Pharmaceutical Benefits Scheme (PBS) prescription—PBS patient contribution, total Australian currency N[NNNNN].NN
Data Element Attributes
Identifying and definitional attributes | |
Metadata item type: | Data Element |
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Short name: | PBS patient contribution |
Synonymous names: | Patient co-payment |
METEOR identifier: | 603362 |
Registration status: | Commonwealth Department of Health, Retired 19/10/2023 |
Definition: | For a given Pharmaceutical Benefits Scheme (PBS) prescription, the total amount paid by the patient or PBS consumer to the approved pharmacy for a prescription, exclusive of any special patient contributions, e.g. brand price premiums or therapeutic group premiums, expressed in Australian dollars. This amount also excludes any optional fees imposed at the discretion of the pharmacy and payable by the patient, e.g. fees associated with the maintenance of Safety Net records on behalf of the patient by the pharmacy. |
Data Element Concept: | Pharmaceutical Benefits Scheme (PBS) prescription—PBS patient contribution |
Value Domain: | Total Australian currency N[NNNNN].NN |
Value domain attributes | ||
Representational attributes | ||
Representation class: | Total | |
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Data type: | Currency | |
Format: | N[NNNNN].NN | |
Maximum character length: | 8 | |
Unit of measure: | Australian currency (AU$) |
Data element attributes | |
Collection and usage attributes | |
Guide for use: | The amount of patient co-payment is adjusted on 1 January each year in line with the Consumer Price Index (CPI). The patient co-payment amount varies according to whether the PBS benefit is being claimed on behalf of a general patient or a concessional patient, and also whether the patient (including their family members) reaches the Safety Net threshold applicable to their circumstances in the relevant calendar year. For example, under the general PBS, in 2014 a general (non-concessional) patient would have paid a maximum over-the-counter price of $36.90 for each prescribed PBS medicinal product, plus any applicable special patient contribution, brand premium or therapeutic group premium. If the total amount spent by the patient during the year reached the general Safety Net threshold of $1,421.20, the maximum over-the-counter price paid for any additional item during the remainder of the year would be $6.00, plus any applicable special patient contribution, brand premium or therapeutic group premium. Similarly, in 2014 a concessional patient would have paid a maximum over-the-counter price of $6.00 for each prescribed PBS medicinal product, plus any applicable special patient contribution, brand premium or therapeutic group premium. If the total amount spent by the patient during the year reached the concessional Safety Net threshold of $360.00, any additional items during the remainder of the year would be supplied free of charge, plus any applicable special patient contribution, brand premium or therapeutic group premium |
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Source and reference attributes | |
Submitting organisation: | Department of Health |
Relational attributes | |
Related metadata references: | |
Implementation in Data Set Specifications: | Pharmaceutical Benefits Scheme (PBS) state/territory data extract 2013-14 Commonwealth Department of Health, Retired 19/10/2023 Implementation start date: 01/07/2013 Implementation end date: 30/06/2014 DSS specific information: Variable name = PTNT_CNTRBTN_AMT |