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Patient eligibility
The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological medicines under the National Health Act 1953, section 85 and section 100 for adult patients with severe psoriatic arthritis.
Where the term biological medicine appears, it refers to:
- adalimumab
- bimekizumab
- certolizumab pegol
- etanercept
- golimumab
- guselkumab
- infliximab
- ixekizumab
- risankizumab
- secukinumab
- tofacitinib
- upadacitinib
- ustekinumab.
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
Infliximab i.v.
This item is 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.
This item isn’t PBS-subsidised for public hospital in-patients. You must include the hospital name and provider number on the authority application form.
Toxicity and severity descriptors
When demonstrating a patient’s intolerance to prior treatment, use the psoriatic arthritis toxicity and severity descriptors with the authority application.
Treatment specifics
To be eligible for PBS-subsidised treatment with biological medicines, patients must be treated by either a:
- rheumatologist
- clinical immunologist with expertise in the management of psoriatic arthritis.
Authority applications
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 severe psoriatic arthritis can be made:
- using the Online PBS Authorities system
- in writing and use HPOS Form upload
- in writing and mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed psoriatic arthritis - initial authority application form
- relevant attachments.
Applying for initial grandfather treatment
Please note: You don’t need to complete this application in writing when you request PBS authority online.
Applications for initial grandfather authority approval to prescribe PBS-subsidised bimekizumab or risankizumab to treat severe psoriatic arthritis can be made:
- using the Online PBS Authorities system
- in writing and use HPOS Form upload
- in writing and mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed psoriatic arthritis - bimekizumab or risankizumab - initial grandfather 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 severe psoriatic arthritis can be made:
- using the Online PBS Authorities system
- in writing and use HPOS Form upload
- in writing and mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed psoriatic arthritis - change or recommencement authority application form
- relevant attachments.
Applying for continuing treatment
Please note: You’ll get an immediate assessment when you request PBS authorities online.
Applications for continuing authority approval to prescribe PBS-subsidised biological medicines to treat severe psoriatic arthritis can be made in:
- real time using the Online PBS Authorities system
- writing and use HPOS Form upload
- writing and mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed psoriatic arthritis - continuing authority application form
- relevant attachments.
After we approve the first application for continuing treatment, subsequent continuing treatments with PBS-subsidised biosimilar brands of biological medicines are Authority Required (Streamlined). You don’t need authority approval from us for the listed quantity and repeats.
More information
Call the PBS Complex Drugs Programs enquiry line for more information.