Who is eligible?
NSW Health pays the co-payment for s100 medicines for patients who meet the eligibility criteria and provide a completed consent form.
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.
Why do I need to see the patient's consent form?
The Patient Consent Form confirms the patient is eligible and has given consent to have their co-payment paid by NSW Health.
Eligible patients need to show the pharmacist their consent form each time a prescription/s and any repeats are dispensed. The form remains valid and can be accepted by pharmacists until the renewal period has expired. The patient is responsible for their form and may present a digital copy to the pharmacist.
Download 
patient consent form.
How do I submit patient co-payment claims?
Community pharmacists are reimbursed for the cost of the co-payment and paid a service fee for submitting the claim by NSW Health.
Community pharmacies submit co-payment claims for eligible patients to the Pharmacy Guild of Australia (PGA) to be reimbursed. You do not need to be a PGA member to participate.
You can claim co-payments for medicines listed on the PBS - s100 Highly Specialised Drugs (HSD) Program (Community Access schedules) for:
- HIV antiretroviral therapy
- Hepatitis B medicines
- Clozapine (maintenance therapy only).
PBS medicines prescribed under the s100 HSD – Private schedule or other s100 schedules cannot be claimed through this program. Medicines listed on s100 Community Access for opioid dependence treatment are not eligible.
Information and resources, including guides and frequently asked questions can be found on the
PGA website
How do I let patients know about the Program?
Please share information with your patients about the Program, by:
- talking to your patients
- putting up the s100 poster in your pharmacy
- printing out the patient factsheet and giving it to your patients.
More information
For further information scan the QR code below.
