Introduce a Medicare Rebate for Iron Infusions in General Practice

Author: Dharshna Baskar | Publish date: 30/04/2025

Problem Identification: 

In Australia, patients who receive iron infusions from a General Practitioner (GP) must often pay out of pocket.

Iron infusions delivered in general practice are currently not listed on the Medicare Benefits Schedule (MBS). 

As a result, iron infusions administered by GPs often remain unaffordable for many patients. This is known to contribute to gender-based health inequities and place avoidable strain on the hospital system.

Context: 

Iron deficiency refers to a condition in which the blood lacks adequate iron to support healthy red blood cells. It is the most common micronutrient deficiency globally. Iron deficiency is known to disproportionately affect women, particularly those who are premenopausal, pregnant or postpartum. This deficiency can lead to serious clinical consequences like cognitive difficulties, fatigue and complications during pregnancy or surgery. It can also lead to anaemia if untreated, which may require hospitalisation.

Iron deficiency can be managed by ‘iron infusions’. They are an intravenous procedure provided by a health professional, which can be administered in general practice. 

More than 54,339 patients were admitted to the hospital in 2021-22 for severe iron deficiency anaemia. According to the Royal Australian College of General Practitioners (RACGP), iron deficiency anaemia remains one of the most common potentially preventable hospitalisations in Australia. They state that many of them could have been treated earlier in a general practice setting.

MBS is the list of health services subsidised by the Australian Government (i.e. services with a rebate). Under Section 3C of the Health Insurance Act 1973, the Federal Health Minister has the power to create a new MBS item and set a fee for a service (e.g. iron infusions) - even if it isn’t currently listed in the legislation.

Without an MBS item number, practices often absorb the cost of staff time, equipment and patient monitoring. A 2019 RACGP survey found 38% of practices currently offer iron infusions, but a further 53% of practices would offer them if a rebate were available for the service.

Many clinics charge patients over $200 out-of-pocket, which RACGP President Dr Nicole Higgins highlights as too expensive for many people. She claims patients left out “end up on waiting lists to receive the iron infusion in a public hospital or outpatient clinic, if one is available”. “Their care is delayed by months, and in the meantime their condition can significantly deteriorate,” says Dr Higgins.

RACGP reports that hospital presentations of even minor or medium complexity cases can cost over $2,000 per presentation. By preventing avoidable admissions and the complications from delayed treatment, the College says this could save the healthcare system up to $73.7 million per year. 

RACGP has proposed a $200 Medicare rebate for a specialist GP to spend up to 15 minutes calculating the dosage, educating the patient and administering the iron infusion by a clinical team member. They expect it to cost $39.2m per year, allow for greater accessibility to the procedure and help to avoid preventable strain on the hospital system. Dr Higgins says it could mean “more patients can get the treatment they need, when they need it”.

There is international precedent for funding iron infusions. For example, in New Zealand and China.

Solution Identification: 

Amend Schedule 1 of the Health Insurance (General Medical Services Table) Regulations 2021 (Cth) to introduce a new item and Schedule fee set at $200 with the notation "(Ministerial Determination)" for iron infusions in general practice, as recommended by the RACGP.

By redirecting more iron infusions from hospitals to GPs, this could offer a safer, more convenient and cost-effective option for both the government and patients (particularly women).

Advice:

The Minister for Health should use Section 3C of the Health Insurance Act 1973 (Cth) to introduce an MBS item for iron infusions in general practice as specified above at the next opportunity.

Download the 1-Page Brief Here - Introduce a Medicare Rebate for Iron Infusions in General.

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Public Support: 

1. Royal Australian College of General Practitioners (RACGP)

Where to go to learn more: 

1. Royal Australian College of General Practitioners (RACGP) Pre-Budget Submission 2025-26 Report - recommends increased funding and support for general practitioners to better manage and treat conditions like iron deficiency in the Australian population. Read RACGP Pre-Budget Submission 2025-26  

2. RACGP web article: GP iron infusions would save the health system $124m - outlines that funding GP-administered iron infusions would save the health system $124m by preventing hospitalisations and improving patient access. Read the article here.  

3. Health Insurance (General Medical Services Table) Regulations 2021 (Cth) - outlines the fees and rules for claiming Medicare benefits for a wide range of medical services provided by general practitioners and other medical professionals in Australia. Read the full act here

   
   

Human Perspective:

Emily (19), a university student, has been dealing with persistent low iron levels. They leave her drained for midday lectures and make late-night study sessions a constant struggle. Between tuition fees, textbooks and part-time work, she has no spare funds for the out-of-pocket cost of iron infusions. As she presses on, losing energy by the day, late-night assignments turn into bleary-eyed mornings in class where the fatigue and fog never lift. This has caused her to fall behind academically and feel increasingly isolated from campus life. A Medicare rebate of $200 could ease her financial worries and allow her to seek timely treatment at her GP. It would free her to focus on her studies and well-being, rather than force her to make unnecessarily difficult choices at a pivotal stage in her life.

To protect the anonymity of those involved, this is a fictionalised account drawn from an amalgamation of real-life stories, experiences, and testimonials gathered during the research process for this brief. Any resemblance to actual individuals is purely coincidental.

Conflict of interest/acknowledgment statement: 

N/a.

Support 

If your organisation would like to add your support to this paper or suggest amendments, please email Info@foreaustralia.com. 

Reference list: 

Benson, C. S., Shah, A., Stanworth, S. J., Frise, C. J., Spiby, H., Lax, S. J., Murray, J., & Klein, A. A. (2021). The effect of iron deficiency and anaemia on women’s health. Anaesthesia, 76(S4), 84–95. https://doi.org/10.1111/anae.15405 

Calafiore, S. (2024, February 22). Medicare item for GP iron infusions a ‘no-brainer’: RACGP president. The Limbic. https://thelimbic.com/haematology/medicare-item-for-gp-iron-infusions-a-no-brainer-racgp-president/ 

East Hills Medical Centre. (n.d.). Iron infusion. https://www.easthillsmedicalcentre.com.au/iron-infusion/

Gorman, G. (2024, October 10). ‘Cost barriers’: More Australian women delaying essential healthcare appointments. Women’s Agenda.  https://womensagenda.com.au/latest/cost-barriers-more-australian-women-delaying-essential-healthcare-appointments/​

Health Direct. (n.d.). Iron deficiency. https://www.healthdirect.gov.au/iron-deficiency#what-is 

Narcyz Ghinea. (2024, September 30). Cost barriers to medication access in Australia. Medical Journal of Australia (MJA). https://apo.org.au/node/328508 

Pharmac - Te Pātaka Whaioranga. (2017, September 11). Iron infusions in the community. https://www.pharmac.govt.nz/news-and-resources/consultations-and-decisions/iron-infusions-in-the-community-2 

Royal Australian College of General Practitioners. (2024). Our plan to improve the health of Australia: Pre-budget submission 2025–26. https://www.racgp.org.au/getmedia/cf12bfd4-fc8e-45a1-af62-f13b09c126e0/RACGP-Pre-Budget-Submission-2025-26.pdf.aspx 

Wisby, M. (2024, February 15). GP iron infusions would save health system $124m: RACGP. newsGP. https://www1.racgp.org.au/newsgp/clinical/gp-iron-infusions-would-save-health-system-124m-ra

Zhang, G. D., Johnstone, D., Leahy, M. F., & Olynyk, J. K.  (2024). Updating the diagnosis and management of iron deficiency in the era of routine ferritin testing. The Medical Journal of Australia, 221(7), 360-364. https://doi.org/10.5694/mja2.52429