Factsheet

NSW Section 100 Co-payment Program Information for patients

NSW Health pays the Pharmaceutical Benefit Scheme (PBS) co-payment for some s100 medicines for eligible NSW residents. This helps lower the cost of medicines for people living with cancer and other chronic conditions. The PBS co-payment is the amount you usually pay towards the cost of your PBS subsidised medicine.

Last updated: 08 November 2024
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​​​​​​​​​​​​​What medicine is covered by the program?

The NSW Section 100 Co-payment Program applies to the following PBS medicines:

  • s100 medicines on the s100 Highly Specialised Drugs Program (Public Hospital and Community Access) schedules
  • injectable and infusible chemotherapy medicines on the s100 Efficient Funding for Chemotherapy (Public Hospital) schedule.

The Program does not apply to s100 medicines prescribed by private hospital providers or s100 medicines for opioid dependence treatment.

Am I eligible?

Please check the criteria below to see if you are eligible for NSW Health to pay your co-payment for s100 medicines.

Eligibility criteria

NSW residents who are patients of:

  • NSW public hospitals, or
  • authorised community prescribers in NSW (for HIV and Hepatitis B, medicines and clozapine maintenance therapy), or
  • ​an interstate specialist/prescriber where the NSW resident lives in a border area.

Prescribed medicines listed under section 100 of the National Health Act 1953 for:

  • s100 Highly Specialised Drugs (Public Hospital), or
  • s100 Highly Specialised Drugs - Community Access (excluding opioid dependence medicines), or
  • s100 injectable and infusible chemotherapy medicines.

Prescriptions filled through NSW:

  • public hospitals, or
  • community pharmacies, or
  • pharmacies used by NSW public hospital oncology services.

If you are not sure if you are eligible, ask your doctor or pharmacist.

Why do I need to fill in a consent form?​

NSW Health needs your agreement to pay the co-payment for you. The consent form shows the pharmacist you are eligible. Information in the consent form is used to make the co-payment and may also be used to evaluate the Program.

How do I complete the consent form?

You and your doctor can complete a Patient Consent Form.

If your consent form is lost, damaged or illegible, you will need a new form from your doctor. You may also take a photo of the form and keep it on your mobile phone. All information on the form must be visible.

How do I get my s100 medicine?

You should get your medicine the same way you normally do.
s100 medicines are available from NSW public hospital pharmacies. You can also get some s100 medicines from community pharmacies.

Show your signed consent form to the pharmacist each time your prescription is filled, including any repeats.
If you are running out of your s100 medicine, go to your nearest public hospital pharmacy or contact your doctor as soon as possible. Call your community pharmacy ahead of time to see if they have your medicine or can order it in.

If your s100 medicine is an injectable or infusible chemotherapy please refer to  Co-payments for section 100 injectable and infusible chemotherapy medicines in NSW - information for patients.

More information

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Current as at: Friday 8 November 2024
Contact page owner: Strategic Reform and Planning