Patient eligibility
Treatment with riociguat can be subsidised through the Pharmaceutical Benefits Scheme (PBS) under the National Health Act 1953, Section 100 for patients with chronic thromboembolic pulmonary hypertension (CTEPH).
Patients must be eligible for the PBS and meet the restriction for prescribing riociguat.
The Schedule of Pharmaceutical Benefits outlines restrictions for prescribing riociguat.
Section 100 arrangements
This item is only available for day admitted patients, non-admitted patients, or patients on discharge who are attending:
- an approved private hospital
- a public participating hospital
- a public hospital.
This item is not PBS-subsidised for hospital in-patients. You must include the hospital name and provider number on the authority application form.
Demonstration of a response
The doctor should assess the patient's response to the initial 20 week course of treatment after the first 16 weeks of treatment. This allows sufficient time to demonstrate a response.
Patients who fail to respond to PBS-subsidised treatment with this agent must stop PBS-subsidised therapy with this agent.
Applications
All patients applying for riociguat treatment must be treated in a centre with expertise in the management of CTEPH.
Initial treatment
Make all initial applications for authority approval to prescribe PBS-subsidised riociguat for the treatment of CTEPH in writing and either:
- upload through Health Professional Online Services (HPOS)
- post to the PBS Complex Drugs Programs.
All applications must include the completed:
- authority prescription form(s)
- Chronic thromboembolic pulmonary hypertension Initial PBS authority application form
- relevant attachments.
Continuing treatment
Make all applications for continuing authority approval to prescribe PBS-subsidised riociguat for the treatment of CTEPH in writing and either:
- upload through HPOS
- post to the PBS Complex Drugs Programs.
All applications must include the completed:
- authority prescription form(s)
- Chronic thromboembolic pulmonary hypertension Continuing PBS authority application form
- relevant attachments.
Further information
For more information call the PBS Complex Drugs Programs enquiry line.