Calculating Pharmaceutical Benefits Scheme services

The Pharmaceutical Benefits Scheme (PBS) analysis was limited to records with a date of supply between 1 January 2021 and 31 December 2021.

This analysis was restricted to prescriptions for medications that were dispensed on the PBS/Repatriation Schedule of Pharmaceutical Benefits (RPBS). 

Most of the listed medicines are dispensed by pharmacists and used by patients at home. Some medicines, because of their clinical use and other special features, need medical supervision (such as chemotherapy drugs) and are only accessible at specialised medical services, usually hospitals. Under the PBS and the RPBS, the Australian PBS data does not cover:  

  • Over-the-counter purchases (non-prescription medicines);
  • Private prescriptions (for example, medicines not listed on the PBS, off-indication prescriptions, or overseas visitors who are not eligible for the PBS);
  • Medicines supplied to admitted patients in public hospitals, although medicines supplied to patients upon discharge, outpatients and day-admitted patients in all jurisdictions are in scope, except New South Wales and the Australian Capital Territory, as those jurisdictions have no Pharmaceutical Reform Agreement in place.
  • The Opiate Dependence Treatment Program prior to 1 July 2023.

The data provides information on drug types dispensed but does not provide information on whether the person took the medicine as prescribed. The type of drugs in the PBS data are identified by the PBS item number on the PBS schedule. The PBS item numbers were mapped to the Anatomical Therapeutic Classification (ATC) code. The ATC classification allows for the grouping of drugs into their site of action and therapeutic and chemical characteristics. For more information about the ATC classification systems, see the Anatomical Therapeutic Chemical (ATC) Classification.

For this analysis prescriptions were grouped at ATC level three (ATC3) (pharmacological subgroup). Medicines are classified according to the main therapeutic use of the main active ingredient. There is only one ATC code for each route of administration, however, many medicines are used and approved for multiple indications. This means that the diagnosis or prevalence of conditions cannot be inferred from rates of medicine use in the cohort.

The ATC3 codes analysed in this cohort were identified through initial analysis as the most dispensed in the humanitarian entrant cohort (Table 1.4).

Table 1.4: Top 10 most dispensed ATC3 groups in humanitarian entrants

ATC3 code



Lipid modifying agents, plain


Blood glucose lowering drugs, excl. insulins


Drugs for peptic ulcer and gastro-oesophageal reflux disease (GORD)




Angiotensin II receptor blockers (ARBS), combinations


Beta-lactam antibacterials, penicillins


Angiotensin II receptor blockers (ARBS), plain


Anti-inflammatory and antirheumatic products, non-steroids




Beta blocking agents

Additionally, prescriptions for mental health drugs were investigated in this analysis. Mental health drugs were identified as those in the following ATC 3 groups: N05A, N05B, N05C, N06A, N06B.

Records of MBS and PBS transactions in 2021 that do not have corresponding spine information were excluded. This is because MBS and PBS transaction data are updated independently, each quarter, while the PLIDA spine is updated once, in the first half of each year. Hence, new enrolees in Medicare after the spine has been updated are not integrated into the spine.