Arthritis - juvenile idiopathic arthritis

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

Patient eligibility

The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological agents under the National Health Act 1953, section 85 and/or sections 100 for adult and paediatric patients with severe active juvenile idiopathic arthritis (JIA).

Where the term biological agent appears, it refers to adalimumab, etanercept and tocilizumab.

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 agents.

Section 100 arrangements

Tocilizumab i.v.

This item is only PBS subsidised for day admitted patients, non-admitted patients, or patients on discharge who are attending either:

  • an approved private hospital
  • a public participating hospital
  • a public hospital.

This item isn’t PBS subsidised for hospital in-patients. You must include the hospital name and provider number on the authority application form.

Toxicity and severity descriptors

When demonstrating a patient’s intolerance to prior treatment, use the juvenile idiopathic arthritis toxicity and severity descriptors with the authority application.

Treatment specifics

To be eligible for PBS subsidised treatment with biological agents for JIA, patients must be treated by one of the following specialists:

  • a paediatric rheumatologist or under the supervision of a paediatric rheumatology treatment centre - paediatric patients only
  • a rheumatologist or clinical immunologist with expertise in the management of rheumatoid arthritis - adult patients only, with a documented history of JIA.

Authority applications

Paediatric patients

Applying for initial treatment

Apply for initial authority approval to prescribe PBS subsidised biological agents to treat paediatric patients with JIA in writing and either:

All written applications must include the completed:

Applying for change or recommencement of treatment

Apply to change or recommence authority approval to prescribe PBS subsidised biological agents to treat paediatric patients with JIA in writing and either:

All written applications must include the completed:

Applying for continuing treatment

Apply for continuing authority approval to prescribe PBS subsidised biological agents to treat paediatric patients with JIA in writing and either:

All written applications must include the completed:

Adult patients

Applying for initial treatment

Apply for initial authority approval to prescribe PBS subsidised biological agents to treat adult patients with JIA in writing and either:

All written applications must include the completed:

Applying for change or recommencement of treatment

Apply to change or recommence authority approval to prescribe PBS subsidised biological agents to treat adult patients with JIA in writing and either:

All written applications must include the completed:

You can use these authority application forms to submit a demonstration of response to the current PBS subsidised treatment.

Applying for continuing treatment

Apply for continuing authority approval to prescribe PBS subsidised biological agents to treat adult patients with JIA in writing and either:

All written applications must include the completed:

Further information

Call the PBS Complex Drugs Programs enquiry line for further information.

Page last updated: 1 April 2021