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Patient eligibility
The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with tocilizumab under the National Health Act 1953, section 85 and section 100 for patients with systemic juvenile idiopathic arthritis (sJIA).
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 tocilizumab.
Section 100 arrangements
Tocilizumab i.v only
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 public hospital in-patients. You must include the hospital provider number for the authority application.
Toxicity and severity descriptors
When demonstrating a patient’s intolerance to prior treatment, use the juvenile idiopathic arthritis toxicity and severity descriptors with the authority application.
Treatment specifics
To be eligible for PBS-subsidised treatment with tocilizumab, patients must be treated by a rheumatologist or under the supervision of a paediatric rheumatology treatment centre.
Authority applications
Applying for initial treatment
Applications for initial authority approval to prescribe PBS-subsidised tocilizumab to treat sJIA 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
Applications to retrial or recommence authority approval to prescribe PBS-subsidised tocilizumab to treat sJIA 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 tocilizumab is Authority Required (Streamlined). You don’t need authority approval from us for the listed quantities and repeats.
More information
Call the PBS Complex Drugs Programs enquiry line for more information.