Severe asthma - adolescent and adult - initial or recommencement after 12 months break authority application form (PB075)

Use this form to apply for initial PBS-subsidised treatment with a biological medicine for patients 12 years or over with uncontrolled severe asthma.

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

You can upload this form in HPOS.

You can also use this form to apply to recommence PBS-subsidised treatment with a biological medicine in a new treatment cycle following a mandatory 12-month break.

Biological medicine refers to:

  • benralizumab
  • dupilumab
  • mepolizumab
  • omalizumab.

Please note: You don’t need to complete this form if you use the Online PBS Authorities system.

Download and complete the severe asthma - adolescent and adult - initial or recommencement after 12 months break authority application form.

Page last updated: 1 December 2025.
QC 20906