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Patient eligibility
The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological agents under the National Health Act 1953, section 85 and section 100 for adult patients with severe psoriatic arthritis.
Where the term 'biological agent' appears, it refers to:
- adalimumab
- certolizumab pegol
- etanercept
- golimumab
- guselkumab
- infliximab
- ixekizumab
- 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 agents.
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:
- an approved private hospital
- a public participating hospital
- a public hospital.
This item isn’t PBS-subsidised for 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 agents, patients must be treated by either a:
- rheumatologist
- clinical immunologist with expertise in the management of psoriatic arthritis.
Authority applications
Applying for initial treatment
Apply for initial authority approval to prescribe PBS-subsidised biological agents to treat severe psoriatic arthritis in writing and either:
- use HPOS Form upload
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- psoriatic arthritis - initial authority application form
- relevant attachments.
Applying for initial grandfather treatment
For patients who received non-PBS-subsidised upadacitinib treatment before 1 October 2021 for severe psoriatic arthritis, apply for initial grandfather authority approval in writing and either:
- use HPOS Form upload
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- psoriatic arthritis - upadacitinib - initial grandfather authority application form.
Applying for change or recommencement of treatment
Apply to change or recommence authority approval to prescribe PBS-subsidised biological agents to treat severe psoriatic arthritis in writing and either:
- use HPOS Form upload
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- psoriatic arthritis - change, recommencement or demonstration of response authority application form
- relevant attachments.
You can also use this authority application form to submit a demonstration of response to the current PBS-subsidised treatment.
Applying for continuing treatment
Apply for continuing authority approval to prescribe PBS-subsidised biological agents to treat severe psoriatic arthritis in writing and either:
- use HPOS Form upload
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- psoriatic arthritis - continuing authority application form
- relevant attachments.
After we approve the first application for continuing treatment, subsequent continuing applications for PBS-subsidised biosimilar brands of biological agents are Authority Required (Streamlined). They 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.