National Health Act 1953 - Declaration under subsection 85(2) (No. PB 39 of 2006) (Cth)
COMMONWEALTH OF AUSTRALIA
National Health Act 1953
PHARMACEUTICAL BENEFITS
DECLARATION UNDER SUBSECTION 85(2)
No. PB 39 of 2006
I, JOAN CORBETT, Assistant Secretary, Pharmaceutical Benefits Branch, Department of Health and Ageing and Delegate of the Minister for Health and Ageing, pursuant to subsection 85(2) of the National Health Act 1953, hereby make the following Declaration:
This declaration commences on 1 October 2006.
2. Declaration No. PB 31 of 2006 under subsection 85(2) of the National Health Act 1953 made on 26 July 2006 with effect from 1 August 2006 is repealed.
3. In this Declaration:
“Act” means the National Health Act 1953;
“base-priced drug” means —
(a) in relation to ranitidine hydrochloride (tablet, effervescent, equivalent to 150 mg ranitidine or syrup equivalent to 150 mg ranitidine per 10 mL, 300 mL): cimetidine or famotidine or nizatidine or ranitidine hydrochloride (tablet equivalent to 150 mg ranitidine or tablet equivalent to 300 mg ranitidine); or
(b) in relation to amlodipine besylate or lercanidipine hydrochloride or nifedipine (tablet 20 mg (controlled release)): felodipine or nifedipine (tablet 10 mg or tablet 20 mg or tablet 30 mg (controlled release) or tablet 60 mg (controlled release)); or
(c) in relation to ramipril: captopril or enalapril maleate or fosinopril sodium or lisinopril or perindopril arginine or perindopril erbumine or quinapril hydrochloride or trandolapril;
“electronic communication” has the meaning given by subsection 5(1) of the Electronic Transactions Act 1999;
“extemporaneously-prepared pharmaceutical benefit” means a pharmaceutical benefit other than a ready-prepared pharmaceutical benefit;
“Medicare Australia CEO” means the Chief Executive Officer of Medicare Australia;
“PBS” means Pharmaceutical Benefits Scheme;
“palliative care patient”, in relation to a circumstance specified in Schedule 1A, means a patient with an active, progressive, far-advanced disease, and for whom the prognosis is limited and the focus of care is the quality of life;
“ready-prepared pharmaceutical benefit” means a drug or medicinal preparation in respect of which there is in force a determination under subsection 85(6) of the Act;
“Regulations” means the National Health (Pharmaceutical Benefits) Regulations 1960 made under the Act.
Part VII of the Act applies in relation to each of the drugs and medicinal preparations the name of which is specified in column 1 of Schedule 1 or 1A and the circumstances (if any) specified in column 2 of Schedule 1 or 1A opposite the name of that drug or medicinal preparation apply when the drug or medicinal preparation is prescribed by a medical practitioner.
4A. Part VII of the Act applies in relation to each of the drugs and medicinal preparations the name of which is specified in column 1 of Schedule 2 and the circumstances (if any) specified in column 2 of Schedule 2 opposite the name of that drug or medicinal preparation apply when the drug or medicinal preparation is prescribed by a participating dental practitioner.
5. A medicinal preparation composed of a compound that includes a pharmaceutical benefit the name of which is specified in column 1 of Schedule 3, other than a compound the name of which is specified in column 2 of that Schedule opposite the name of that pharmaceutical benefit, is not a medicinal preparation to which Part VII of the Act applies, unless the name of that pharmaceutical benefit is also specified in Schedule 4, in which case the provisions of paragraphs 7 and 8 apply.
6. Part VII of the Act does not apply in relation to a medicinal preparation composed of a compound that includes a ready-prepared pharmaceutical benefit, other than a pharmaceutical benefit the name of which is specified in column 1 of Schedule 3.
7. Part VII of the Act applies in relation to medicinal preparations composed of one or more of the drugs or medicinal preparations the names of which are specified in Schedule 4.
8. Part VII of the Act applies in relation to medicinal preparations composed of one or more of the drugs or medicinal preparations the names of which are specified in Schedule 4 with the addition of one or more of the substances the names of which are specified in Schedule 5.
9. The substances the names of which are specified in Schedule 5 are additives for the purposes of paragraph 85(2)(b) of the Act.
10. Part VII of the Act applies in relation to each of the drugs and medicinal preparations the name of which is specified in Schedule 6.
11. The drugs and medicinal preparations the names of which are specified in Schedule 6 are additional pharmaceutical benefits made available under arrangements provided for by section 100 of the Act.
12. Where circumstances are specified in column 2 of Schedule 1, 1A, 2 or 4 opposite the name of a pharmaceutical benefit specified in column 1 of any of those Schedules, that pharmaceutical benefit is a relevant pharmaceutical benefit for the purposes of section 88A of the Act.
13. Where circumstances are specified in column 2 of Schedule 4 opposite the name of a pharmaceutical benefit specified in column 1 of that Schedule, those circumstances are also specified in relation to any medicinal preparation containing that pharmaceutical benefit.
14. Subject to paragraph 16, the following circumstances are specified in relation to each relevant pharmaceutical benefit for the purposes of section 88A of the Act:
(a) where a class of persons is specified in column 2 of Schedule 1, 1A, 2 or 4 — that the pharmaceutical benefit is to be supplied for the treatment of a person included in that class of persons;
(b) where a disease or condition is specified in column 2 of Schedule 1, 1A, 2 or 4 —
(i) if subsubparagraph (ii) does not apply — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in relation to any person; or
(ii) if the disease or condition is specified in relation to a specified class of persons — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in a person included in that class of persons;
(c) where a purpose is specified in column 2 of Schedule 1, 1A, 2 or 4 — that the pharmaceutical benefit is to be supplied for that purpose;
(d) where it is specified in column 2 of Schedule 1 or 1A that compliance with authority procedures set out in subparagraph 14(d) is required — that a medical practitioner has submitted to the Medicare Australia CEO a prescription for the supply of the pharmaceutical benefit:
(i)by preparing and signing the prescription:
(A) in a form approved by the Secretary and completed by the medical practitioner in ink in his or her own handwriting; or
(B) in a form, prepared by means of a computer, that is in accordance with the form approved by the Secretary under subsubsubparagraph (A); or
(C) in a form, prepared by means of a computer, approved in writing for the purpose by the Secretary and in the format approved in writing by the Secretary; or
(D) by a method approved in writing by the Secretary; or
(ii)by submitting the prescription by giving the Medicare Australia CEO, by telephone, details of the prescription which has been prepared and signed by the medical practitioner in accordance with subsubparagraph (i); or
(iii)where the medical practitioner has attempted to obtain an authorisation by submitting details of the prescription to the Medicare Australia CEO in accordance with subsubparagraph (ii) but has been unable to do so because of a failure or other form of unavailability in the telephone system established by the Medicare Australia CEO for the provision of such authorisations, by submitting the prescription in accordance with the instructions stipulated in an emergency telephone message provided to the medical practitioner by the Medicare Australia CEO; or
(iv)by submitting the prescription by giving the Medicare Australia CEO, by means of an electronic communication of a kind approved in writing by the Medicare Australia CEO, details of the prescription which has been prepared and signed by the medical practitioner in accordance with subsubparagraph (i).
14A. For the purposes of subsubparagraph 14(d)(i), a prescription that has been prepared and signed by the medical practitioner in accordance with that subparagraph is taken to have been submitted by him or her if it is submitted by one of his or her employees.
15. Subject to paragraph 15B, the authorisation of a prescription submitted under subparagraph 14(d) may be made:
(a) if the prescription was submitted in accordance with subsubparagraph 14(d)(i) — by the Medicare Australia CEO signing his or her authorisation of the prescription on it and:
(i) if the Medicare Australia CEO requires the medical practitioner to alter the prescription — by returning it to the medical practitioner for alteration before the medical practitioner gives it to the person in respect of whom it was prepared; or
(ii) in any other case:
(A) by returning it to the medical practitioner; or
(B) by sending it to the person in respect of whom it was prepared; or
(b) if the prescription was submitted in accordance with subsubparagraph 14(d)(ii) — orally, at the time the Medicare Australia CEO is given details of the prescription; or
(c) if the prescription was submitted in accordance with subsubparagraph 14(d)(iv) — by the Medicare Australia CEO sending his or her authorisation, by electronic communication, to the medical practitioner.
15A. If the Medicare Australia CEO authorises a prescription in accordance with subparagraph 15(b) or (c):
(a) the Medicare Australia CEO must tell the medical practitioner, orally or by electronic communication, the number that has been allotted to the authorised prescription; and
(b) the medical practitioner must:
(i) mark that number on the prescription; and
(ii) retain a copy of the prescription for 1 year from the date on which the prescription was authorised.
15B. Notwithstanding paragraph 15, if the prescription was submitted in accordance with subsubparagraph 14(d)(iii), authorisation shall be deemed to have been granted upon completion by the medical practitioner of the prescription in accordance with the instructions stipulated in the emergency telephone message provided to the medical practitioner by the Medicare Australia CEO.
16. Where the circumstances “For use in accordance with paragraph 16” are specified in column 2 of Schedule 1, the circumstances specified for the purpose of subparagraph 14(c) are:
(a) that the pharmaceutical benefit is to be supplied for the treatment, in conjunction with dietary therapy, of a patient identified as being in one of the following very high risk categories:
(i)coronary heart disease which has become symptomatic;
(ii)cerebrovascular disease which has become symptomatic;
(iii)peripheral vascular disease which has become symptomatic;
(iv)diabetes mellitus with microalbuminuria (defined as urinary albumin excretion rate of greater than 20 micrograms per minute, or urinary albumin to creatinine ratio of greater than 2.5 for males or greater than 3.5 for females);
(v)diabetes mellitus in Aboriginal or Torres Strait Islander patients;
(vi)diabetes mellitus in patients aged 60 years or more;
(vii)family history of coronary heart disease which has become symptomatic before the age of 55 years in two or more first degree relatives;
(viii)family history of coronary heart disease which has become symptomatic before the age of 45 years in one or more first degree relatives; or
(b) if subparagraph 16(a) does not apply—that the pharmaceutical benefit is to be supplied for the treatment, in conjunction with dietary therapy, of a patient who, after at least 6 weeks of dietary therapy, qualifies for the supply of the benefit in accordance with the following table:
Category of patient Fasting lipid level Patients with diabetes mellitus not otherwise included total cholesterol greater than 5.5 mmol per L Aboriginal or Torres Strait Islander patients;
Patients with hypertensiontotal cholesterol greater than 6.5 mmol per L;
or
total cholesterol greater than 5.5 mmol per L and high density lipoprotein cholesterol less than 1 mmol per LPatients with high density lipoprotein cholesterol less than 1 mmol per L total cholesterol greater than 6.5 mmol per L Patients with familial hypercholesterolaemia identified by:
(1) DNA mutation; or
(2) tendon xanthomas in the patient or their first or second degree relative
Patients with:
(1) family history of coronary heart disease which has become symptomatic before the age of 60 years in one or more first degree relatives; or
(2) family history of coronary heart disease which has become symptomatic before the age of 50 years in one or more second degree relatives
If aged 18 years or less at treatment initiation:
low density lipoprotein cholesterol greater than 4 mmol per L
If aged more than 18 years at treatment initiation:
low density lipoprotein cholesterol greater than 5 mmol per L;
or
total cholesterol greater than 6.5 mmol per L;
or
total cholesterol greater than 5.5 mmol per L and high density lipoprotein cholesterol less than 1 mmol per L
Patients not eligible under the above:
(1) men over 34 but less than 76 years of age;
(2) post-menopausal women less than 76 years of age
total cholesterol greater than 7.5 mmol per L;
or
triglyceride greater than 4 mmol per LPatients not otherwise included total cholesterol greater than 9 mmol per L;
or
triglyceride greater than 8 mmol per L
| Abciximab | In compliance with authority procedures set out in subparagraph 14 (d): |
| Patients undergoing percutaneous coronary balloon angioplasty | |
| Patients undergoing percutaneous coronary atherectomy | |
| Patients undergoing percutaneous coronary stent placement | |
| Acamprosate Calcium | In compliance with authority procedures set out in subparagraph 14 (d): |
| For use within a comprehensive treatment program for alcohol dependence with the goal of maintaining abstinence | |
| Acarbose | — |
| Acetazolamide | — |
| Acetylcysteine Sodium | Bronchiectasis |
| Cystic fibrosis | |
| Aciclovir | In respect of the eye ointment 30 mg per g, 4.5 g: |
| Herpes simplex keratitis | |
| In respect of the tablet 200 mg: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Moderate to severe initial genital herpes | |
| Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis | |
| In respect of the tablet 800 mg: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Treatment of patients with herpes zoster within 72 hours of the onset of the rash | |
| Herpes zoster ophthalmicus | |
| Patients with advanced human immunodeficiency virus disease (CD4 cell counts of less than 150 million per L) | |
| Acitretin | In compliance with authority procedures set out in subparagraph 14 (d): |
| Severe intractable psoriasis | |
| Severe forms of disorders of keratinisation | |
| Adalimumab | In compliance with authority procedures set out in subsubparagraph 14 (d)(i): |
| Initial treatment in a biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and: (a) (i) who have not previously received treatment with a bDMARD for this condition subsidised under the Pharmaceutical Benefits Scheme (PBS); or (ii) who, where the patient has previously received PBS-subsidised bDMARD treatment, have received no PBS-subsidised treatment with a bDMARD for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised bDMARD therapy was approved; and (b) who have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide alone or with leflunomide in combination with methotrexate or with cyclosporin alone, unless: (i) treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to that particular agent (or agents) only; or | |
| (ii) the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and (c) who have signed a patient acknowledgement form declaring that they understand and acknowledge that, within a single bDMARD treatment cycle, PBS-subsidised treatment with any bDMARD will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and where bDMARD means a drug included in the following list of drugs: adalimumab, anakinra, etanercept or infliximab; and where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: failure to achieve an adequate response to the treatment regimens specified at (b) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied; where the patient is exempted from demonstrating an inadequate response to a treatment regimen specified at (b) above on the basis of contraindication or intolerance, the authority application includes details of the contraindication or intolerance, including the degree of toxicity; the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form; a course of treatment is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment in a bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment or recommencement of treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who have received prior PBS-subsidised treatment with a bDMARD for this condition in this bDMARD treatment cycle and who are eligible to receive further bDMARD therapy within this treatment cycle; and where bDMARD means a drug included in the following list of drugs: adalimumab, anakinra, etanercept or infliximab; and where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle; patients are eligible to commence therapy with adalimumab within this bDMARD treatment cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this treatment cycle, and provided they also meet the conditions applying to recommencement of adalimumab therapy specified below, if applicable; patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with adalimumab within this bDMARD treatment cycle are eligible to recommence therapy with this drug within this same cycle if: (i) they have demonstrated an adequate response to their most recent course of PBS-subsidised adalimumab treatment; and (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and (iii) the response was assessed following a minimum of 12 weeks of therapy when the most recent course of PBS-subsidised treatment was an initial 16 week course; and (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment; an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form and, where this is required, evidence of the patient's response to their most recent course of adalimumab therapy; a course of treatment is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment, or of a course which recommences treatment, within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Commencement of adalimumab treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with adalimumab prior to 1 November 2004, who failed to qualify for PBS-subsidised therapy after 1 May 2004 due to an inability to receive concomitant methotrexate, and who have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab detailed below; and where bDMARD means a drug included in the following list of drugs: adalimumab, anakinra, etanercept or infliximab; and where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient; the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| Commencement of adalimumab treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with adalimumab prior to 1 March 2005, who failed to qualify for PBS-subsidised therapy after 1 May 2004 due to testing negative for rheumatoid factor, and who have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab detailed below; and where bDMARD means a drug included in the following list of drugs: where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and | |
| where the following conditions apply: the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient; the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| Continuing treatment within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and: (a) who have demonstrated an adequate response to treatment with adalimumab; and (b) whose most recent course of bDMARD treatment subsidised under the Pharmaceutical Benefits Scheme (PBS) in this bDMARD treatment cycle was with adalimumab; and where bDMARD means a drug included in the following list of drugs: where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle; an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response; the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course; if the most recent course of adalimumab therapy was an initial 16 week course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course; a course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuing treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who: (1) have severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and (2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and (3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with either methotrexate or sulfasalazine, at an adequate dose, for a minimum of 3 months; and (4) have had the psoriatic component of their disease confirmed by a dermatologist or by biopsy at any time; and (5) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and where biological agent means adalimumab or etanercept or infliximab; and where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); | |
| if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied; if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication; if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity; the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form; a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment, or recommencement of treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who: (1) have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and (2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and (3) have not failed treatment with adalimumab during the current Treatment Cycle; and where biological agent means adalimumab or etanercept or infliximab; and where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle; |
| patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with adalimumab within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if: (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with adalimumab, to their most recent course of PBS-subsidised adalimumab treatment; and (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment; the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form; a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of adalimumab for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who: (1) have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and (2) were receiving treatment with adalimumab prior to 16 March 2006; and (3) have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab; and (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and where biological agent means adalimumab or etanercept or infliximab; and | |
| where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and | |
| where the following conditions apply: the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgment form; the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight; patients are eligible for PBS-subsidised treatment under the above criteria once only | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults: (1) who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status; and (2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with adalimumab; and (3) who, at the time of application, demonstrate an adequate response to treatment with adalimumab; and where biological agent means adalimumab or etanercept or infliximab; and where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response; | |
| the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course; if the most recent course of adalimumab therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course; a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight | |
| Adrenaline | In compliance with authority procedures set out in subparagraph 14 (d): |
| Initial supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient who has been assessed to be at significant risk of anaphylaxis by, or in consultation with, a clinical immunologist, allergist, paediatrician or respiratory physician, where the name of the specialist consulted is included in the authority application | |
| Initial supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient who has been discharged from hospital or an emergency department after treatment with adrenaline for acute allergic reaction with anaphylaxis | |
| Continuing supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis, where the patient has previously been issued with an authority prescription for this drug | |
| Adrenaline Acid Tartrate | — |
| Albendazole | In respect of the tablet 200 mg: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Treatment of tapeworm infestation | |
| In respect of the tablet 400 mg: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| For the treatment of hydatid disease in conjunction with surgery or when a surgical cure cannot be achieved or where surgery cannot be used | |
| Alendronate Sodium | In respect of the tablet equivalent to 70 mg alendronic acid: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Initial treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in patients with fracture due to minimal trauma, where the fracture has been demonstrated radiologically and the year of plain x-ray or computed tomography scan or magnetic resonance imaging scan is included in the authority application, provided that if the fracture is a vertebral fracture, there is a 20% or greater reduction in height of the anterior or mid portion of the affected vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body | |
| Continuing treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in patients with fracture due to minimal trauma, where the patient has previously been issued with an authority prescription for this drug | |
| In respect of the tablet equivalent to 40 mg alendronic acid: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Symptomatic Paget's disease of bone | |
| Alendronate Sodium with Colecalciferol | In compliance with authority procedures set out in subparagraph 14 (d): |
| Initial treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in patients with fracture due to minimal trauma, where the fracture has been demonstrated radiologically and the year of plain x-ray or computed tomography scan or magnetic resonance imaging scan is included in the authority application, provided that if the fracture is a vertebral fracture, there is a 20% or greater reduction in height of the anterior or mid portion of the affected vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body | |
| Continuing treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in patients with fracture due to minimal trauma, where the patient has previously been issued with an authority prescription for this drug | |
| "Alfaré" | In compliance with authority procedures set out in subparagraph 14 (d): |
| Initial treatment, for up to 3 months, for intolerance (not infant colic) to both cows' milk protein and soy protein in children up to the age of 2 years, where intolerance is demonstrated when the child has failed to respond to a strict cows' milk protein free diet with a soy protein as the principal formula, and where the date of birth of the patient is included in the authority application | |
| Continuing treatment for intolerance (not infant colic) to both cows' milk protein and soy protein in children up to the age of 2 years, where clinical improvement has been demonstrated with the protein hydrolysate formula with medium chain triglycerides, and where the date of birth of the patient is included in the authority application | |
| Continuing treatment for intolerance (not infant colic) to both cows' milk protein and soy protein in children aged 2 years and over, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application | |
| Biliary atresia | |
| Chronic liver failure with fat malabsorption | |
| Chylous ascites | |
| Chylothorax | |
| Cystic fibrosis | |
| Enterokinase deficiency | |
| Proven fat malabsorption | |
| Severe diarrhoea of greater than 2 weeks' duration in infants under the age of 4 months, where the date of birth of the patient is included in the authority application | |
| Severe intestinal malabsorption including short bowel syndrome | |
| Allopurinol | — |
| Alprazolam | In compliance with authority procedures set out in subparagraph 14 (d): |
| Panic disorder where other treatments have failed or are inappropriate | |
| Aluminium Hydroxide - Dried with Magnesium Hydroxide | — |
| Aluminium Hydroxide - Dried with Magnesium Trisilicate and Magnesium Hydroxide | — |
| Amantadine Hydrochloride | Parkinson's disease which is not drug induced |
| Amiloride Hydrochloride | — |
| Aminoglutethimide | — |
| Amiodarone Hydrochloride | Severe cardiac arrhythmias |
| Amisulpride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Schizophrenia | |
| Amitriptyline Hydrochloride | — |
| Amlodipine Besylate | — |
| Amoxycillin Trihydrate | In respect of the tablet, chewable, equivalent to 250 mg amoxycillin, capsule equivalent to 250 mg amoxycillin, capsule equivalent to 500 mg amoxycillin and sachet containing oral powder equivalent to 3 g amoxycillin: |
| — | |
| In respect of the tablet equivalent to 1 g amoxycillin: | |
| Acute exacerbations of chronic bronchitis | |
| Amoxycillin Trihydrate with Potassium Clavulanate | Infections where resistance to amoxycillin trihydrate is suspected |
| Infections where resistance to amoxycillin trihydrate is proven | |
| Amoxycillin Trihydrate with Potassium Clavulanate and Water - Purified BP | Infections where resistance to amoxycillin trihydrate is suspected |
| Infections where resistance to amoxycillin trihydrate is proven | |
| Amoxycillin Trihydrate with Water - Purified BP | — |
| Amphotericin | — |
| Ampicillin Sodium | — |
| Ampicillin Trihydrate | — |
| Anakinra | In compliance with authority procedures set out in subsubparagraph 14 (d)(i): |
| Initial treatment in a biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and: (a) (i) who have not previously received treatment with a bDMARD for this condition subsidised under the Pharmaceutical Benefits Scheme (PBS); or (ii) who, where the patient has previously received PBS-subsidised bDMARD treatment, have received no PBS-subsidised treatment with a bDMARD for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised bDMARD therapy was approved; and (b) who have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide alone or with leflunomide in combination with methotrexate or with cyclosporin alone, unless: (i) treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to that particular agent (or agents) only; or (ii) the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and (c) who have signed a patient acknowledgement form declaring that they understand and acknowledge that, within a single bDMARD treatment cycle, PBS-subsidised treatment with any bDMARD will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and where bDMARD means a drug included in the following list of drugs: where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly; | |
| failure to achieve an adequate response to the treatment regimens specified at (b) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied; where the patient is exempted from demonstrating an inadequate response to a treatment regimen specified at (b) above on the basis of contraindication or intolerance, the authority application includes details of the contraindication or intolerance, including the degree of toxicity; the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgement form; a course of treatment is limited to a maximum of 16 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment in a bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who are receiving concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment or recommencement of treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who have received prior PBS-subsidised treatment with a bDMARD for this condition in this bDMARD treatment cycle and who are eligible to receive further bDMARD therapy within this treatment cycle; and where bDMARD means a drug included in the following list of drugs: where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly; | |
| patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle; patients are eligible to commence therapy with anakinra within this bDMARD treatment cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this treatment cycle, and provided they also meet the conditions applying to recommencement of anakinra therapy specified below, if applicable; unless this treatment cycle is the patient's first bDMARD treatment cycle and the patient has failed to demonstrate a response to PBS-subsidised treatment with adalimumab, etanercept and infliximab commenced prior to 1 December 2004, in which case the patient is eligible to commence therapy with anakinra in this first treatment cycle, despite having previously failed to respond to 3 bDMARDs; patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with anakinra within this bDMARD treatment cycle are eligible to recommence therapy with this drug within this same cycle if: (i) they have demonstrated an adequate response to their most recent course of PBS-subsidised anakinra treatment; and (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and (iii) the response was assessed following a minimum of 12 weeks of therapy when the most recent course of PBS-subsidised treatment was an initial 16 week course; and (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment; an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form and, where this is required, evidence of the patient's response to their most recent course of anakinra therapy; a course of treatment is limited to a maximum of 16 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment, or of a course which recommences treatment, within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who are receiving concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Commencement of anakinra treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with anakinra prior to 1 July 2004 and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with anakinra detailed below; and where bDMARD means a drug included in the following list of drugs: where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly; the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient; the course of treatment is limited to a maximum of 24 weeks of treatment | |
| Commencement of anakinra treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with anakinra prior to 1 March 2005, who failed to qualify for PBS-subsidised therapy after 1 December 2004 due to testing negative for rheumatoid factor, and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with anakinra detailed below; and where bDMARD means a drug included in the following list of drugs: where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly; the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient; the course of treatment is limited to a maximum of 24 weeks of treatment | |
| Continuing treatment within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and: (a) who have demonstrated an adequate response to treatment with anakinra; and (b) whose most recent course of bDMARD treatment subsidised under the Pharmaceutical Benefits Scheme (PBS) in this bDMARD treatment cycle was with anakinra; and where bDMARD means a drug included in the following list of drugs: where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly; patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle; if this treatment cycle is the patient's first bDMARD treatment cycle and the patient has failed to demonstrate a response to PBS-subsidised treatment with adalimumab, etanercept and infliximab commenced prior to 1 December 2004, the patient is eligible to continue PBS-subsidised therapy with anakinra in this first treatment cycle, despite having previously failed to respond to 3 bDMARDs; an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%: — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response; the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with anakinra, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course; if the most recent course of anakinra therapy was an initial 16 week course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course; a course of treatment is limited to a maximum of 24 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuing treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who are receiving concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total | |
| Anastrozole | Treatment of hormone-dependent breast cancer in post-menopausal women |
| Apraclonidine Hydrochloride | Short-term reduction of intra-ocular pressure in patients already on maximally tolerated anti-glaucoma therapy |
| Aprepitant | In compliance with authority procedures set out in subparagraph 14 (d): |
| Management of nausea and vomiting associated with cytotoxic chemotherapy being used to treat malignancy, when aprepitant is used in combination with a 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone, where treatment with aprepitant is limited to an initial dose of 125 mg and 2 subsequent doses of 80 mg per cycle of cytotoxic chemotherapy, and where the cytotoxic chemotherapy to be administered to the patient includes any of the following agents: altretamine; carmustine; cisplatin, when a single dose constitutes a cycle of chemotherapy; cyclophosphamide, at a dose of 1500 mg per square metre per day or greater; dacarbazine; procarbazine, when a single dose constitutes a cycle of chemotherapy; streptozocin | |
| Management of nausea and vomiting associated with cytotoxic chemotherapy being used to treat breast cancer where cyclophosphamide and an anthracycline are to be co-administered, when aprepitant is used in combination with a 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone, and where treatment with aprepitant is limited to an initial dose of 125 mg and 2 subsequent doses of 80 mg per cycle of cytotoxic chemotherapy | |
| Aripiprazole | In compliance with authority procedures set out in subparagraph 14 (d): |
| Schizophrenia | |
| Aspirin | — |
| Atenolol | — |
| Atorvastatin Calcium | For use in accordance with paragraph 16 |
| Atovaquone | In compliance with authority procedures set out in subparagraph 14 (d): |
| Treatment of mild to moderate Pneumocystis carinii pneumonia in adult patients who are intolerant of trimethoprim with sulfamethoxazole therapy | |
| Atropine Sulfate | — |
| Auranofin | — |
| Azathioprine | — |
| Azithromycin Dihydrate | Uncomplicated urethritis due to Chlamydia trachomatis |
| Uncomplicated cervicitis due to Chlamydia trachomatis | |
| Trachoma | |
| Azithromycin Dihydrate with Water - Purified BP | Trachoma |
| Baclofen | — |
| Balsalazide Sodium | In compliance with authority procedures set out in subparagraph 14 (d): |
| Ulcerative colitis where hypersensitivity to sulfonamides exists | |
| Ulcerative colitis where intolerance to sulfasalazine exists | |
| "BCG Immunotherapeutic" (Bacillus Calmette-Guérin/ Connaught strain) | Treatment of carcinoma in situ of the urinary bladder |
| "BCG-Tice" (Bacillus Calmette-Guérin/ Tice strain) | Primary and relapsing superficial urothelial carcinoma of the bladder |
| Beclomethasone Dipropionate | In respect of the pressurised inhalation 50 micrograms per dose, 200 doses (CFC-free formulation) and pressurised inhalation 100 micrograms per dose, 200 doses (CFC-free formulation): |
| — | |
| In respect of the pressurised inhalation in breath actuated device 50 micrograms per dose, 200 doses (CFC-free formulation) and pressurised inhalation in breath actuated device 100 micrograms per dose, 200 doses (CFC-free formulation): | |
| Patients unable to achieve co-ordinated use of other metered dose inhalers containing this drug | |
| Benzathine Penicillin | — |
| Benzhexol Hydrochloride | — |
| Benztropine Mesylate | — |
| Benzydamine Hydrochloride | Radiation induced mucositis |
| Benzyl Benzoate | — |
| Benzylpenicillin Sodium | — |
| Betamethasone Acetate with Betamethasone Sodium Phosphate | Alopecia areata |
| For local intra-articular or peri-articular infiltration | |
| Granulomata, dermal | |
| Keloid | |
| Lichen planus hypertrophic | |
| Lichen simplex chronicus | |
| Lupus erythematosus, chronic discoid | |
| Necrobiosis lipoidica | |
| Uveitis | |
| Betamethasone Dipropionate | Treatment of corticosteroid-responsive dermatoses |
| Betamethasone Valerate | Treatment of corticosteroid-responsive dermatoses |
| Betaxolol Hydrochloride | — |
| Bethanechol Chloride | — |
| Bicalutamide | In compliance with authority procedures set out in subparagraph 14 (d): |
| Metastatic (equivalent to stage D) prostatic carcinoma, when used in combination with gonadotrophin-releasing hormone (luteinising hormone-releasing hormone) agonist therapy | |
| Bifonazole | In compliance with authority procedures set out in subparagraph 14 (d): |
| Treatment of a fungal or a yeast infection in an Aboriginal or a Torres Strait Islander person | |
| Bimatoprost | — |
| Biperiden Hydrochloride | — |
| Bisacodyl | Paraplegic and quadriplegic patients and others with severe neurogenic impairment of bowel function |
| Patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities | |
| For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult | |
| Patients receiving palliative care | |
| Terminal malignant neoplasia | |
| Anorectal congenital abnormalities | |
| Megacolon | |
| Bisoprolol Fumarate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Bivalirudin Trifluoroacetate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Patients undergoing non-emergency percutaneous coronary intervention | |
| Bleomycin Sulfate | Germ cell neoplasms |
| Lymphoma | |
| Brimonidine Tartrate | — |
| Brimonidine Tartrate with Timolol Maleate | Reduction of elevated intra-ocular pressure in patients with open-angle glaucoma who are not adequately controlled with timolol maleate eye drops equivalent to 5 mg timolol per mL |
| Reduction of elevated intra-ocular pressure in patients with ocular hypertension who are not adequately controlled with timolol maleate eye drops equivalent to 5 mg timolol per mL | |
| Brinzolamide | — |
| Bromocriptine Mesylate | In respect of the tablet equivalent to 2.5 mg bromocriptine: |
| Prevention of the onset of lactation in the puerperium for medical reasons | |
| Acromegaly | |
| Parkinson's disease | |
| Pathological hyperprolactinaemia where surgery is not indicated | |
| Pathological hyperprolactinaemia where surgery has already been used with incomplete resolution | |
| Pathological hyperprolactinaemia where radiotherapy is not indicated | |
| Pathological hyperprolactinaemia where radiotherapy has already been used with incomplete resolution | |
| In respect of the capsule equivalent to 5 mg bromocriptine and capsule equivalent to 10 mg bromocriptine: | |
| Acromegaly | |
| Parkinson's disease | |
| Pathological hyperprolactinaemia where surgery is not indicated | |
| Pathological hyperprolactinaemia where surgery has already been used with incomplete resolution | |
| Pathological hyperprolactinaemia where radiotherapy is not indicated | |
| Pathological hyperprolactinaemia where radiotherapy has already been used with incomplete resolution | |
| Budesonide | In respect of the powder for oral inhalation in breath actuated device 100 micrograms per dose, 200 doses, powder for oral inhalation in breath actuated device 200 micrograms per dose, 200 doses and powder for oral inhalation in breath actuated device 400 micrograms per dose, 200 doses: |
| — | |
| In respect of the nebuliser suspension 500 micrograms in 2 mL single dose units, 30 and nebuliser suspension 1 mg in 2 mL single dose units, 30: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Severe chronic asthma in patients who require long-term steroid therapy and who are unable to use other forms of inhaled steroid therapy | |
| Budesonide with Eformoterol Fumarate Dihydrate | Patients who previously had frequent episodes of asthma while receiving treatment with oral corticosteroids and who have been stabilised on concomitant inhaled eformoterol fumarate dihydrate and budesonide |
| Patients who previously had frequent episodes of asthma while receiving treatment with optimal doses of inhaled corticosteroids and who have been stabilised on concomitant inhaled eformoterol fumarate dihydrate and budesonide | |
| Buprenorphine | Chronic severe disabling pain not responding to non-narcotic analgesics |
| Bupropion Hydrochloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Commencement of treatment as short-term adjunctive therapy for nicotine dependence to facilitate the goal of achieving abstinence in patients who have indicated that they are ready to cease smoking and who have entered a comprehensive support and counselling program, and where details of the program are specified in the authority application | |
| Commencement of treatment as short-term adjunctive therapy for nicotine dependence to facilitate the goal of achieving abstinence in patients who have indicated that they are ready to cease smoking and who are entering a comprehensive support and counselling program during the same consultation at which the authority application is made, and where details of the program are specified in the authority application | |
| Completion of treatment as short-term adjunctive therapy for nicotine dependence to facilitate the goal of achieving abstinence in patients who have indicated that they are ready to cease smoking and who have entered a comprehensive support and counselling program, and where the patient has previously been issued with an authority prescription for commencement of treatment with this drug | |
| Busulfan | — |
| Cabergoline | In respect of the tablet 500 micrograms: |
| Prevention of the onset of lactation in the puerperium for medical reasons | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Pathological hyperprolactinaemia where surgery is not indicated | |
| Pathological hyperprolactinaemia where surgery has already been used with incomplete resolution | |
| Pathological hyperprolactinaemia where radiotherapy is not indicated | |
| Pathological hyperprolactinaemia where radiotherapy has already been used with incomplete resolution | |
| In respect of the tablet 1 mg, tablet 2 mg and tablet 4 mg: | |
| Parkinson's disease | |
| Calcipotriol | Chronic stable plaque type psoriasis vulgaris |
| Calcitriol | In compliance with authority procedures set out in subparagraph 14 (d): |
| Hypocalcaemia due to renal disease | |
| Hypoparathyroidism | |
| Hypophosphataemic rickets | |
| Vitamin D-resistant rickets | |
| Initial treatment for established osteoporosis in patients with fracture due to minimal trauma, where the fracture has been demonstrated radiologically and the year of plain x-ray or computed tomography scan or magnetic resonance imaging scan is included in the authority application, provided that if the fracture is a vertebral fracture, there is a 20% or greater reduction in height of the anterior or mid portion of the affected vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body | |
| Continuing treatment for established osteoporosis in patients with fracture due to minimal trauma, where the patient has previously been issued with an authority prescription for this drug | |
| Calcium Carbonate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Hyperphosphataemia associated with chronic renal failure | |
| Calcium Citrate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Hyperphosphataemia associated with chronic renal failure | |
| Calcium Folinate | In respect of the injection equivalent to 50 mg folinic acid in 5 mL and injection equivalent to 100 mg folinic acid in 10 mL: |
| — | |
| In respect of the tablet equivalent to 15 mg folinic acid: | |
| Antidote to folic acid antagonists | |
| Candesartan Cilexetil | — |
| Candesartan Cilexetil with Hydrochlorothiazide | Hypertension in patients who are not adequately controlled with 16 mg candesartan cilexetil |
| Capecitabine | In compliance with authority procedures set out in subparagraph 14 (d): |
| Advanced breast cancer after failure of prior therapy which includes a taxane and an anthracycline | |
| Advanced breast cancer where therapy with a taxane or an anthracycline is contraindicated | |
| Advanced breast cancer in combination with docetaxel after failure of prior anthracycline-containing chemotherapy | |
| Treatment of advanced or metastatic colorectal cancer | |
| Adjuvant treatment of stage III (Dukes C) colon cancer, following complete resection of the primary tumour | |
| "Caprilon" | Chylous ascites |
| Chylothorax | |
| Fat malabsorption due to liver disease, short gut syndrome, cystic fibrosis or gastrointestinal disorders | |
| Captopril | In respect of the tablet 12.5 mg, tablet 25 mg and tablet 50 mg: |
| — | |
| In respect of the oral solution 5 mg per mL, 95 mL: | |
| For patients unable to take a solid dose form of an angiotensin-converting enzyme inhibitor | |
| Carbamazepine | — |
| Carbimazole | — |
| "Carbohydrate Free Mixture" | Patients with intractable seizures requiring treatment with a ketogenic diet |
| Glucose transport protein defects | |
| Pyruvate dehydrogenase deficiency | |
| Infants and young children with glucose-galactose intolerance and multiple monosaccharide intolerance | |
| Carbomer 974 | In compliance with authority procedures set out in subparagraph 14 (d): |
| Severe dry eye syndrome in patients who are sensitive to preservatives in multi-dose eye drops | |
| Carbomer 980 | In respect of the ocular lubricating gel 2 mg per g, 10 g: |
| Severe dry eye syndrome, including Sjogren's syndrome | |
| In respect of the eye drops 2 mg per g, single dose units 0.6 mL, 30: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Severe dry eye syndrome in patients who are sensitive to preservatives in multi-dose eye drops | |
| Carboplatin | — |
| Carmellose Sodium | In respect of the eye drops 5 mg per mL, 15 mL and eye drops 10 mg per mL, 15 mL: |
| Severe dry eye syndrome, including Sjogren's syndrome | |
| In respect of the eye drops 2.5 mg per mL, single dose units 0.6 mL, 24, eye drops 5 mg per mL, single dose units 0.4 mL, 30, eye drops 10 mg per mL, single dose units 0.4 mL, 30 and ocular lubricating gel 10 mg per mL, single dose units 0.6 mL, 28: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Severe dry eye syndrome in patients who are sensitive to preservatives in multi-dose eye drops | |
| Carmustine | Newly-diagnosed glioblastoma multiforme as an adjunct to surgery and radiation |
| Carvedilol | In respect of the pack containing 30 tablets 3.125 mg, 30 tablets 6.25 mg and 10 tablets 12.5 mg: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Moderate to severe heart failure in patients stabilised on conventional therapy which must include an angiotensin-converting enzyme inhibitor if tolerated | |
| In respect of the tablet 3.125 mg, tablet 6.25 mg, tablet 12.5 mg and tablet 25 mg: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Moderate to severe heart failure in patients stabilised on conventional therapy which must include an angiotensin-converting enzyme inhibitor if tolerated | |
| Patients receiving this drug as a pharmaceutical benefit prior to 1 August 2002 | |
| Cefaclor Monohydrate | — |
| Cefaclor Monohydrate with Water - Purified BP | — |
| Cefepime Hydrochloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Treatment of febrile neutropenia | |
| Cefotaxime Sodium | Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent |
| Septicaemia, suspected | |
| Septicaemia, proven | |
| Ceftriaxone Sodium | In respect of the powder for injection equivalent to 250 mg ceftriaxone: |
| Gonorrhoea | |
| Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent | |
| Septicaemia, suspected | |
| Septicaemia, proven | |
| In respect of the powder for injection equivalent to 500 mg ceftriaxone, powder for injection equivalent to 1 g ceftriaxone and powder for injection equivalent to 2 g ceftriaxone: | |
| Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent | |
| Septicaemia, suspected | |
| Septicaemia, proven | |
| Cefuroxime Axetil | — |
| Celecoxib | Symptomatic treatment of osteoarthritis |
| Symptomatic treatment of rheumatoid arthritis | |
| Cephalexin | — |
| Cephalexin with Water - Purified BP | — |
| Cephalothin Sodium | — |
| Cephazolin Sodium | Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent |
| Septicaemia, suspected | |
| Septicaemia, proven | |
| Chlorambucil | — |
| Chloramphenicol | — |
| Chlorpromazine Hydrochloride | — |
| Chlorthalidone | — |
| Cholestyramine | — |
| Chorionic Gonadotrophin | In respect of the injection set containing 3 ampoules powder for injection 500 units and 3 ampoules solvent 1 mL: |
| Anovulatory infertility | |
| For the treatment of infertility in males due to hypogonadotrophic hypogonadism | |
| For the treatment of infertility in males associated with isolated luteinising hormone deficiency | |
| For the treatment of males who have combined deficiency of human growth hormone and gonadotrophins and in whom the absence of secondary sexual characteristics indicates a lag in maturation | |
| For the treatment, for a period not exceeding 6 months, of males over the age of 16 years who show clinical evidence of hypogonadism or delayed puberty | |
| Cryptorchism not due to organic obstruction in boys over 12 months of age | |
| In respect of the injection set containing 3 ampoules powder for injection 1,500 units and 3 ampoules solvent 1 mL: | |
| Anovulatory infertility | |
| For the treatment of infertility in males due to hypogonadotrophic hypogonadism | |
| For the treatment of infertility in males associated with isolated luteinising hormone deficiency | |
| For the treatment of males who have combined deficiency of human growth hormone and gonadotrophins and in whom the absence of secondary sexual characteristics indicates a lag in maturation | |
| For the treatment, for a period not exceeding 6 months, of males over the age of 16 years who show clinical evidence of hypogonadism or delayed puberty | |
| Ciclesonide | — |
| Cimetidine | — |
| Ciprofloxacin Hydrochloride | In respect of the tablet equivalent to 250 mg ciprofloxacin: |
| Gonorrhoea | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Respiratory tract infection proven or suspected to be caused by Pseudomonas aeruginosa in severely immunocompromised patients | |
| Bacterial gastroenteritis in severely immunocompromised patients | |
| Treatment of infections proven to be due to Pseudomonas aeruginosa or other gram-negative bacteria resistant to all other oral antimicrobials | |
| Treatment of joint and bone infections, epididymo-orchitis, prostatitis or perichondritis of the pinna, suspected or proven to be caused by gram-negative bacteria or gram-positive bacteria resistant to all other appropriate antimicrobials | |
| In respect of the tablet equivalent to 500 mg ciprofloxacin and tablet equivalent to 750 mg ciprofloxacin: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Respiratory tract infection proven or suspected to be caused by Pseudomonas aeruginosa in severely immunocompromised patients | |
| Bacterial gastroenteritis in severely immunocompromised patients | |
| Treatment of infections proven to be due to Pseudomonas aeruginosa or other gram-negative bacteria resistant to all other oral antimicrobials | |
| Treatment of joint and bone infections, epididymo-orchitis, prostatitis or perichondritis of the pinna, suspected or proven to be caused by gram-negative bacteria or gram-positive bacteria resistant to all other appropriate antimicrobials | |
| In respect of the eye drops equivalent to 3 mg ciprofloxacin per mL, 5 mL: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Bacterial keratitis | |
| Cisplatin | — |
| Citalopram Hydrobromide | Major depressive disorders |
| Cladribine | In compliance with authority procedures set out in subparagraph 14 (d): |
| Hairy cell leukaemia | |
| Clarithromycin | — |
| Clindamycin Hydrochloride | Gram-positive coccal infections where these cannot be safely and effectively treated with a penicillin |
| Clomiphene Citrate | Anovulatory infertility |
| Patients undergoing in-vitro fertilisation | |
| Clomipramine Hydrochloride | Cataplexy associated with narcolepsy |
| Obsessive-compulsive disorder | |
| Phobic disorders in adults | |
| Clonazepam | In respect of the injection 1 mg in 2 mL (set containing solution 1 mg in 1 mL and 1 mL diluent): |
| Epilepsy | |
| In respect of the tablet 500 micrograms, tablet 2 mg and oral liquid 2.5 mg per mL, 10 mL: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Neurologically proven epilepsy | |
| Clonidine Hydrochloride | — |
| Clopidogrel Hydrogen Sulfate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Prevention of recurrence of ischaemic stroke or transient cerebral ischaemic events: | |
| in patients with a history of symptomatic cerebrovascular ischaemic episodes while on therapy with low-dose aspirin | |
| in patients where low-dose aspirin poses an unacceptable risk of gastrointestinal bleeding | |
| in patients where there is a history of anaphylaxis, urticaria or asthma within 4 hours of ingestion of aspirin, other salicylates, or non-steroidal anti-inflammatory drugs | |
| Prevention of recurrence of myocardial infarction or unstable angina: | |
| in patients with a history of symptomatic cardiac ischaemic events while on therapy with low-dose aspirin | |
| in patients where low-dose aspirin poses an unacceptable risk of gastrointestinal bleeding | |
| in patients where there is a history of anaphylaxis, urticaria or asthma within 4 hours of ingestion of aspirin, other salicylates, or non-steroidal anti-inflammatory drugs | |
| Clotrimazole | In compliance with authority procedures set out in subparagraph 14 (d): |
| Treatment of a fungal or a yeast infection in an Aboriginal or a Torres Strait Islander person | |
| Coal Tar - Prepared | — |
| Codeine Phosphate | — |
| Codeine Phosphate with Paracetamol | — |
| Colchicine | — |
| Colestipol Hydrochloride | — |
| Copper Sulfate | — |
| Cortisone Acetate | — |
| Cyclophosphamide | — |
| Cyclosporin | In compliance with authority procedures set out in subparagraph 14 (d): |
| Maintenance therapy, following initiation and stabilisation of treatment with cyclosporin, of patients with organ or tissue transplants, where therapy remains under the supervision and direction of the transplant unit reviewing the patient and where the name of the specialised transplant unit reviewing treatment and the date of the latest review at the specialised transplant unit are included in the authority application | |
| Maintenance therapy, following initiation and stabilisation of treatment with cyclosporin, of patients with severe atopic dermatitis for whom other systemic therapies are ineffective or inappropriate, where therapy remains under the supervision and direction of a dermatologist, clinical immunologist or specialised unit reviewing the patient and where the name of the dermatologist, clinical immunologist or specialised unit reviewing treatment and the date of the latest review are included in the authority application | |
| Maintenance therapy, following initiation and stabilisation of treatment with cyclosporin, of patients with severe psoriasis for whom other systemic therapies are ineffective or inappropriate and in whom the disease has caused significant interference with quality of life, where therapy remains under the supervision and direction of a dermatologist or specialised unit reviewing the patient and where the name of the dermatologist or specialised unit reviewing treatment and the date of the latest review are included in the authority application | |
| Maintenance therapy, following initiation and stabilisation of treatment with cyclosporin, of patients with nephrotic syndrome in whom steroids and cytostatic drugs have failed or are not tolerated or are considered inappropriate and in whom renal function is unimpaired, where therapy remains under the supervision and direction of a nephrologist or specialised unit reviewing the patient and where the name of the nephrologist or specialised unit reviewing treatment and the date of the latest review are included in the authority application | |
| Maintenance therapy, following initiation and stabilisation of treatment with cyclosporin, of patients with severe active rheumatoid arthritis for whom classical slow-acting anti-rheumatic agents (including methotrexate) are ineffective or inappropriate, where therapy remains under the supervision and direction of a rheumatologist, clinical immunologist or specialised unit reviewing the patient and where the name of the rheumatologist, clinical immunologist or specialised unit reviewing treatment and the date of the latest review are included in the authority application | |
| Management (which includes initiation, stabilisation and review of therapy) by dermatologists or clinical immunologists of patients with severe atopic dermatitis for whom other systemic therapies are ineffective or inappropriate | |
| Management (which includes initiation, stabilisation and review of therapy) by dermatologists of patients with severe psoriasis for whom other systemic therapies are ineffective or inappropriate and in whom the disease has caused significant interference with quality of life | |
| Management (which includes initiation, stabilisation and review of therapy) by rheumatologists or clinical immunologists of patients with severe active rheumatoid arthritis for whom classical slow-acting anti-rheumatic agents (including methotrexate) are ineffective or inappropriate | |
| Cyproheptadine Hydrochloride | Prevention of migraine |
| Cyproterone Acetate | In respect of the tablet 50 mg: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Moderate to severe androgenisation, of which acne alone is not a sufficient indication, in non-pregnant women | |
| Advanced carcinoma of the prostate | |
| To reduce drive in sexual deviations in males | |
| In respect of the tablet 100 mg: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Advanced carcinoma of the prostate | |
| To reduce drive in sexual deviations in males | |
| Cytarabine | — |
| Dalteparin Sodium | — |
| Danazol | In compliance with authority procedures set out in subparagraph 14 (d): |
| Endometriosis, visually proven | |
| Hereditary angio-oedema | |
| Treatment, for up to 6 months, of intractable primary menorrhagia | |
| Treatment, for up to 6 months, of severe benign (fibrocystic) breast disease or mastalgia associated with severe symptomatic benign breast disease in patients refractory to other treatments | |
| Dantrolene Sodium | Treatment of chronic spasticity |
| Dapsone | — |
| Desmopressin Acetate | In respect of the intranasal solution 100 micrograms per mL, 2.5 mL dropper bottle: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Cranial diabetes insipidus | |
| In respect of the tablet 200 micrograms and nasal spray (pump pack) 10 micrograms per actuation, 60 actuations, 6 mL: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Primary nocturnal enuresis: | |
| in patients aged 6 years or older who are refractory to an enuresis alarm, where, if the application is for the tablet presentation of this drug, a period of 6 months or more has elapsed since an application was last approved for the issue of an authority prescription to the patient for the tablet presentation of this drug for this purpose | |
| in patients aged 6 years or older for whom an enuresis alarm is contraindicated, where the reason for the contraindication is included in the authority application, and where, if the application is for the tablet presentation of this drug, a period of 6 months or more has elapsed since an application was last approved for the issue of an authority prescription to the patient for the tablet presentation of this drug for this purpose | |
| Cranial diabetes insipidus | |
| Dexamethasone | — |
| Dexamethasone Sodium Metasulfobenzoate with Framycetin Sulfate and Gramicidin | — |
| Dexamethasone Sodium Phosphate | — |
| Dexamphetamine Sulfate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Use in attention deficit hyperactivity disorder, in accordance with State/Territory law | |
| Narcolepsy | |
| "Dialamine" | Gyrate atrophy of the choroid and retina |
| Urea cycle disorders | |
| Diazepam | — |
| Diclofenac Sodium | In respect of the suppository 100 mg: |
| — | |
| In respect of the tablet 25 mg (enteric coated) and tablet 50 mg (enteric coated): | |
| Chronic arthropathies (including osteoarthritis) with an inflammatory component | |
| Bone pain due to malignant disease | |
| In respect of the eye drops 1 mg per mL, 5 mL: | |
| Inhibition of intraoperative miosis | |
| Dicloxacillin Sodium | In respect of the powder for injection equivalent to 500 mg dicloxacillin and powder for injection equivalent to 1 g dicloxacillin: |
| — | |
| In respect of the capsule equivalent to 250 mg dicloxacillin and capsule equivalent to 500 mg dicloxacillin: | |
| Serious staphylococcal infections | |
| "Digestelact" | In compliance with authority procedures set out in subparagraph 14 (d): |
| Acute lactose intolerance in children aged 1 year and over, where the date of birth of the patient is included in the authority application and where the patient has not previously been issued with an authority prescription for this medicinal preparation for this purpose | |
| Proven chronic lactose intolerance in children aged 1 year and over who are significantly malnourished, where the date of birth of the patient is included in the authority application, and where lactose intolerance has been proven either by the relief of symptoms on supervised withdrawal of lactose from the diet for 3 or 4 days and subsequent re-emergence of symptoms on rechallenge with lactose containing formulae or milk or food, or by the presence of not less than 0.5% reducing substance in stool exudate tested with copper sulfate diagnostic compound tablet | |
| Digoxin | — |
| Dihydroergotamine Mesylate | — |
| Diltiazem Hydrochloride | — |
| Diphenoxylate Hydrochloride with Atropine Sulfate | — |
| Diphtheria and Tetanus Vaccine - Adsorbed | — |
| Diphtheria and Tetanus Vaccine - Adsorbed (Diluted) | — |
| Dipivefrine Hydrochloride | — |
| Dipyridamole | Prevention of recurrence of ischaemic stroke or transient cerebral ischaemic events: |
| in patients receiving therapy with low-dose aspirin | |
| in patients where low-dose aspirin poses an unacceptable risk of gastrointestinal bleeding | |
| in patients where there is a history of anaphylaxis, urticaria or asthma within 4 hours of ingestion of aspirin, other salicylates, or non-steroidal anti-inflammatory drugs | |
| Dipyridamole with Aspirin | Prevention of recurrence of ischaemic stroke or transient cerebral ischaemic events |
| Disodium Etidronate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Symptomatic Paget's disease of bone when salcatonin has been found to be unsatisfactory due to lack of efficacy | |
| Symptomatic Paget's disease of bone when salcatonin has been found to be unsatisfactory due to unacceptable side effects | |
| Heterotopic ossification | |
| Disodium Etidronate and Calcium Carbonate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Initial treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in patients with fracture due to minimal trauma, where the fracture has been demonstrated radiologically and the year of plain x-ray or computed tomography scan or magnetic resonance imaging scan is included in the authority application, provided that if the fracture is a vertebral fracture, there is a 20% or greater reduction in height of the anterior or mid portion of the affected vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body | |
| Continuing treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in patients with fracture due to minimal trauma, where the patient has previously been issued with an authority prescription for this drug | |
| Disodium Pamidronate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Symptomatic Paget's disease of bone | |
| Disopyramide | — |
| Docetaxel | In compliance with authority procedures set out in subparagraph 14 (d): |
| Adjuvant treatment of node-positive breast cancer in combination with an anthracycline and cyclophosphamide | |
| Advanced breast cancer after failure of prior therapy which includes an anthracycline | |
| Advanced metastatic ovarian cancer after failure of prior therapy which includes a platinum compound | |
| Locally advanced or metastatic non-small cell lung cancer | |
| Treatment of HER2 positive early breast cancer in combination with trastuzumab | |
| Docusate Sodium with Bisacodyl | Paraplegic and quadriplegic patients and others with severe neurogenic impairment of bowel function |
| Patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities | |
| For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult | |
| Patients receiving palliative care | |
| Terminal malignant neoplasia | |
| Anorectal congenital abnormalities | |
| Megacolon | |
| Dolasetron Mesylate | Management of nausea and vomiting associated with cytotoxic chemotherapy being used to treat malignancy |
| Domperidone | — |
| Donepezil Hydrochloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Initial treatment, for up to 2 months, of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 10 or more, where the diagnosis is confirmed by a specialist or consultant physician, and where the result of the baseline Mini-Mental State Examination and, if this result is at least 25 points, the result of the baseline Alzheimer's Disease Assessment Scale, cognitive sub-scale, are included in the authority application | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Continuation of initial treatment of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 10 or more, where the patient has previously been issued with an authority prescription for initial treatment with this drug for a period of up to 2 months, where the application confirms the information which established the patient's eligibility for initial treatment, and where approval of the application would enable the patient to complete a period of initial treatment of not more than 6 months of uninterrupted therapy Initial treatment, for up to 6 months, of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 10 or more, where the diagnosis is confirmed by a specialist or consultant physician, and where the result of the baseline Mini-Mental State Examination and, if this result is at least 25 points, the result of the baseline Alzheimer's Disease Assessment Scale, cognitive sub-scale, are included in the authority application | |
| Continuing treatment of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 10 or more who demonstrate improvement in cognitive function following initial therapy, as measured by an increase of at least 2 points from baseline on the Mini-Mental State Examination, or a decrease of at least 4 points from baseline on the Alzheimer's Disease Assessment Scale, cognitive sub-scale, for patients with a Mini-Mental State Examination baseline score of at least 25 points, where the relevant result from the Mini-Mental State Examination or the Alzheimer's Disease Assessment Scale, cognitive sub-scale, is included in the authority application for continuing treatment | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Continuing treatment of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 10 or more and with demonstrated improvement in cognitive function following initial therapy, where the patient has previously been issued with an authority prescription for continuing treatment | |
| Initial treatment, for up to 2 months, of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 9 or less, who are unable to register a score of 10 or more for reasons other than their Alzheimer's disease as they are from 1 or more of the following groups, where the diagnosis is confirmed by a specialist or consultant physician, and where the authority application includes the result of the baseline Mini-Mental State Examination and specifies to which of the groups the patient belongs: Unable to communicate adequately because of lack of competence in English, in people of non-English speaking background; Limited education, as defined by less than 6 years of education, or who are illiterate or innumerate; Aboriginal or Torres Strait Islanders who, by virtue of cultural factors, are unable to complete a Mini-Mental State Examination test; Intellectual (developmental or acquired) disability; Significant sensory impairment despite best correction, which precludes completion of a Mini-Mental State Examination test; Prominent dysphasia, out of proportion to other cognitive and functional impairment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Continuation of initial treatment of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 9 or less, who are unable to register a score of 10 or more for reasons other than their Alzheimer's disease, where the patient has previously been issued with an authority prescription for initial treatment with this drug for a period of up to 2 months, where the application confirms the information which established the patient's eligibility for initial treatment, and where approval of the application would enable the patient to complete a period of initial treatment of not more than 6 months of uninterrupted therapy Initial treatment, for up to 6 months, of mild to moderately severe Alzheimer's disease in patients with a baseline Mini-Mental State Examination score of 9 or less, who are unable to register a score of 10 or more for reasons other than their Alzheimer's disease as they are from 1 or more of the following groups, where the diagnosis is confirmed by a specialist or consultant physician, and where the authority application includes the result of the baseline Mini-Mental State Examination and specifies to which of the groups the patient belongs: Unable to communicate adequately because of lack of competence in English, in people of non-English speaking background; Limited education, as defined by less than 6 years of education, or who are illiterate or innumerate; Aboriginal or Torres Strait Islanders who, by virtue of cultural factors, are unable to complete a Mini-Mental State Examination test; Intellectual (developmental or acquired) disability; Significant sensory impairment despite best correction, which precludes completion of a Mini-Mental State Examination test; Prominent dysphasia, out of proportion to other cognitive and functional impairment | |
| Continuing treatment of mild to moderately severe Alzheimer's disease in eligible patients with a baseline Mini-Mental State Examination score of 9 or less who are unable to register a score of 10 or more for reasons other than their Alzheimer's disease and who demonstrate improvement in function following initial therapy, based on a rating of very much improved or much improved on the Clinicians Interview Based Impression of Change scale, as assessed by the same clinician who initiated treatment, and where the improvement rating achieved on the Clinicians Interview Based Impression of Change scale is stated in the authority application for continuing treatment | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Continuing treatment of mild to moderately severe Alzheimer's disease in eligible patients with a baseline Mini-Mental State Examination score of 9 or less and with demonstrated improvement in function following initial therapy, where the patient has previously been issued with an authority prescription for continuing treatment | |
| Dorzolamide Hydrochloride | — |
| Dorzolamide Hydrochloride with Timolol Maleate | Reduction of elevated intra-ocular pressure in patients with open-angle glaucoma who are not adequately controlled with timolol maleate eye drops equivalent to 5 mg timolol per mL |
| Reduction of elevated intra-ocular pressure in patients with ocular hypertension who are not adequately controlled with timolol maleate eye drops equivalent to 5 mg timolol per mL | |
| Dothiepin Hydrochloride | — |
| Doxepin Hydrochloride | — |
| Doxorubicin Hydrochloride | — |
| Doxorubicin Hydrochloride - Pegylated Liposomal | In compliance with authority procedures set out in subparagraph 14 (d): |
| Advanced epithelial ovarian cancer in women who have failed a first-line platinum-based chemotherapy regimen | |
| Metastatic breast cancer, as monotherapy, after failure of prior therapy which includes capecitabine and a taxane | |
| Metastatic breast cancer, as monotherapy, where therapy with capecitabine or a taxane is contraindicated | |
| Doxycycline Hydrochloride | In respect of the tablet equivalent to 100 mg doxycycline and capsule equivalent to 100 mg doxycycline (containing enteric coated pellets): |
| — | |
| In respect of the tablet equivalent to 50 mg doxycycline and capsule equivalent to 50 mg doxycycline (containing enteric coated pellets): | |
| Bronchiectasis in patients aged 8 years or older | |
| Chronic bronchitis in patients aged 8 years or older | |
| Severe acne | |
| Doxycycline Monohydrate | In respect of the tablet equivalent to 100 mg doxycycline: |
| — | |
| In respect of the tablet equivalent to 50 mg doxycycline: | |
| Bronchiectasis in patients aged 8 years or older | |
| Chronic bronchitis in patients aged 8 years or older | |
| Severe acne | |
| Drotrecogin Alfa (Activated) | In compliance with authority procedures set out in subparagraph 14 (d): |
| Adult patients with severe sepsis who have a high risk of death as determined by acute dysfunction in at least 2 organs or modified Acute Physiology and Chronic Health Evaluation II score of at least 25, where acute organ dysfunction is defined as follows: For cardiovascular-system dysfunction, an arterial systolic blood pressure of less than or equal to 90 mmHg or mean arterial pressure of less than or equal to 70 mmHg for at least 1 hour despite adequate fluid resuscitation, adequate intravascular volume status or the use of vasopressors in an attempt to maintain a systolic blood pressure of greater than or equal to 90 mmHg or a mean arterial pressure of greater than or equal to 70 mmHg; For kidney dysfunction, urine output of less than 0.5 mL per kg of body weight per hour for 1 hour despite adequate fluid resuscitation; For respiratory-system dysfunction, a ratio of partial pressure of oxygen in arterial blood (in mmHg) to the percentage of oxygen in the inspired air (expressed as a decimal) of less than or equal to 250; For haematologic dysfunction, a platelet count of less than 80,000 per cubic millimetre or which has decreased by 50 percent in the previous 3 days; In the case of unexplained metabolic acidosis, a pH of less than or equal to 7.30 or a base deficit of greater than or equal to 5.0 mmol per L in association with a plasma lactate level of greater than 1.5 times the upper limit of the normal value for the reporting laboratory | |
| "Duocal" | Patients with proven inborn errors of protein metabolism who are unable to meet their energy requirements with permitted food and formulae |
| Dydrogesterone |
| "Easiphen" | Phenylketonuria |
| Efalizumab | In compliance with authority procedures set out in subsubparagraph 14 (d)(i): |
| Initial treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who: (a) have severe chronic plaque psoriasis where lesions have been present for at least 6 months from the time of initial diagnosis; and | |
| (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and (c) have signed a patient acknowledgement form indicating that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the relevant restriction for continuing PBS-subsidised treatment; and (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments: (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks; unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and where biological agent means efalizumab or etanercept; and where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: failure to achieve an adequate response is indicated by a current Psoriasis Area and Severity Index (PASI) score of greater than 15, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment, and is demonstrable in the patient at the time of the authority application; a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment; the most recent PASI assessment is no more than 1 month old at the time of application; if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Adminstration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication; if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity; the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following: (i) copies of the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets and whole body area diagrams including the dates of assessment of the patient's condition; and | |
| (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and (iii) a copy of the signed patient acknowledgement form; a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment as systemic monotherapy, in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment, or recommencement of treatment, with efalizumab as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who: (a) have a documented history of severe chronic plaque psoriasis; and (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and (c) have not failed PBS-subsidised therapy with efalizumab for the treatment of this condition more than once in the current Treatment Cycle; and where biological agent means efalizumab or etanercept; and where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: patients who have previously demonstrated a response to PBS-subsidised treatment with efalizumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised efalizumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment; patients who demonstrate a response to a 12-week course of PBS-subsidised treatment with etanercept and wish to transfer to treatment with efalizumab are not eligible to commence treatment with efalizumab until they have completed a period free from biological agent treatment of at least 12 weeks duration, immediately following cessation of the etanercept treatment course; the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following: (i) a copy of the completed current Psoriasis Area and Severity Index (PASI) calculation sheets and whole body area diagrams including the dates of assessment of the patient's condition; and (ii) details of prior biological agent treatment, including dosage, date and duration of treatment; a course of initial treatment within a Treatment Cycle is limited to a maximum of 16 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment, or of a course which recommences treatment, with efalizumab as systemic monotherapy, within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of efalizumab for continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin) by a dermatologist for adults 18 years and over who: (a) have a documented history of severe chronic plaque psoriasis and were receiving treatment with efalizumab prior to 10 November 2005; and (b) had a Psoriasis Area and Severity Index (PASI) score of greater than 15 prior to commencing treatment with efalizumab; and (c) have signed a patient acknowledgement form indicating that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the relevant restriction for continuing PBS-subsidised treatment; and (d) have demonstrated a response as specified in the criterion included in the relevant restriction for continuing PBS-subsidised treatment with efalizumab; and where biological agent means efalizumab or etanercept; and where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following: (i) a copy of the completed Psoriasis Area and Severity Index (PASI) calculation sheet and whole body area diagrams including the date of the assessment of the patient's condition at baseline (prior to initiation of efalizumab therapy) and the most recent PASI assessment; and (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and (iii) a copy of the signed patient acknowledgement form; the course of treatment is limited to a maximum of 24 weeks of treatment; patients are eligible for PBS-subsidised treatment under the above criteria once only | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy, commencing a Biological Treatment cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis, who were receiving non-PBS-subsidised treatment with efalizumab prior to 10 November 2005, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over: (a) who have a documented history of severe chronic plaque psoriasis; and (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with efalizumab; and (c) who have demonstrated an adequate response to their most recent course of treatment with efalizumab; and where biological agent means efalizumab or etanercept; and where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: an adequate response to efalizumab treatment is defined as a Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, or is sustained at this level, after at least 12 weeks of efalizumab treatment, when compared with the baseline value for this Treatment Cycle established prior to biological agent treatment; the PASI assessment is performed on the same affected body area assessed to establish the baseline pre-treatment PASI score; patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless: (i) the assessment of response is conducted following at least 12 weeks of therapy, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course; and (ii) the response assessment is submitted to the Medicare Australia CEO no later than 1 month from the date that course of treatment ceased; the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes a copy of the completed Psoriasis Area and Severity Index (PASI) calculation sheet and whole body area diagrams along with the date of the assessment of the patient's condition; a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuing treatment as systemic monotherapy, within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who: (a) have severe chronic plaque psoriasis of the face or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and (c) have signed a patient acknowledgement form indicating that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the relevant restriction for continuing PBS-subsidised treatment; and (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments: (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks; unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and where biological agent means efalizumab or etanercept; and where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: failure to achieve an adequate response is demonstrable in the patient at the time of the authority application and is indicated by chronic plaque psoriasis classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where: (i) at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling are rated as severe or very severe, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment; or | |
| (ii) the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment; a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment; the most recent PASI assessment is no more than 1 month old at the time of application; if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication; if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity; the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following: (i) copies of the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area diagrams including the dates of assessment of the patient's condition; and (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and (iii) a copy of the signed patient acknowledgement form; | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment as systemic monotherapy, in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment, or recommencement of treatment, with efalizumab as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who: (a) have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and (c) have not failed PBS-subsidised therapy with efalizumab for the treatment of this condition more than once in the current Treatment Cycle; and where biological agent means efalizumab or etanercept; and where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and | |
| where the following conditions apply: patients who have previously demonstrated a response to PBS-subsidised treatment with efalizumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised efalizumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment; patients who demonstrate a response to a 12-week course of PBS-subsidised treatment with etanercept and wish to transfer to treatment with efalizumab are not eligible to commence treatment with efalizumab until they have completed a period free from biological agent treatment of at least 12 weeks duration, immediately following cessation of the etanercept treatment course; the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following: (i) a copy of the completed current Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area diagrams including the dates of assessment of the patient's condition; and a course of initial treatment within a Treatment Cycle is limited to a maximum of 16 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of initial treatment, or of a course which recommences treatment, with efalizumab as systemic monotherapy, within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of efalizumab for continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin) by a dermatologist for adults 18 years and over: (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and were receiving treatment with efalizumab prior to 10 November 2005; and (b) whose disease, prior to treatment with efalizumab, was classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where either at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling were rated as severe or very severe, or the skin area affected was 30% or more of the face, palm of a hand or sole of a foot; and (c) who have signed a patient acknowledgement form indicating that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the relevant restriction for continuing PBS-subsidised treatment; and (d) who have demonstrated a response as specified in the criterion included in the relevant restriction for continuing PBS-subsidised treatment with efalizumab; and where biological agent means efalizumab or etanercept; and | |
| where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following: the PASI assessment is performed on the same affected body area assessed to establish the baseline pre-treatment score; the most recent PASI assessment is no more than 1 month old at the time of application; the course of treatment is limited to a maximum of 24 weeks of treatment; patients are eligible for PBS-subsidised treatment under the above criteria once only | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy, commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, who were receiving non-PBS-subsidised treatment with efalizumab prior to 10 November 2005, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over: (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with efalizumab; (c) who have demonstrated an adequate response to their most recent course of treatment with efalizumab; and where biological agent means efalizumab or etanercept; and | |
| where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: an adequate response to efalizumab treatment is defined as the plaque or plaques assessed prior to biological agent treatment showing: (i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, after at least 12 weeks of efalizumab treatment, as compared to the baseline values established prior to biological agent treatment; or (ii) a reduction by 75% or more in the skin area affected, or sustained at this level, after at least 12 weeks of efalizumab treatment, as compared to the baseline value established prior to biological agent treatment; the PASI assessment is performed on the same affected body area assessed to establish the baseline pre-treatment PASI score; patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless: (i) the assessment of response is conducted following at least 12 weeks of therapy, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course; and (ii) the response assessment is submitted to the Medicare Australia CEO no later than 1 month from the date that course of treatment ceased; the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes a copy of the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams along with the date of the assessment of the patient's condition; a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment | |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i) or 14 (d)(ii): | |
| Continuing treatment as systemic monotherapy, within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total | |
| Eformoterol Fumarate Dihydrate | Patients with frequent episodes of asthma who are currently receiving treatment with oral corticosteroids |
| Patients with frequent episodes of asthma who are currently receiving treatment with optimal doses of inhaled corticosteroids | |
| "EleCare" | In compliance with authority procedures set out in subparagraph 14 (d): |
| Initial treatment, for up to 3 months, for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children up to the age of 2 years, where combined intolerance is demonstrated when the child has failed to respond to a strict cows' milk protein free and strict soy protein free diet with a protein hydrolysate (with or without medium chain triglycerides) as the principal formula, and where the date of birth of the patient is included in the authority application | |
| Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application | |
| Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application | |
| Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed | |
| Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition | |
| Enalapril Maleate | — |
| Enalapril Maleate with Hydrochlorothiazide | Hypertension in patients who are not adequately controlled with 20 mg enalapril maleate |
| "Energivit" | Patients with proven inborn errors of protein metabolism who are unable to meet their energy requirements with permitted food and formulae |
| Enoxaparin Sodium | — |
| Entacapone | In compliance with authority procedures set out in subparagraph 14 (d): |
| Parkinson's disease as adjunctive therapy in patients being treated with levodopa—decarboxylase inhibitor combinations who are experiencing fluctuations in motor function due to end-of-dose effect | |
| Epirubicin Hydrochloride | — |
| Eplerenone | In compliance with authority procedures set out in subparagraph 14 (d): |
| Initial therapy subsidised under the Pharmaceutical Benefits Scheme (PBS) for heart failure with a left ventricular ejection fraction of 40% or less occurring within 3 to 14 days following an acute myocardial infarction, where the date of the acute myocardial infarction is included in the authority application, and where the treatment commences within 14 days of the acute myocardial infarction or continues treatment which was commenced in a hospital within 14 days of the acute myocardial infarction | |
| Continuation of therapy for heart failure with a left ventricular ejection fraction of 40% or less occurring following an acute myocardial infarction, where the patient has previously been issued with a PBS authority prescription for eplerenone | |
| Eprosartan Mesylate | — |
| Eprosartan Mesylate with Hydrochlorothiazide | Hypertension in patients who are not adequately controlled with either hydrochlorothiazide or eprosartan mesylate monotherapy |
| Eptifibatide Acetate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Patients undergoing non-urgent percutaneous intervention with intracoronary stenting | |
| Erythromycin | — |
| Erythromycin Ethyl Succinate | — |
| Erythromycin Ethyl Succinate with Water - Purified BP | — |
| Erythromycin Lactobionate | — |
| Escitalopram Oxalate | Major depressive disorders |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Major depressive disorders, where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Major depressive disorders, where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Major depressive disorders, where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Major depressive disorders, where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance | |
| Major depressive disorders, where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences | |
| Esomeprazole Magnesium Trihydrate | In respect of the tablet (enteric coated), equivalent to 20 mg esomeprazole: |
| Initial treatment of gastric ulcer | |
| Maintenance of healed gastro-oesophageal reflux disease | |
| In respect of the tablet (enteric coated), equivalent to 40 mg esomeprazole: | |
| Healing of gastro-oesophageal reflux disease | |
| Esomeprazole Magnesium Trihydrate and Clarithromycin and Amoxycillin Trihydrate | Eradication of Helicobacter pylori associated with peptic ulcer disease |
| Etanercept | In respect of the injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL: |
| In compliance with authority procedures set out in subsubparagraph 14 (d)(i): | |
| Initial treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who: (a) have severe chronic plaque psoriasis where lesions have been present for at least 6 months from the time of initial diagnosis; and (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and (c) have signed a patient acknowledgement form indicating that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the relevant restriction for continuing PBS-subsidised treatment; and (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments: (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks; unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and where biological agent means efalizumab or etanercept; and where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and where the following conditions apply: failure to achieve an adequate response is indicated by a current Psoriasis Area and Severity Index (PASI) score of greater than 15, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment, and is demonstrable in the patient at the time of the authority application; a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment; the most recent PASI assessment is no more than 1 month old at the time of application; |
| Tobramycin | Invasive ocular infection |
| Perioperative use in ophthalmic surgery | |
| Suspected pseudomonal eye infection | |
| Tobramycin Sulfate | Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent |
| Septicaemia, suspected | |
| Septicaemia, proven | |
| Topiramate | In respect of the tablet 25 mg, tablet 50 mg, tablet 100 mg and tablet 200 mg: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences | |
| In respect of the capsule 15 mg, capsule 25 mg and capsule 50 mg: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance | |
| Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid form dose of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences | |
| Topotecan Hydrochloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Advanced metastatic ovarian cancer after failure of prior therapy which includes a platinum compound | |
| Toremifene Citrate | Treatment of hormone-dependent metastatic breast cancer in post-menopausal patients |
| Tramadol Hydrochloride | In respect of the capsule 50 mg: |
| For acute pain where aspirin or paracetamol alone is inappropriate or has failed | |
| For dosage titration in chronic pain where aspirin or paracetamol alone is inappropriate or has failed | |
| In respect of the tablet 100 mg (sustained release), tablet 150 mg (sustained release), tablet 200 mg (sustained release) and oral drops 100 mg per mL, 10 mL: | |
| For pain where aspirin or paracetamol alone is inappropriate or has failed | |
| In respect of the injection 100 mg in 2 mL ampoule: | |
| Short-term treatment of acute pain | |
| Trandolapril | — |
| Tranexamic Acid | — |
| Tranylcypromine Sulfate | — |
| Travoprost | — |
| Triamcinolone Acetonide | In respect of the injection 10 mg in 1 mL ampoule: |
| Alopecia areata | |
| For local intra-articular or peri-articular infiltration | |
| Granulomata, dermal | |
| Keloid | |
| Lichen planus hypertrophic | |
| Lichen simplex chronicus | |
| Lupus erythematosus, chronic discoid | |
| Necrobiosis lipoidica | |
| Psoriasis | |
| In respect of the cream 200 micrograms per g, 100 g and ointment 200 micrograms per g, 100 g: | |
| Treatment of corticosteroid-responsive dermatoses | |
| Triamcinolone Acetonide with Neomycin Sulfate, Gramicidin and Nystatin | — |
| Trifluoperazine Hydrochloride | — |
| Triglycerides Oil - Medium Chain | In compliance with authority procedures set out in subparagraph 14 (d): |
| Chylous ascites | |
| Chylothorax | |
| Fat malabsorption due to liver disease, short gut syndrome, cystic fibrosis or gastrointestinal disorders | |
| Hyperlipoproteinaemia type 1 | |
| Intractable childhood epilepsy or cerebrospinal fluid glucose transporter defect, requiring a ketogenic diet | |
| Long chain fatty acid oxidation disorders | |
| Trimethoprim | — |
| Trimethoprim with Sulfamethoxazole | — |
| Tropisetron Hydrochloride | Management of nausea and vomiting associated with cytotoxic chemotherapy being used to treat malignancy |
| "TYR gel" | Tyrosinaemia |
| "TYR Express" | Tyrosinaemia |
| Ursodeoxycholic Acid | In compliance with authority procedures set out in subparagraph 14 (d): |
| Primary biliary cirrhosis | |
| Valaciclovir Hydrochloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Moderate to severe initial genital herpes | |
| Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis | |
| Treatment of patients with herpes zoster within 72 hours of the onset of the rash | |
| Herpes zoster ophthalmicus | |
| Vancomycin Hydrochloride | In respect of the powder for injection equivalent to 500 mg (500,000 I.U.) vancomycin activity: |
| Prophylaxis of endocarditis in patients hypersensitive to penicillin | |
| Endophthalmitis | |
| Use initiated in a hospital for infections where vancomycin hydrochloride is an appropriate antibiotic | |
| In respect of the capsule equivalent to 125 mg (125,000 I.U.) vancomycin activity and capsule equivalent to 250 mg (250,000 I.U.) vancomycin activity: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Antibiotic associated pseudomembranous colitis due to Clostridium difficile which is unresponsive to metronidazole | |
| Antibiotic associated pseudomembranous colitis due to Clostridium difficile where there is intolerance to metronidazole | |
| Venlafaxine Hydrochloride | Major depressive disorders |
| Verapamil Hydrochloride | — |
| Vigabatrin | In compliance with authority procedures set out in subparagraph 14 (d): |
| Treatment of epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs | |
| Vinblastine Sulfate | — |
| Vincristine Sulfate | — |
| Vinorelbine Tartrate | In respect of the capsule equivalent to 20 mg vinorelbine and capsule equivalent to 30 mg vinorelbine: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Locally advanced or metastatic non-small cell lung cancer | |
| In respect of the solution for I.V. infusion equivalent to 10 mg vinorelbine in 1 mL and solution for I.V. infusion equivalent to 50 mg vinorelbine in 5 mL: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Advanced breast cancer after failure of prior therapy which includes an anthracycline | |
| Locally advanced or metastatic non-small cell lung cancer | |
| Warfarin Sodium | — |
| "XMET Analog" | For infants and very young children with pyridoxine non-responsive homocystinuria |
| "XMET Maxamaid" | Pyridoxine non-responsive homocystinuria |
| "XMET Maxamum" | Pyridoxine non-responsive homocystinuria |
| "XMTVI Analog" | Methylmalonic acidaemia |
| Propionic acidaemia | |
| "XMTVI Asadon" | Methylmalonic acidaemia |
| Propionic acidaemia | |
| "XMTVI Maxamaid" | Methylmalonic acidaemia |
| Propionic acidaemia | |
| "XMTVI Maxamum" | Methylmalonic acidaemia |
| Propionic acidaemia | |
| "XP Analog" | Phenylketonuria |
| "XP Analog LCP" | Phenylketonuria |
| "XP Maxamaid" | Phenylketonuria |
| "XP Maxamum" | Phenylketonuria |
| "XPhen, Tyr Analog" | Tyrosinaemia |
| "XPhen, Tyr Maxamaid" | Tyrosinaemia |
| "XPhen, Tyr Maxamum" | Tyrosinaemia |
| "XPTM Tyrosidon" | Tyrosinaemia |
| Zolmitriptan | In compliance with authority procedures set out in subparagraph 14 (d): |
| Migraine attacks in patients receiving, or who have failed a reasonable trial of, prophylactic medication and where attacks in the past have usually failed to respond to oral therapy with ergotamine and other appropriate agents, or in whom these agents are contraindicated | |
| Zuclopenthixol Decanoate | — |
| Benzydamine Hydrochloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where a painful mouth is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where a painful mouth is a problem | |
| Continuing supply for palliative care patients where a painful mouth is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Bisacodyl | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where constipation is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where constipation is a problem | |
| Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Carmellose Sodium | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where dry mouth is a symptom | |
| Initial supply, for up to 4 months, for palliative care patients where dry mouth is a symptom | |
| Continuing supply for palliative care patients where dry mouth is a symptom, and where consultation with a palliative care specialist or service has occurred | |
| Clonazepam | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients for the prevention of epilepsy | |
| Initial supply, for up to 4 months, for palliative care patients for the prevention of epilepsy | |
| Continuing supply for palliative care patients for the prevention of epilepsy, where consultation with a palliative care specialist or service has occurred | |
| Diazepam | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where anxiety is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem | |
| Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Diclofenac Sodium | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where severe pain is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem | |
| Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Docusate Sodium with Bisacodyl | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where constipation is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where constipation is a problem | |
| Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Glycerol | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where constipation is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where constipation is a problem | |
| Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Hyoscine Butylbromide | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where colicky pain is a symptom | |
| Initial supply, for up to 4 months, for palliative care patients where colicky pain is a symptom | |
| Continuing supply for palliative care patients where colicky pain is a symptom, and where consultation with a palliative care specialist or service has occurred | |
| Ibuprofen | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where severe pain is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem | |
| Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Indomethacin | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where severe pain is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem | |
| Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Lactulose | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where constipation is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where constipation is a problem | |
| Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where constipation is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where constipation is a problem | |
| Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Morphine Sulfate | In respect of the tablet 10 mg and tablet 20 mg: |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Continuing supply, for up to 1 month, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics | |
| Initial supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics | |
| Continuing supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred | |
| In respect of the tablet 200 mg (controlled release): | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Continuing supply, for up to 1 month, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics | |
| Initial supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics | |
| Continuing supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred | |
| Naproxen | In respect of the tablet 250 mg, tablet 500 mg, tablet 750 mg (sustained release) and tablet 1 g (sustained release): |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Continuing supply for palliative care patients where severe pain is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem | |
| Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred | |
| In respect of the oral suspension 125 mg per 5 mL, 474 mL: | |
| In compliance with authority procedures set out in subparagraph 14 (d): | |
| Continuing supply for palliative care patients where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent | |
| Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent | |
| Continuing supply for palliative care patients where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent, and where consultation with a palliative care specialist or service has occurred | |
| Naproxen Sodium | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where severe pain is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem | |
| Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Nitrazepam | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where insomnia is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where insomnia is a problem | |
| Continuing supply for palliative care patients where insomnia is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Oxazepam | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where anxiety is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem | |
| Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Paracetamol | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated | |
| Initial supply, for up to 4 months, for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated | |
| Continuing supply for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated, and where consultation with a palliative care specialist or service has occurred | |
| Promethazine Hydrochloride | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where nausea and/or vomiting is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where nausea and/or vomiting is a problem | |
| Continuing supply for palliative care patients where nausea and/or vomiting is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where constipation is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where constipation is a problem | |
| Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Sterculia with Frangula Bark | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where constipation is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where constipation is a problem | |
| Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Sulindac | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where severe pain is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem | |
| Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Temazepam | In compliance with authority procedures set out in subparagraph 14 (d): |
| Continuing supply for palliative care patients where insomnia is a problem | |
| Initial supply, for up to 4 months, for palliative care patients where insomnia is a problem | |
| Continuing supply for palliative care patients where insomnia is a problem, and where consultation with a palliative care specialist or service has occurred | |
| Adrenaline Acid Tartrate | — |
| Amoxycillin Trihydrate | — |
| Amoxycillin Trihydrate with Potassium Clavulanate | Infections where resistance to amoxycillin trihydrate is suspected |
| Infections where resistance to amoxycillin trihydrate is proven | |
| Amoxycillin Trihydrate with Potassium Clavulanate and Water - Purified BP | Infections where resistance to amoxycillin trihydrate is suspected |
| Infections where resistance to amoxycillin trihydrate is proven | |
| Amoxycillin Trihydrate with Water - Purified BP | — |
| Amphotericin | — |
| Ampicillin Sodium | — |
| Ampicillin Trihydrate | — |
| Aspirin | — |
| Atropine Sulfate | — |
| Benzathine Penicillin | — |
| Benztropine Mesylate | — |
| Benzydamine Hydrochloride | Radiation induced mucositis |
| Benzylpenicillin Sodium | — |
| Betamethasone Acetate with Betamethasone Sodium Phosphate | For local intra-articular or peri-articular infiltration |
| Keloid | |
| Lichen planus hypertrophic | |
| Carbamazepine | — |
| Cefaclor Monohydrate | — |
| Cefaclor Monohydrate with Water - Purified BP | — |
| Cefotaxime Sodium | Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent |
| Cefuroxime Axetil | — |
| Cephalexin | — |
| Cephalexin with Water - Purified BP | — |
| Cephalothin Sodium | — |
| Chloramphenicol | — |
| Clindamycin Hydrochloride | Gram-positive coccal infections where these cannot be safely and effectively treated with a penicillin |
| Codeine Phosphate | — |
| Codeine Phosphate with Paracetamol | — |
| Diazepam | — |
| Diclofenac Sodium | In respect of the suppository 100 mg: |
| — | |
| In respect of the tablet 25 mg (enteric coated) and tablet 50 mg (enteric coated): | |
| Chronic arthropathies (including osteoarthritis) with an inflammatory component | |
| Bone pain due to malignant disease | |
| Dicloxacillin Sodium | In respect of the powder for injection equivalent to 500 mg dicloxacillin and powder for injection equivalent to 1 g dicloxacillin: |
| — | |
| In respect of the capsule equivalent to 250 mg dicloxacillin and capsule equivalent to 500 mg dicloxacillin: | |
| Serious staphylococcal infections | |
| Doxycycline Hydrochloride | — |
| Doxycycline Monohydrate | — |
| Erythromycin | — |
| Erythromycin Ethyl Succinate | — |
| Erythromycin Ethyl Succinate with Water - Purified BP | — |
| Erythromycin Lactobionate | — |
| Flucloxacillin Magnesium with Water - Purified BP | Serious staphylococcal infections |
| Flucloxacillin Sodium | In respect of the powder for injection equivalent to 500 mg flucloxacillin and powder for injection equivalent to 1 g flucloxacillin: |
| — | |
| In respect of the capsule equivalent to 250 mg flucloxacillin and capsule equivalent to 500 mg flucloxacillin: | |
| Serious staphylococcal infections | |
| Glucagon Hydrochloride | — |
| Glucose | — |
| Glyceryl Trinitrate | — |
| Hydrocortisone Acetate | Treatment of corticosteroid-responsive dermatoses |
| Hydrocortisone Sodium Succinate | For use in a hospital |
| Hydromorphone Hydrochloride | In respect of the injection 2 mg in 1 mL ampoule, injection 10 mg in 1 mL ampoule and injection 50 mg in 5 mL ampoule: |
| — | |
| In respect of the tablet 2 mg, tablet 4 mg, tablet 8 mg and oral liquid 1 mg per mL, 473 mL: | |
| Severe disabling pain not responding to non-narcotic analgesics | |
| Ibuprofen | In respect of the tablet 400 mg: |
| — | |
| In respect of the tablet 200 mg: | |
| Chronic arthropathies (including osteoarthritis) with an inflammatory component | |
| Bone pain due to malignant disease | |
| Indomethacin | In respect of the suppository 100 mg: |
| — | |
| In respect of the capsule 25 mg: | |
| Chronic arthropathies (including osteoarthritis) with an inflammatory component | |
| Bone pain due to malignant disease | |
| Ketoprofen | In respect of the suppository 100 mg: |
| — | |
| In respect of the capsule 200 mg (sustained release): | |
| Chronic arthropathies (including osteoarthritis) with an inflammatory component | |
| Lignocaine Hydrochloride | — |
| Lincomycin Hydrochloride | — |
| Methylprednisolone Acetate | For local intra-articular or peri-articular infiltration |
| Metoclopramide Hydrochloride | — |
| Metronidazole | In respect of the tablet 200 mg, tablet 400 mg and suppositories 500 mg, 10: |
| — | |
| In respect of the I.V. infusion 500 mg in 100 mL: | |
| Treatment, in a hospital, of acute anaerobic sepsis | |
| Metronidazole Benzoate | — |
| Morphine Hydrochloride | Severe disabling pain not responding to non-narcotic analgesics |
| Morphine Sulfate | In respect of the injection 10 mg in 1 mL ampoule, injection 15 mg in 1 mL ampoule and injection 30 mg in 1 mL ampoule: |
| — | |
| In respect of the tablet 30 mg: | |
| Severe disabling pain not responding to non-narcotic analgesics | |
| In respect of the tablet 5 mg (controlled release), tablet 10 mg (controlled release), tablet 15 mg (controlled release), tablet 30 mg (controlled release), tablet 60 mg (controlled release), tablet 100 mg (controlled release), capsule 10 mg (containing sustained release pellets), capsule 20 mg (containing sustained release pellets), capsule 30 mg (controlled release), capsule 50 mg (containing sustained release pellets), capsule 60 mg (controlled release), capsule 90 mg (controlled release), capsule 100 mg (containing sustained release pellets), capsule 120 mg (controlled release), sachet containing controlled release granules for oral suspension, 20 mg per sachet, sachet containing controlled release granules for oral suspension, 30 mg per sachet, sachet containing controlled release granules for oral suspension, 60 mg per sachet and sachet containing controlled release granules for oral suspension, 100 mg per sachet: | |
| Chronic severe disabling pain not responding to non-narcotic analgesics | |
| Naloxone Hydrochloride | — |
| Naproxen | Chronic arthropathies (including osteoarthritis) with an inflammatory component |
| Bone pain due to malignant disease | |
| Naproxen Sodium | Chronic arthropathies (including osteoarthritis) with an inflammatory component |
| Bone pain due to malignant disease | |
| Nitrazepam | — |
| Nystatin | — |
| Oxazepam | — |
| Oxycodone Hydrochloride | In respect of the tablet 5 mg, capsule 5 mg, capsule 10 mg, capsule 20 mg and oral solution 5 mg per 5 mL, 250 mL: |
| Severe disabling pain not responding to non-narcotic analgesics | |
| In respect of the tablet 5 mg (controlled release), tablet 10 mg (controlled release), tablet 20 mg (controlled release), tablet 40 mg (controlled release) and tablet 80 mg (controlled release): | |
| Chronic severe disabling pain not responding to non-narcotic analgesics | |
| Oxycodone Pectinate | Severe disabling pain not responding to non-narcotic analgesics |
| Paracetamol | — |
| Pethidine Hydrochloride | Short-term treatment of acute pain |
| Phenoxymethylpenicillin Benzathine | — |
| Phenoxymethylpenicillin Potassium | — |
| Piroxicam | Chronic arthropathies (including osteoarthritis) with an inflammatory component |
| Procaine Penicillin | — |
| Prochlorperazine | — |
| Prochlorperazine Maleate | — |
| Prochlorperazine Mesylate | — |
| Promethazine Hydrochloride | — |
| Sodium Chloride | — |
| Sodium Chloride with Glucose | — |
| Sulindac | Chronic arthropathies (including osteoarthritis) with an inflammatory component |
| Bone pain due to malignant disease | |
| Temazepam | — |
| Ticarcillin Sodium with Potassium Clavulanate | Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent |
| Tramadol Hydrochloride | In respect of the capsule 50 mg: |
| For acute pain where aspirin or paracetamol alone is inappropriate or has failed | |
| For dosage titration in chronic pain where aspirin or paracetamol alone is inappropriate or has failed | |
| In respect of the tablet 100 mg (sustained release), tablet 150 mg (sustained release), tablet 200 mg (sustained release) and oral drops 100 mg per mL, 10 mL: | |
| For pain where aspirin or paracetamol alone is inappropriate or has failed | |
| In respect of the injection 100 mg in 2 mL ampoule: | |
| Short-term treatment of acute pain | |
| Triamcinolone Acetonide | For local intra-articular or peri-articular infiltration |
| Keloid | |
| Lichen planus hypertrophic | |
| Trimethoprim with Sulfamethoxazole | — |
| Vancomycin Hydrochloride | Prophylaxis of endocarditis in patients hypersensitive to penicillin |
| Abacavir Sulfate | Abacavir Sulfate with Lamivudine |
| Abacavir Sulfate with Lamivudine and Zidovudine | |
| Alendronate Sodium | Alendronate Sodium with Colecalciferol |
| Aluminium Hydroxide - Dried | Aluminium Hydroxide - Dried with Magnesium Hydroxide |
| Aluminium Hydroxide - Dried with Magnesium Trisilicate and Magnesium Hydroxide | |
| Amiloride Hydrochloride | Hydrochlorothiazide with Amiloride Hydrochloride |
| Amoxycillin Trihydrate | Amoxycillin Trihydrate with Potassium Clavulanate |
| Amoxycillin Trihydrate with Potassium Clavulanate and Water - Purified BP | |
| Amoxycillin Trihydrate with Water - Purified BP | |
| Aspirin | Dipyridamole with Aspirin |
| Atropine Sulfate | Diphenoxylate Hydrochloride with Atropine Sulfate |
| Azithromycin Dihydrate | Azithromycin Dihydrate with Water - Purified BP |
| Bacitracin Zinc | Neomycin Undecenoate with Bacitracin Zinc |
| Benserazide Hydrochloride | Levodopa with Benserazide Hydrochloride |
| Betamethasone Acetate | Betamethasone Acetate with Betamethasone Sodium Phosphate |
| Betamethasone Sodium Phosphate | Betamethasone Acetate with Betamethasone Sodium Phosphate |
| Bisacodyl | Docusate Sodium with Bisacodyl |
| Brimonidine Tartrate | Brimonidine Tartrate with Timolol Maleate |
| Budesonide | Budesonide with Eformoterol Fumarate Dihydrate |
| Buprenorphine Hydrochloride | Buprenorphine Hydrochloride with Naloxone Hydrochloride |
| Calcium Carbonate | Sodium Alginate with Calcium Carbonate and Sodium Bicarbonate |
| Calcium Chloride | Sodium Chloride with Potassium Chloride and Calcium Chloride |
| Sodium Lactate with Sodium Chloride, Potassium Chloride and Calcium Chloride | |
| Candesartan Cilexetil | Candesartan Cilexetil with Hydrochlorothiazide |
| Carbidopa | Levodopa with Carbidopa |
| Levodopa with Carbidopa and Entacapone | |
| Carbomer 980 | Hypromellose with Carbomer 980 |
| Cefaclor Monohydrate | Cefaclor Monohydrate with Water - Purified BP |
| Cephalexin | Cephalexin with Water - Purified BP |
| Chlorhexidine Gluconate | Silver Sulfadiazine with Chlorhexidine Gluconate |
| Codeine Phosphate | Codeine Phosphate with Paracetamol |
| Colecalciferol | Alendronate Sodium with Colecalciferol |
| Cyproterone Acetate | Oestradiol Valerate with Cyproterone Acetate |
| Dexamethasone Sodium Metasulfobenzoate | Dexamethasone Sodium Metasulfobenzoate with Framycetin Sulfate and Gramicidin |
| Dextran 70 | Hypromellose 2900 with Dextran 70 |
| Hypromellose 4500 with Dextran 70 | |
| Diphenoxylate Hydrochloride | Diphenoxylate Hydrochloride with Atropine Sulfate |
| Dipyridamole | Dipyridamole with Aspirin |
| Docusate Sodium | Docusate Sodium with Bisacodyl |
| Dorzolamide Hydrochloride | Dorzolamide Hydrochloride with Timolol Maleate |
| Dydrogesterone | Oestradiol with Dydrogesterone |
| Eformoterol Fumarate Dihydrate | Budesonide with Eformoterol Fumarate Dihydrate |
| Emtricitabine | Tenofovir Disoproxil Fumarate with Emtricitabine |
| Enalapril Maleate | Enalapril Maleate with Hydrochlorothiazide |
| Entacapone | Levodopa with Carbidopa and Entacapone |
| Eprosartan Mesylate | Eprosartan Mesylate with Hydrochlorothiazide |
| Erythromycin Ethyl Succinate | Erythromycin Ethyl Succinate with Water - Purified BP |
| Ethinyloestradiol | Levonorgestrel with Ethinyloestradiol |
| Norethisterone with Ethinyloestradiol | |
| Ezetimibe | Ezetimibe with Simvastatin |
| Ferrous Fumarate | Ferrous Fumarate with Folic Acid |
| Flucloxacillin Magnesium | Flucloxacillin Magnesium with Water - Purified BP |
| Fluticasone Propionate | Fluticasone Propionate with Salmeterol Xinafoate |
| Folic Acid | Ferrous Fumarate with Folic Acid |
| Fosinopril Sodium | Fosinopril Sodium with Hydrochlorothiazide |
| Framycetin Sulfate | Dexamethasone Sodium Metasulfobenzoate with Framycetin Sulfate and Gramicidin |
| Frangula Bark | Sterculia with Frangula Bark |
| Glibenclamide | Metformin Hydrochloride with Glibenclamide |
| Glucose | Glucose with Sodium Chloride, Potassium Chloride and Sodium Acid Citrate |
| Sodium Chloride with Glucose | |
| Gramicidin | Dexamethasone Sodium Metasulfobenzoate with Framycetin Sulfate and Gramicidin |
| Triamcinolone Acetonide with Neomycin Sulfate, Gramicidin and Nystatin | |
| Hydrochlorothiazide | Candesartan Cilexetil with Hydrochlorothiazide |
| Enalapril Maleate with Hydrochlorothiazide | |
| Eprosartan Mesylate with Hydrochlorothiazide | |
| Fosinopril Sodium with Hydrochlorothiazide | |
| Hydrochlorothiazide with Amiloride Hydrochloride | |
| Hydrochlorothiazide with Triamterene | |
| Irbesartan with Hydrochlorothiazide | |
| Quinapril Hydrochloride with Hydrochlorothiazide | |
| Telmisartan with Hydrochlorothiazide | |
| Hypromellose | Hypromellose with Carbomer 980 |
| Hypromellose 2900 | Hypromellose 2900 with Dextran 70 |
| Hypromellose 4500 | Hypromellose 4500 with Dextran 70 |
| Indapamide Hemihydrate | Perindopril Erbumine with Indapamide Hemihydrate |
| Insulin - Isophane | Insulin - Neutral with Insulin - Isophane |
| Insulin - Neutral | Insulin - Neutral with Insulin - Isophane |
| Insulin Aspart | Insulin Aspart with Insulin Aspart Protamine Suspension |
| Insulin Aspart Protamine Suspension | Insulin Aspart with Insulin Aspart Protamine Suspension |
| Insulin Lispro | Insulin Lispro with Insulin Lispro Protamine Suspension |
| Insulin Lispro Protamine Suspension | Insulin Lispro with Insulin Lispro Protamine Suspension |
| Irbesartan | Irbesartan with Hydrochlorothiazide |
| Lamivudine | Abacavir Sulfate with Lamivudine |
| Abacavir Sulfate with Lamivudine and Zidovudine | |
| Lamivudine with Zidovudine | |
| Latanoprost | Latanoprost with Timolol Maleate |
| Levodopa | Levodopa with Benserazide Hydrochloride |
| Levodopa with Carbidopa | |
| Levodopa with Carbidopa and Entacapone | |
| Levonorgestrel | Levonorgestrel with Ethinyloestradiol |
| Lopinavir | Lopinavir with Ritonavir |
| Macrogol 3350 | Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride |
| Magnesium Chloride | Sodium Chloride with Sodium Acetate, Sodium Gluconate, Potassium Chloride and Magnesium Chloride |
| Magnesium Hydroxide | Aluminium Hydroxide - Dried with Magnesium Hydroxide |
| Aluminium Hydroxide - Dried with Magnesium Trisilicate and Magnesium Hydroxide | |
| Magnesium Trisilicate | Aluminium Hydroxide - Dried with Magnesium Trisilicate and Magnesium Hydroxide |
| Medroxyprogesterone Acetate | Oestrogens—Conjugated with Medroxyprogesterone Acetate |
| Mestranol | Norethisterone with Mestranol |
| Metformin Hydrochloride | Metformin Hydrochloride with Glibenclamide |
| Mycophenolate Mofetil | Mycophenolate Mofetil with Water - Purified BP |
| Naloxone Hydrochloride | Buprenorphine Hydrochloride with Naloxone Hydrochloride |
| Neomycin Sulfate | Triamcinolone Acetonide with Neomycin Sulfate, Gramicidin and Nystatin |
| Neomycin Undecenoate | Neomycin Undecenoate with Bacitracin Zinc |
| Norethisterone | Norethisterone with Ethinyloestradiol |
| Norethisterone with Mestranol | |
| Norethisterone Acetate | Oestradiol with Norethisterone Acetate |
| Oestradiol Hemihydrate with Norethisterone Acetate | |
| Nystatin | Triamcinolone Acetonide with Neomycin Sulfate, Gramicidin and Nystatin |
| Oestradiol | Oestradiol with Dydrogesterone |
| Oestradiol with Norethisterone Acetate | |
| Oestradiol Hemihydrate | Oestradiol Hemihydrate with Norethisterone Acetate |
| Oestradiol Valerate | Oestradiol Valerate with Cyproterone Acetate |
| Oestrogens—Conjugated | Oestrogens—Conjugated with Medroxyprogesterone Acetate |
| Paracetamol | Codeine Phosphate with Paracetamol |
| Paraffin - Liquid | Paraffin - Soft White with Paraffin - Liquid |
| Paraffin - Soft White | Paraffin - Soft White with Paraffin - Liquid |
| Perindopril Erbumine | Perindopril Erbumine with Indapamide Hemihydrate |
| Phenylephrine Hydrochloride | Prednisolone Acetate with Phenylephrine Hydrochloride |
| Polyethylene Glycol 400 | Polyethylene Glycol 400 with Propylene Glycol |
| Potassium Bicarbonate | Potassium Chloride with Potassium Bicarbonate |
| Potassium Chloride | Glucose with Sodium Chloride, Potassium Chloride and Sodium Acid Citrate |
| Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride | |
| Potassium Chloride with Potassium Bicarbonate | |
| Sodium Chloride with Potassium Chloride and Calcium Chloride | |
| Sodium Chloride with Sodium Acetate, Sodium Gluconate, Potassium Chloride and Magnesium Chloride | |
| Sodium Lactate with Sodium Chloride, Potassium Chloride and Calcium Chloride | |
| Potassium Clavulanate | Amoxycillin Trihydrate with Potassium Clavulanate |
| Amoxycillin Trihydrate with Potassium Clavulanate and Water - Purified BP | |
| Ticarcillin Sodium with Potassium Clavulanate | |
| Prednisolone Acetate | Prednisolone Acetate with Phenylephrine Hydrochloride |
| Propylene Glycol | Polyethylene Glycol 400 with Propylene Glycol |
| Quinapril Hydrochloride | Quinapril Hydrochloride with Hydrochlorothiazide |
| Ritonavir | Lopinavir with Ritonavir |
| Salmeterol Xinafoate | Fluticasone Propionate with Salmeterol Xinafoate |
| Silver Sulfadiazine | Silver Sulfadiazine with Chlorhexidine Gluconate |
| Simvastatin | Ezetimibe with Simvastatin |
| Sodium Acetate | Sodium Chloride with Sodium Acetate, Sodium Gluconate, Potassium Chloride and Magnesium Chloride |
| Sodium Acid Citrate | Glucose with Sodium Chloride, Potassium Chloride and Sodium Acid Citrate |
| Sodium Alginate | Sodium Alginate with Calcium Carbonate and Sodium Bicarbonate |
| Sodium Bicarbonate | Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride |
| Sodium Alginate with Calcium Carbonate and Sodium Bicarbonate | |
| Sodium Chloride | Glucose with Sodium Chloride, Potassium Chloride and Sodium Acid Citrate |
| Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride | |
| Sodium Chloride with Glucose | |
| Sodium Chloride with Potassium Chloride and Calcium Chloride | |
| Sodium Chloride with Sodium Acetate, Sodium Gluconate, Potassium Chloride and Magnesium Chloride | |
| Sodium Lactate with Sodium Chloride, Potassium Chloride and Calcium Chloride | |
| Sodium Citrate | Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate |
| Sodium Gluconate | Sodium Chloride with Sodium Acetate, Sodium Gluconate, Potassium Chloride and Magnesium Chloride |
| Sodium Lactate | Sodium Lactate with Sodium Chloride, Potassium Chloride and Calcium Chloride |
| Sodium Lauryl Sulfoacetate | Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate |
| Sorbitol | Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate |
| Stavudine | Stavudine with Water - Purified BP |
| Sterculia | Sterculia with Frangula Bark |
| Sulfamethoxazole | Trimethoprim with Sulfamethoxazole |
| Telmisartan | Telmisartan with Hydrochlorothiazide |
| Tenofovir Disoproxil Fumarate | Tenofovir Disoproxil Fumarate with Emtricitabine |
| Testosterone Decanoate | Testosterone Propionate with Testosterone Phenylpropionate, Testosterone Isocaproate and Testosterone Decanoate |
| Testosterone Isocaproate | Testosterone Propionate with Testosterone Phenylpropionate and Testosterone Isocaproate |
| Testosterone Propionate with Testosterone Phenylpropionate, Testosterone Isocaproate and Testosterone Decanoate | |
| Testosterone Phenylpropionate | Testosterone Propionate with Testosterone Phenylpropionate and Testosterone Isocaproate |
| Testosterone Propionate with Testosterone Phenylpropionate, Testosterone Isocaproate and Testosterone Decanoate | |
| Testosterone Propionate | Testosterone Propionate with Testosterone Phenylpropionate and Testosterone Isocaproate |
| Testosterone Propionate with Testosterone Phenylpropionate, Testosterone Isocaproate and Testosterone Decanoate | |
| Ticarcillin Sodium | Ticarcillin Sodium with Potassium Clavulanate |
| Timolol Maleate | Brimonidine Tartrate with Timolol Maleate |
| Dorzolamide Hydrochloride with Timolol Maleate | |
| Latanoprost with Timolol Maleate | |
| Triamcinolone Acetonide | Triamcinolone Acetonide with Neomycin Sulfate, Gramicidin and Nystatin |
| Triamterene | Hydrochlorothiazide with Triamterene |
| Trimethoprim | Trimethoprim with Sulfamethoxazole |
| Water - Purified BP | Amoxycillin Trihydrate with Potassium Clavulanate and Water - Purified BP |
| Amoxycillin Trihydrate with Water - Purified BP | |
| Azithromycin Dihydrate with Water - Purified BP | |
| Cefaclor Monohydrate with Water - Purified BP | |
| Cephalexin with Water - Purified BP | |
| Erythromycin Ethyl Succinate with Water - Purified BP | |
| Flucloxacillin Magnesium with Water - Purified BP | |
| Mycophenolate Mofetil with Water - Purified BP | |
| Stavudine with Water - Purified BP | |
| Zidovudine | Abacavir Sulfate with Lamivudine and Zidovudine |
| Lamivudine with Zidovudine |
Acacia BP, powdered —
Acetic Acid (33 per cent) BP —
Alum BP —
Aluminium Acetate Solution BP —
Aqueous Cream APF For use only as a base combined with active ingredients
Ascorbic Acid BP For use only as an ingredient of ferrous sulfate mixtures
Aspirin BP —
Belladonna Tincture BP —
Benzocaine BP —
Benzoic Acid BP —
Benzoin Tincture, Compound BP —
Boric Acid, Olive Oil and Zinc Oxide Ointment QHF —
Calcium Hydroxide BP —
Cetomacrogol Cream, Aqueous APF For use only as a base combined with active ingredients
Cetrimide Cream, Aqueous APF For use only as a base combined with active ingredients
Chlorhexidine Cream, Aqueous APF For use only as a base combined with active ingredients
Citric Acid Monohydrate BP —
Coal Tar BP —
Coal Tar Solution BP —
Cocaine Hydrochloride BP —
Coconut Oil BP —
Codeine Phosphate BP May only be prescribed in linctuses, mixtures and mixtures for children
Collodion, Flexible BP —
Dithranol BP —
Emulsifying Ointment BP For use only as a base combined with active ingredients
Ephedrine Hydrochloride BP May only be prescribed in nasal instillations
Ferrous Sulfate BP —
Formaldehyde Solution BP —
Gentian Alkaline Mixture APF —
Glycerol BP —
Iodine BP —
Kaolin Mixture BPC 1968 —
Kaolin and Opium Mixture APF 14 —
Lactic Acid BP —
Lavender Oil, Spike BPC 1968 —
Levomenthol BP —
Liquorice Liquid Extract BP —
Magnesium Carbonate, Light BP —
Magnesium Sulfate BP May only be prescribed for other than oral use
Magnesium Trisilicate BP —
Menthol, Racemic BP —
Methyl Hydroxybenzoate BP —
Paraffin, Hard BP —
Paraffin, Light Liquid BP —
Paraffin, Liquid BP May only be prescribed for other than oral use
Paraffin, Soft White BP —
Paraffin, Soft Yellow BP —
Phenobarbitone Sodium BP May only be prescribed for the treatment of epilepsy
Phenol, Liquefied BP Not available for ear drops
Podophyllum Resin BP —
Potassium Citrate BP —
Potassium Iodide BP —
Potassium Permanganate BP —
Propylene Glycol BP —
Propyl Hydroxybenzoate BP —
Red Syrup APF 15 —
Resorcinol BP —
Salicylic Acid BP —
Simple Ointment (white) BP For use only as a base combined with active ingredients
Simple Ointment (yellow) BP For use only as a base combined with active ingredients
Sodium Bicarbonate BP —
Sodium Chloride BP —
Sodium Citrate BP —
Starches BP —
Sulfur, Precipitated BP 1980 —
Syrup BP —
Talc, Purified BP, sterilised —
Thymol BP —
Thymol Mouth Wash, Compound APF 15 —
Tragacanth BP, powdered —
Tragacanth Powder, Compound BP 1980 —
Trichloroacetic Acid BP 1980 —
Triethanolamine BP —
Water for Injections, sterilised BP May only be prescribed in eye drops and eye lotions
Water, Purified BP —
Wool Alcohols Ointment (white) BP For use only as a base combined with active ingredients
Wool Alcohols Ointment (yellow) BP For use only as a base combined with active ingredients
Wool Fat BP —
Wool Fat, Hydrous BP —
Zinc Cream BP For use only as a base combined with active ingredients
Zinc Oxide BP —
Zinc Sulfate BP —
SCHEDULE 5 — ADDITIVES
Acetone BP
Anise Water, Concentrated BP
Boric Acid BP
Castor Oil BP
Chlorhexidine Acetate BP
Chloroform BP
Ethanol (96 per cent) BP
Ethanols, Dilute BP
Ether, Solvent BP
Eucalyptus Oil BP
Honey, Purified BP 1993
Industrial Methylated Spirit BP
Olive Oil BP
Peppermint Oil BP
Peppermint Water, Concentrated APF
Pholcodine Citrate Syrup BPC 1959
Sodium Thiosulfate BP
| Abacavir Sulfate |
| Abacavir Sulfate with Lamivudine |
| Abacavir Sulfate with Lamivudine and Zidovudine |
| Adefovir Dipivoxil |
| Amprenavir |
| Apomorphine Hydrochloride |
| Atazanavir Sulfate |
| Bosentan Monohydrate |
| Botulinum Toxin Type A Purified Neurotoxin Complex |
| Buprenorphine Hydrochloride |
| Buprenorphine Hydrochloride with Naloxone Hydrochloride |
| Charcoal - Activated |
| Cidofovir |
| Clostridium Botulinum Type A Toxin—Haemagglutinin Complex |
| Clozapine |
| Darbepoetin Alfa |
| Deferiprone |
| Delavirdine Mesylate |
| Desferrioxamine Mesylate |
| Didanosine |
| Dornase Alfa |
| Efavirenz |
| Emtricitabine |
| Enfuvirtide |
| Epoetin Alfa |
| Epoetin Beta |
| Epoprostenol Sodium |
| Filgrastim |
| Fosamprenavir Calcium |
| Foscarnet Sodium |
| Ganciclovir |
| Ganciclovir Sodium |
| Iloprost Trometamol |
| Imatinib Mesylate |
| Indinavir Sulfate |
| Infliximab |
| Interferon Gamma-1b |
| Lamivudine |
| Lamivudine with Zidovudine |
| Lanreotide Acetate |
| Lenograstim |
| Lopinavir with Ritonavir |
| Nelfinavir Mesylate |
| Nevirapine |
| Octreotide Acetate |
| Pegfilgrastim |
| Peginterferon Alfa-2a |
| Peginterferon Alfa-2b |
| Progesterone |
| Ribavirin and Peginterferon Alfa-2a |
| Ribavirin and Peginterferon Alfa-2b |
| Rifabutin |
| Ritonavir |
| Saquinavir |
| Saquinavir Mesylate |
| Somatropin |
| Stavudine |
| Stavudine with Water - Purified BP |
| Tenofovir Disoproxil Fumarate |
| Tenofovir Disoproxil Fumarate with Emtricitabine |
| Thalidomide |
| Trastuzumab |
| Valganciclovir Hydrochloride |
| Zidovudine |
| Zoledronic Acid |
Dated this 21st day of September 2006.
| JOAN CORBETT Assistant Secretary Pharmaceutical Benefits Branch Department of Health and Ageing Delegate of the Minister for Health and Ageing |
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