Drug, program or condition for PBS medicines

You’ll need prior authority approval to prescribe some Pharmaceutical Benefits Scheme (PBS) subsidised medicines that require your patients to meet clinical criteria.

You can get this through:

the Online PBS Authorities (OPA) system
by uploading written applications through the Health Professional Online Services (HPOS)
by mailing them to us.

These medicines can’t be PBS-subsidised without authority approval. We can’t grant retrospective approval.

Eligibility Requirements

Patients must meet the criteria recommended by the Pharmaceutical Benefits Advisory Committee (PBAC) to be eligible for PBS-subsidised medicines. We can’t approve an Authority Required medication if a patient does not meet the criteria established by the PBAC and published in the Schedule of Pharmaceutical Benefits.

Acromegaly

The PBS subsidises pasireotide and pegvisomant for patients with acromegaly.

Ankylosing spondylitis

The PBS subsidises biological medicines for patients with ankylosing spondylitis.

Arthritis - juvenile idiopathic arthritis

The PBS subsidises biological medicines for patients with severe active juvenile idiopathic arthritis.

Arthritis - psoriatic arthritis

The PBS subsidises biological medicines for adult patients with severe psoriatic arthritis.

Arthritis - rheumatoid arthritis

The PBS subsidises biological medicines for patients with severe active rheumatoid arthritis.

Arthritis - systemic juvenile idiopathic arthritis

The PBS subsidises tocilizumab for patients with systemic juvenile idiopathic arthritis.

Severe asthma

The PBS subsidises biological medicines for patients with severe asthma.

Atypical haemolytic uraemic syndrome

The PBS subsidises eculizumab and ravulizumab for patients with atypical haemolytic uraemic syndrome (aHUS).

Basal cell carcinoma - metastatic or locally advanced

The PBS subsidises sonidegib and vismodegib for patients with metastatic or locally advanced basal cell carcinoma (BCC).

Breast cancer

The PBS subsidises lapatinib, pertuzumab, trastuzumab, trastuzumab deruxtecan and trastuzumab emtansine for patients with breast cancer.

Cardiomyopathy

The PBS subsidises mavacamten for patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM), and tafamidis for patients with transthyretin amyloid cardiomyopathy.

Chronic kidney disease-associated pruritus

The PBS subsidises difelikefalin for patients with chronic kidney disease-associated pruritus (CKD-aP).

Chronic pouchitis

The PBS subsidises vedolizumab for patients with moderate to severe chronic pouchitis.

Chronic rhinosinusitis with nasal polyps

The PBS subsidises mepolizumab for patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

Crohn’s disease - adult patient

The PBS subsidises biological medicines for adult patients with severe Crohn’s disease.

Crohn’s disease - fistulising Crohn’s disease

The PBS subsidises biological medicines for patients with complex refractory fistulising Crohn’s disease.

Crohn's disease - paediatric patient

The PBS subsidises biological medicines for paediatric patients with severe or moderate to severe refractory Crohn's disease.

Cystic fibrosis

The PBS subsidises ivacaftor, lumacaftor+ivacaftor, tezacaftor+ivacaftor and elexacaftor+tezacaftor+ivacaftor for patients with cystic fibrosis.

Eye - diabetic macular oedema

The PBS subsidises aflibercept, dexamethasone intravitreal implant, faricimab and ranibizumab for patients with diabetic macular oedema.

Eye - retinal vein occlusion

The PBS subsidises aflibercept, dexamethasone intravitreal implant, faricimab and ranibizumab for patients with branched or central retinal vein occlusion (BRVO or CRVO) with macular oedema.

Eye - subfoveal choroidal neovascularisation

The PBS subsidises aflibercept, brolucizumab, faricimab and ranibizumab for patients with subfoveal choroidal neovascularisation.

Fabry disease

The PBS subsidises migalastat for patients with Fabry disease.

Gastrointestinal stromal tumour

The PBS subsidises imatinib, ripretinib and sunitinib for patients with gastrointestinal stromal tumour.

Giant Cell Arteritis

The PBS subsidises tocilizumab for patients with active giant cell arteritis.

Growth hormone deficiency - childhood onset or late onset

The PBS subsidises somatropin for patients with childhood onset or late onset of severe growth hormone deficiency.

Growth Hormone deficiency - paediatric patients

The PBS subsidises somatrogon and somatropin for eligible paediatric patients with severe growth hormone deficiency.

Hereditary angioedema type 1 or 2

The PBS subsidises lanadelumab for patients with hereditary angioedema type 1 or 2.

Hereditary transthyretin amyloidosis

The PBS subsidises patisiran and vutrisiran for patients with hereditary transthyretin amyloidosis.

Hidradenitis suppurativa

The PBS subsidises adalimumab and secukinumab for patients with moderate to severe hidradenitis suppurativa.

Idiopathic pulmonary fibrosis

The PBS subsidises nintedanib and pirfenidone for patients with idiopathic pulmonary fibrosis (IPF).

Idiopathic thrombocytopenic purpura

The PBS subsidises avatrombopag, eltrombopag and romiplostim for patients with severe chronic immune idiopathic thrombocytopenic purpura (ITP).

Leukaemia - acute lymphoblastic leukaemia

The PBS subsidises blinatumomab, dasatinib, imatinib, inotuzumab ozogamicin and ponatinib for patients with acute lymphoblastic leukaemia.

Leukaemia - acute myeloid leukaemia

The PBS subsidises azacitidine, daunorubicin+cytarabine, decitabine+cedazuridine and midostaurin for patients with acute myeloid leukaemia (AML).

Leukaemia - chronic lymphocytic leukaemia

The Pharmaceutical Benefits Scheme (PBS) subsidises idelalisib for patients with chronic lymphocytic leukaemia (CLL).

Leukaemia - chronic myeloid leukaemia

The PBS subsidises asciminib and ponatinib for patients with chronic myeloid leukaemia (CML).

Leukaemia - chronic myelomonocytic leukaemia

The PBS subsidises azacitidine and decitabine+cedazuridine for patients with chronic myelomonocytic leukaemia (CMML).

Lymphoma - T-cell lymphoma

The PBS subsidises brentuximab vedotin or vorinostat for patients with cutaneous T-cell lymphoma (CTCL), and brentuximab vedotin for patients with peripheral T-cell lymphoma (PTCL).

Lymphoma - Hodgkin lymphoma

The PBS subsidises brentuximab vedotin for patients with relapsed or refractory Hodgkin lymphoma.

Lymphoma - refractory follicular B-cell non-Hodgkin’s lymphoma

The Pharmaceutical Benefits Scheme (PBS) subsidises idelalisib for patients with refractory follicular B-cell non-Hodgkin’s lymphoma.

Lymphoma - small lymphocytic lymphoma

The Pharmaceutical Benefits Scheme (PBS) subsidises idelalisib for patients with small lymphocytic lymphoma (SLL).

Lymphoma - systemic anaplastic large cell lymphoma

The PBS subsidises brentuximab vedotin for patients with CD30 positive systemic anaplastic large cell lymphoma (sALCL).

Multiple myeloma

The PBS subsidises elotuzumab, lenalidomide, pomalidomide and selinexor for patients with multiple myeloma.

Myelodysplastic syndrome - lenalidomide

The PBS subsidises lenalidomide for patients with myelodysplastic syndrome.

Myelofibrosis

The PBS subsidises momelotinib and ruxolitinib for patients with myelofibrosis.

Narcolepsy

The PBS subsidises armodafinil and modafinil for patients with narcolepsy.

Neurofibromatosis type 1

The PBS subsidises selumetinib for patients with neurofibromatosis type 1.

Neuromyelitis optica spectrum disorder

The PBS subsidises ravulizumab for patients with neuromyelitis optica spectrum disorder (NMOSD).

Non-infectious uveitis

The PBS subsidises adalimumab for patients with non-infectious uveitis.

Non-radiographic axial spondyloarthritis

The PBS subsidises biological medicines for patients with non-radiographic axial spondyloarthritis.

Non-small cell lung cancer

The PBS subsidises crizotinib and entrectinib for patients with Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC).

Opioid treatment

The Pharmaceutical Benefits Scheme (PBS) subsidises medicines for patients who require short or long-term opioid treatment.

Paroxysmal nocturnal haemoglobinuria

The PBS subsidises eculizumab, pegcetacoplan and ravulizumab for patients with paroxysmal nocturnal haemoglobinuria (PNH).

Progressive fibrosing interstitial lung disease

The PBS subsidises nintedanib for patients with progressive fibrosing interstitial lung disease (PF-ILD).

Psoriasis - severe chronic plaque psoriasis

The PBS subsidises biological medicines for patients with severe chronic plaque psoriasis.

Pulmonary hypertension - chronic thromboembolic pulmonary hypertension

The PBS subsidises riociguat for patients with chronic thromboembolic pulmonary hypertension (CTEPH).

Pulmonary hypertension - arterial

The PBS subsidises a range of medicines for patients with pulmonary arterial hypertension (PAH).

Severe aplastic anaemia

The PBS subsidises eltrombopag for patients with severe aplastic anaemia.

Severe growth failure

The PBS subsidises mecasermin for patients with severe growth failure with primary insulin-like growth factor-1 deficiency (IGFD).

Short bowel syndrome

The PBS subsidises teduglutide for patients with type III short bowel syndrome with intestinal failure.

Solid tumours with confirmed NTRK gene fusion

The PBS subsidises larotrectinib for patients with solid tumours with confirmed neurotrophic tropomyosin receptor kinase (NTRK) gene fusion.

Spinal muscular atrophy

The PBS subsidises nusinersen, onasemnogene abeparvovec, and risdiplam for patients with spinal muscular atrophy (SMA).

Systemic light chain amyloidosis

The PBS subsidises daratumumab for patients with newly diagnosed systemic light chain amyloidosis.

Systemic lupus erythematosus

The PBS subsidises anifrolumab for patients with systemic lupus erythematosus (SLE).

Ulcerative colitis

The PBS subsidises biological medicines for patients with moderate to severe ulcerative colitis.

Severe chronic spontaneous urticaria

The PBS subsidises omalizumab for patients with severe chronic spontaneous urticaria.

X-linked hypophosphataemia

The PBS subsidises burosumab for patients with X-linked hypophosphataemia (XLH).

Authority approval for PBS medicines by condition

Eligibility Requirements

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