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Patient eligibility
The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological agents under the National Health Act 1953, section 85 and section 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 the 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.
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 severe chronic plaque psoriasis toxicity and severity descriptors with the authority application.
Treatment specifics
To be eligible for PBS subsidised treatment with a biological agent, patients must be treated by a dermatologist.
Authority applications for adult patients
Applying for initial treatment
Apply for initial authority approval to prescribe PBS subsidised biological agents to treat adult patients with severe chronic plaque psoriasis in writing and either:
- upload through Health Professional Online Services (HPOS)
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- severe chronic plaque psoriasis initial authority application form
- relevant attachments.
Applying for change or recommencement of 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:
- upload through HPOS
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- severe chronic plaque psoriasis change or recommencement or demonstration of response authority application form
- relevant attachments.
You can also use this authority application form 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 severe chronic plaque psoriasis in writing and either:
- upload through HPOS
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- severe chronic plaque psoriasis continuing authority application form
- relevant attachments.
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 need authority approval from us for listed quantity and repeats.
Authority applications for patients under 18 years of age
Applying for initial, change, recommencement, re-treatment, course completion or demonstration of response treatment
Apply for initial, change, recommencement, re-treatment (etanercept only), course completion (etanercept only) or demonstration of response (ustekinumab only) authority approval to prescribe PBS subsidised etanercept or ustekinumab to treat patients under 18 years with severe chronic plaque psoriasis in writing and either:
- upload through HPOS
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- Severe chronic plaque psoriasis - etanercept - for patients under 18 years initial, re-treatment, course completion, change or recommencing authority application form
- Severe chronic plaque psoriasis ustekinumab - for patients under 18 years initial, change, recommencement or demonstration of response authority application form
- relevant attachments.
You can also use this authority application form to submit a demonstration of response to the current PBS subsidised treatment.
Applying for initial grandfather treatment
For patients under 18 years who received non-PBS subsidised ustekinumab before 1 October 2021 for severe chronic plaque psoriasis, apply for initial grandfather authority approval in writing and either:
- upload through HPOS
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- Severe chronic plaque psoriasis ustekinumab - for patients under 18 years initial grandfather authority application
- relevant attachments.
Applying for continuing treatment
Apply for continuing authority approval to prescribe PBS subsidised ustekinumab to treat patients under 18 years with severe chronic plaque psoriasis in writing and either:
- upload through HPOS
- post to PBS Complex Drugs Programs.
All written applications must include the completed:
- authority prescription form or forms
- Severe chronic plaque psoriasis ustekinumab – for patients under 18 years continuing authority application
- relevant attachments.
More information
Call the PBS Complex Drugs Programs enquiry line for more information.