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This includes adalimumab for patients with enthesitis/spondylitis related juvenile idiopathic arthritis and tocilizumab for patients with systemic juvenile idiopathic arthritis.
Patient eligibility
The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological medicines under the National Health Act 1953, section 85 and/or section 100 for patients with severe active juvenile idiopathic arthritis (JIA), enthesitis/spondylitis related JIA and systemic JIA.
Where the term biological medicine appears, it refers to adalimumab, etanercept, tocilizumab and tofacitinib.
Patients must be eligible for the PBS and meet the relevant restriction criteria.
The Schedule of Pharmaceutical Benefits on the PBS website outlines the restrictions for prescribing biological medicines.
Section 100 arrangements
Adalimumab (for JIA<18), etanercept (for JIA<18) and tocilizumab IV (for JIA<18, JIA>18 and systemic JIA)
These items are only PBS-subsidised for non-admitted patients, day admitted patients, or patients on discharge who are attending either:
- an approved private hospital
- a public hospital.
These items aren’t PBS-subsidised for public hospital in-patients. You must include the hospital provider number for the authority application.
Treatment specifics
To be eligible for PBS-subsidised treatment with biological medicines, patients must be treated by either a:
- paediatric rheumatologist or under the supervision of a paediatric rheumatology treatment centre - paediatric patients only
- rheumatologist or clinical immunologist with expertise in the management of rheumatoid arthritis - adult patients only, with a documented history of JIA.
Authority applications
Paediatric patients
Applying for initial treatment
Applications for initial authority approval to prescribe PBS-subsidised biological medicines to treat paediatric patients with severe active JIA, adalimumab to treat patients with enthesitis/spondylitis related JIA or tocilizumab to treat patients with systemic JIA can be made either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
Applying for initial grandfather treatment with adalimumab for severe active JIA or for enthesitis/spondylitis related JIA
For patients who received non-PBS-subsidised adalimumab treatment before 1 January 2026 for severe active JIA or enthesitis/spondylitis related JIA, apply for initial grandfather authority approval either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
Applying for change or recommencement of treatment for severe active JIA
Applications to change or recommence authority approval to prescribe PBS-subsidised biological medicines to treat paediatric patients with severe active JIA can be made either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
Applying for retrial or recommencement of treatment for tocilizumab to treat systemic JIA
Applications to retry or recommence authority approval to prescribe PBS-subsidised tocilizumab to treat systemic JIA can be made either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
Applying for continuing treatment
Continuing PBS-subsidised treatment with biological medicines is Authority Required (Streamlined). You don’t need authority approval from us for the listed quantities and repeats.
Applying for change of treatment after resolution of critical shortage of tocilizumab
Apply for change of treatment after resolution of critical shortage of tocilizumab to treat paediatric patients with severe active JIA in writing and either:
- use HPOS Form upload
- mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed juvenile idiopathic arthritis - change of treatment after resolution of critical shortage of tocilizumab authority application form
- relevant attachments.
Adult patients with severe active JIA who started PBS treatment before turning 18
Applying for change or recommencement of treatment
Applications to change or recommence authority approval to prescribe PBS-subsidised biological medicines to treat adult patients with severe active JIA who commenced PBS treatment prior to turning 18 can be made either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
Applying for continuing treatment
Continuing PBS-subsidised treatment with biological medicines is Authority Required (Streamlined). You don’t need authority approval from us for the listed quantities and repeats.
Adult patients with severe active JIA who started PBS treatment after turning 18
Applying for initial treatment
Please note: You don’t need to complete this application in writing when you request PBS authority online.
Applications for initial authority approval to prescribe PBS-subsidised biological medicines to treat adult patients with severe active JIA who commenced PBS treatment after turning 18 years of age can be made:
- using the Online PBS Authorities system
- in writing and using HPOS Form upload
- in writing and mailed to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed juvenile idiopathic arthritis - for adult patients with onset prior to age 18 - initial authority application form
- relevant attachments.
Applying for change or recommencement of treatment
Please note: You don’t need to complete this application in writing when you request PBS authority online.
Applications to change or recommence authority approval to prescribe PBS-subsidised biological medicines to treat adult patients with severe active JIA who commenced PBS treatment after turning 18 years of age can be made:
- using the Online PBS Authorities system
- in writing and using HPOS Form upload
- in writing and mailed to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed juvenile idiopathic arthritis - for adult patients with onset prior to age 18 - change or recommencement authority application form
- relevant attachments.
Applying for continuing treatment
Please note: You don’t need to complete this application in writing when you request PBS authority online.
Applications for continuing authority approval to prescribe PBS-subsidised biological medicines to treat adult patients with severe active JIA who commenced PBS treatment after turning 18 years of age can be made:
- using the Online PBS Authorities system
- in writing and using HPOS Form upload
- in writing and mailed to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed juvenile idiopathic arthritis - for adult patients with onset prior to age 18 - continuing authority application form
- relevant attachments.
Applications for subsequent continuing PBS-subsidised treatment with biosimilar brands of biological medicines is Authority Required (Streamlined). You don’t need authority approval from us for the listed quantities and repeats.
Applying for change of treatment after resolution of critical shortage of tocilizumab
Apply for change of treatment after resolution of critical shortage of tocilizumab to treat adult patients with severe active JIA in writing and either:
- use HPOS Form upload
- mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed juvenile idiopathic arthritis - change of treatment after resolution of critical shortage of tocilizumab authority application form
- relevant attachments.
More information
Call the PBS Complex Drugs Programs enquiry line for more information.