Paroxysmal nocturnal haemoglobinuria - eculizumab or ravulizumab - initial, switching, returning or balance of supply authority application form (PB327)

Use this form to apply for initial, switching, returning or balance of supply PBS-subsidised treatment with eculizumab or ravulizumab for paroxysmal nocturnal haemoglobinuria.

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.

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

Download and complete the paroxysmal nocturnal haemoglobinuria - eculizumab or ravulizumab - initial, switching, returning or balance of supply authority application form.

Page last updated: 1 December 2025.
QC 62063