Psoriatic arthritis - initial grandfather PBS authority application form (PB184)

Use this form to apply for initial grandfather PBS subsidised treatment with ixekizumab or tofacitinib for an adult patient with psoriatic arthritis.

Download and complete the Psoriatic arthritis - initial grandfather PBS authority application form.

A rheumatologist or clinical immunologist with expertise in the management of psoriatic arthritis must be treating the patient.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

You can upload this form in HPOS.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.

Page last updated: 20 February 2020