Pulmonary arterial hypertension - initial grandfather dual therapy authority application form (PB301)

Use this form to apply for initial grandfather PBS subsidised dual therapy PAH treatment.

You can apply for dual therapy PAH treatment with a phosphodiesterase-5 inhibitor with either:

  • an endothelin receptor antagonist (ERA)
  • a prostanoid.

Download and complete the Pulmonary arterial hypertension - initial grandfather dual therapy authority application form.

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: 1 March 2021