Pay up or go without: the medicines Australians struggle to access

Patients Australia is today calling on the Federal Government to act on medicines access, after a national survey of almost 4,000 patients and carers found that Australians are borrowing money, skipping bills and raiding their super just to fill a prescription. The national survey lays bare a medicines system that quietly sorts the country in two: those who can pay, and those left behind.

The report from Patients Australia, Australian perspectives on medicines access, released today, found half of all patients (50%) have needed a medicine the Pharmaceutical Benefits Scheme (PBS) does not cover, including 37% in the past year. When the bill lands, it is the lowest earners who pay the steepest price, and not in dollars alone.

The numbers are stark. Low-income patients were more than ten times as likely as higher income households to borrow from family or friends to afford treatment. They were almost nine times as likely to apply for income support or dip into their superannuation. And they were around twice as likely to delay treatment altogether, or settle for a less preferred drug, because they could not access the one they needed.

More than half of everyone affected called the impact moderately to extremely severe.

“A two-tier health system is widening in plain sight,” said Patients Australia CEO Lisa Robins. “The exact same medicine is within reach for someone who can pay privately, and out of reach for someone who can’t and needs to access subsidised medicines through the PBS. People are going into debt and burning through their retirement savings just to stay on treatment. That is not a safety net. That is a sorting machine.”

The survey found women carried a markedly heavier load. Women were 96% more likely than men to report having to wait for their condition to worsen before accessing a medicine, and 87% more likely to have needed a non-PBS medicine in the past year. They were also 43% less likely than men to regard the system as fair.

What the survey found

• Only three in ten patients understood how PBS authority requirements affect their prescription, and almost three in ten knew nothing about them at all.

• Almost half of patients had struggled to get a medicine due to a shortage. One in eight of those affected reported their health or symptoms worsened.

• Of patients offered a biosimilar medicine, fewer than half (43%) were then prescribed one, but of those prescribed one, 89% went on to try it, showing that the step between offering a biosimilar and writing the script is where wider uptake can be unlocked.

Asked what would most improve access, patients pointed to three concrete pressure points: the cost of co-payments and out-of-pocket expenses (40%), the wait to see a specialist (39%), and the delay between a medicine being approved and subsidised (28%).

“Patients have handed government the to-do list," said Patients Australia Health Reform Ambassador Dr Nicholas Coatsworth. "List medicines faster. Bring treatment costs down through efficiencies like biosimilars, and reinvest those savings back into the PBS. Improve specialist affordability so people can be seen when they need to be. Every day of delay compounds the harm for patients whose conditions don't pause while the system catches up."

Patients Australia is calling on the Federal Government to act on what patients have asked for: list medicines on the PBS faster, bring down the out-of-pocket costs that force people to choose between treatment and the bills, and make specialists easier to see. Every Australian should be able to access the treatment they need, not just those who can afford to step outside the PBS or carry large out-of-pocket costs to see a specialist. A fair system is one that leaves no patient behind.

ENDS 

For more information, contact: 

Lisa Robins 

Chief Executive Officer

Patients Australia 

media@patients.org.au 

About The Research

The report draws on a national survey of 3,996 patients and carers, conducted from 11 to 29 March 2026. Results were weighted to 2021 Census benchmarks and tested with statistical modelling to isolate the factors driving each outcome. The research was made possible with the financial support of Sandoz, the global leader in affordable medicines and a corporate partner of Patients Australia.

About Patients Australia 

Patients Australia is a leading independent not-for-profit organisation championing the rights of patients across Australia. We’re here to ensure that patients’ voices are amplified and their needs prioritised within the healthcare system. Our organisation drives significant improvements in patient care, advocating for greater transparency, accessibility, and quality within Australia’s healthcare landscape. By actively engaging with health consumers, policymakers, and industry stakeholders, we empower patients to create a more responsive and equitable healthcare system for all Australians.