Since the beginning of 2010 the Australian Government has applied cost recovery to the listing process of the Pharmaceutical Benefits Scheme (PBS). Drug companies seeking to list their drugs on the PBS or vaccines on the National Immunisation Program pay a fee at two key points - upon lodgement of the application and at the pricing stage. The lodgement fee relates to the evaluation work of the Pharmaceutical Benefits Advisory Committee (PBAC) and all of its supporting administrative functions. The pricing fee relates to the pricing work of the Pharmaceutical Benefits Pricing Authority and its supporting functions. Companies that want an independent review of a PBAC recommendation to not list a drug on the PBS will also pay. The fees are not trivial - $119 500 for a major PBAC evaluation, $25 000 for a complex 'pricing' and $119 500 for an independent review. Hardly spare change, even for a pharmaceutical company. So what is the purpose of the cost recovery scheme and what are the likely consequences?