoing prescriptions:
Keep a medication list: Record each medicine, its dose, how often it is taken and when a repeat prescription is needed.
Track your spending: Keep receipts or ask your pharmacy to help record eligible PBS spending towards your family’s Safety Net.
Use one pharmacy where practical: This can make it easier to keep track of prescriptions and discuss costs, although your family can still ask about combining eligible spending across pharmacies.
Ask about generic brands: Where appropriate and permitted, a less expensive equivalent brand may be available.
Check repeats before you run out: Plan ahead for appointments, school holidays and travel so you have time to obtain prescriptions.
Ask questions early: If a medicine becomes difficult to afford, speak with your pharmacist or IBD team before your supply runs low.
💙 Supporting your child’s treatment
Medication is often an important part of managing IBD, and families should not have to navigate prescription costs without support. Knowing what is subsidised, understanding the PBS Safety Net and asking your child’s treating team about costs can help you make informed decisions.
If you are worried about affording your child’s medication, let their paediatric gastroenterology team know. They can explain the available options and help you work out the next steps.
🔗 Where to find more information
Pharmaceutical Benefits Scheme (PBS) — search for medicines and check subsidy information.
Services Australia: PBS Safety Net thresholds — learn about the annual thresholds and how to combine eligible family spending.
Australian Government: PBS co-payments — check current prescription contribution rates.
This article provides general information for Australian families. Prescription costs, PBS listings and eligibility rules can change. Confirm current details with your pharmacist, specialist or the relevant government service.
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