Psoriasis - severe chronic plaque psoriasis

The PBS subsidises biological agents for patients with severe chronic plaque psoriasis.

Patient eligibility

The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological agents under the National Health Act 1953, sections 85 and 100 for patients with severe chronic plaque psoriasis.

Where the term biological agent appears, it refers to:

  • adalimumab
  • etanercept
  • guselkumab
  • infliximab
  • ixekizumab
  • risankizumab
  • secukinumab
  • tildrakizumab
  • ustekinumab.

Patients must be eligible for the PBS and meet the relevant restriction criteria.

The Schedule of Pharmaceutical Benefits on the PBS website outlines restrictions for prescribing biological agents.

Section 100 arrangements

Infliximab

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.

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

Toxicity and severity descriptors

When demonstrating a patient’s intolerance to prior treatment, use the severe chronic plaque psoriasis toxicity and severity descriptors with the authority application.

Treatment specifics

To be eligible for PBS subsidised treatment with these biological agents, patients must be treated by a dermatologist with expertise in the management of severe chronic plaque psoriasis.

Applications

Initial treatment

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

All applications must include the completed:

Apply for authority approval to prescribe initial PBS subsidised etanercept to treat patients under 18 years of age with severe chronic plaque psoriasis in writing and either:

All applications must include the completed:

Initial grandfather treatment

For adult patients who received non-PBS subsidised guselkumab or tildrakizumab before 1 February 2019 or risankizumab before 1 December 2019 for severe chronic plaque psoriasis, apply for initial grandfather authority approval in writing and either:

All applications must include the completed:

Changing or recommencing treatment

Apply for authority approval to change or recommence PBS subsidised biological agents to treat adult patients with severe chronic plaque psoriasis in writing and either:

All applications must include the completed:

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

Continuing treatment

Apply for authority approval to continue PBS subsidised biological agents to treat adult patients with severe chronic plaque psoriasis in writing and either:

All applications must include the completed:

After we approve the first application for continuing treatment, subsequent continuing treatment with PBS subsidised biosimilar brands of biological agents are Authority Required (Streamlined). They don’t require authority approval from us for the listed quantity and repeats.

More information

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

Page last updated: 29 November 2019