Atypical haemolytic uraemic syndrome (aHUS) - eculizumab or ravulizumab - recommencement authority application form (PB176)

Use this form to apply to recommence PBS-subsidised treatment with eculizumab or ravulizumab for aHUS.

You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology or need an interpreter.

You can upload this form in HPOS.

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

Download and complete the atypical haemolytic uraemic syndrome (aHUS) - eculizumab or ravulizumab - recommencement authority application form.

Page last updated: 1 March 2026.
QC 34216