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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 ankylosing spondylitis.
Where the term biological medicine appears it refers to:
- adalimumab
- bimekizumab
- certolizumab pegol
- etanercept
- golimumab
- infliximab
- ixekizumab
- secukinumab
- tofacitinib
- upadacitinib.
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.
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 managing ankylosing spondylitis.
Authority applications
Biosimilars
Applying for initial treatment
Applications for initial authority approval to prescribe PBS-subsidised biosimilar brands of biological medicines to treat ankylosing spondylitis can be made either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
Applying for change or recommencement of treatment
Applications to change or recommence authority approval to prescribe PBS-subsidised biosimilar brands of biological medicines to treat ankylosing spondylitis 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
Application for continuing PBS-subsidised treatment with biosimilar brands of biological medicines is Authority required (Streamlined). You don’t need authority approval from us for the listed quantities and repeats.
Originators
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 ankylosing spondylitis can be made:
- using the Online PBS Authorities system
- in writing and using HPOS Form upload
- in writing and mailed to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed ankylosing spondylitis - 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.
For patients who received non-PBS-subsidised bimekizumab treatment before 1 October 2024 for ankylosing spondylitis, applications for initial grandfather authority approval can be made:
- using the Online PBS Authorities system
- in writing and using HPOS form upload
- in writing and mailed to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed ankylosing spondylitis - bimekizumab - 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 ankylosing spondylitis can be made:
- using the Online PBS Authorities system
- in writing and using HPOS form upload
- in writing and mailed to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed ankylosing spondylitis - 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 ankylosing spondylitis can be made in:
- real time using the Online PBS Authorities system
- writing and using HPOS form upload
- writing and mailed to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed ankylosing spondylitis - 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.