Early HER2 positive breast cancer - initial PBS authority application form (PB289)

Use this form to apply for initial PBS subsidised treatment with trastuzumab emtansine for early HER2 positive breast cancer.

Download and complete the Early HER2 positive breast cancer initial PBS authority application form.

PBS is the Pharmaceutical Benefits Scheme.

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

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: 21 August 2020