The Pharmaceutical Benefits Scheme (PBS) subsidises Proton Pump Inhibitors (PPIs) for patients with gastro-oesophageal reflux disease (GORD).
The PBS subsidises treatment with PPIs under the National Health Act 1953, section 85 for patients with GORD.
Patients must be eligible for the PBS and meet the relevant restriction criteria. Patients who don’t meet the restriction criteria, may be eligible for non-PBS subsidised PPIs. The prescriber should endorse the prescription as 'non-PBS'.
The Schedule of Pharmaceutical Benefits on the PBS website outlines the restrictions for prescribing PPIs.
Information for prescribers
High dose PPIs
From 1 May 2019, PBS subsidised high dose PPIs for the treatment of GORD are Authority Required and need prior approval from us.
You can call the PBS authority approvals line . You can also use the Online PBS Authorities system. Find out how to Request an authority using Online PBS Authorities in HPOS.
PBS subsidised high dose PPIs for the treatment of GORD include:
- Esomeprazole 40mg
Standard dose PPIs
From 1 May 2019, PBS subsidised standard dose PPIs for the treatment of GORD are Authority Required (STREAMLINED) and don’t need prior approval from us. You must endorse the authority prescription with a valid streamlined code.
PBS subsidised standard dose PPIs for the treatment of GORD include:
- Esomeprazole 20mg
- Lansoprazole 30mg
- Omeprazole 20mg
- Pantoprazole 40mg
- Rabeprazole 20mg
Low dose PPIs
Low dose PPIs for the treatment of GORD are listed as a restricted benefit. They don’t need prior approval from us for the listed quantity and repeats.
PBS subsidised low dose PPIs for the treatment of GORD include:
- Lansoprazole 15mg
- Omeprazole 10mg
- Pantoprazole 20mg
- Rabeprazole 10mg
Information for pharmacists
From 1 May 2019, changes to the authority requirements for PPIs mean:
- PPIs that are Authority Required must be written on an authority prescription and require the prescriber to get prior approval from us for PBS subsidy.
- PPIs that are Authority Required (STREAMLINED) must be written on an authority prescription and endorsed with the correct streamlined code for PBS subsidy.
- If the wrong prescription form is used, refer back to the prescriber.
PPIs prescriptions written before 1 May 2019 will still be valid for PBS supply for 12 months from the date the prescription was written.
You must acknowledge any warning codes received in PBS Online. Where there is a risk of rejection either through warning or rejection reasons codes you must resolve this in PBS Online prior to supplying Pharmaceutical Benefits including PPI items. This means checking prescriptions for prior authority approval or a valid streamlined code.
The restrictions for standard and high dose PPIs for the treatment of GORD don’t allow increased quantity or repeats. We have no delegation to administer these medications outside the listed quantity and repeats.