Patients

​​​​​​​NSW Health pays the patient co-payment for some prescriptions under Section 100 of the National Health Act 1953 for eligible patients. 

This includes medicines listed on the Pharmaceutical Benefits Scheme under the s100 Highly Specialised Drugs (HSD) Program Public Hospital schedule, s100 HSD Community Access schedule (excluding opioid dependence medicines), and injectable and infusible chemotherapy medicines on the PBS s100 Efficient Funding for Chemotherapy (Public Hospital) schedule.

Patients are eligible for the co-payment for s100 medicines if they meet the eligibility criteria and provide consent.

Eligibility criteria

All of the following eligibility criteria must be met for the co-payment to be paid by NSW Health.

• 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.
• Patient prescriptions under section 100 of the National Health Act 1953 for:
• s100 HSD (Public Hospital), or
  
• s100 HSD 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.

More information about authorised community prescribers is found on the ASHM website. For clozapine, prescribers and patients must meet the PBS eligibility requirements.

Consent

Eligible patients need to provide consent for NSW Health to make s100 co-payments on their behalf. The process varies according to patient prescription, as follows:

s100 Highly Specialised Drugs

• Patients complete and sign a 3 Year Patient Consent Form with their prescriber/doctor.
• The signed form must be presented each time a prescription is filled (including repeats) for NSW Health to make the s100 co-payments on the patients behalf.
• Patients must ensure a new consent form is completed by their prescriber every 3 years.
  

s100 injectable and infusible chemotherapy medicines

• Patients sign a local pharmacy consent form when their prescription is filled through a pharmacy used by NSW public hospital oncology services.
• This form includes consent for NSW Health to make the s100 co-payments on the patient’s behalf.
• The 3 Year Patient Consent Form is not required.

Fact sheets

• Co-payments for s100 Highly Specialised Drugs
• Co-payments for s100 injectable and infusible chemotherapy medicines.

More information

• Co-payments for s100
• Pharmacists
• Prescribers and medical practitioners
• Frequently asked questions

NSW s100 co-payment enquiries can be emailed to: NSWH-s100CoPayment@health.nsw.gov.au

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