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Patient eligibility
The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with difelikefalin under the National Health Act 1953, section 100 for adult patients with CKD-aP.
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 difelikefalin.
Section 100 arrangements
Difelikefalin
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 hospital.
This item isn’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 difelikefalin for initial treatment, patients must be treated by a nephrologist.
For continuing treatment, patients must be treated by either a:
- nephrologist
- a medical practitioner in consultation with a nephrologist.
Authority applications
Applying for initial treatment
Applications for initial authority approval to prescribe PBS-subsidised difelikefalin to treat CKD-aP 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
For patients who received non-PBS-subsidised difelikefalin treatment before 1 May 2024 for CKD-aP, 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 continuing treatment
Applications for continuing authority approval to prescribe PBS-subsidised difelikefalin to treat CKD-aP can be made either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
More information
Call the PBS Complex Drugs Programs enquiry line for more information.