National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2012 (No. 8) (No. PB 93 of 2012) (Cth)

Case

PB 93 of 2012

National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2012
(No. 8)1


National Health Act 1953

I, FELICITY McNEILL, First Assistant Secretary, Pharmaceutical Benefits Division, Department of Health and Ageing, delegate of the Minister for Health, make this Instrument under sections 84AF, 84AK, 85, 85A, 88 and 101 of the National Health Act 1953.

Dated 26 November 2012

FELICITY McNEILL

First Assistant Secretary

Pharmaceutical Benefits Division

Department of Health and Ageing

1          Name of Instrument

(1)        This Instrument is the National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2012 (No. 8).

(2)        This Instrument may also be cited as PB 93 of 2012.

2          Commencement

This Instrument commences on 1 December 2012.

3          Amendment of National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012)

Schedule 1 amends the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012).

Schedule 1     Amendments

  1. Section 4, Definitions

(a)           omit full stop from the definition of Team Care Arrangements and substitute a semicolon

(b)           insert after definition of Team Care Arrangements and before Note:

TGA means Therapeutic Goods Administration;

WHO means World Health Organisation.

  1. Schedule 1, entry for Aciclovir in the form Tablet 200 mg [GenRx Aciclovir; Max Quantity 50; Number of Repeats 0]

omit from the column headed “Pack Quantity”:          25           substitute:             50

  1. Schedule 1, after entry for Adrenaline in the form I.M. injection 300 micrograms in 0.3 mL single dose syringe auto-injector (Anapen)

insert:

Aflibercept Solution for intravitreal injection 4 mg in 100 microlitres (40 mg per mL) Injection Eylea BN MP C4153 C4154 1 2 1
  1. Schedule 1, entry for Alendronic Acid in the form Tablet 70 mg (as alendronate sodium)

(a)omit from the column headed “Circumstances” (all instances):

C2646 C3070
C3933

substitute:

C4122 C4123
C4133

(b)insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Alendronate Pfizer FZ MP NP C4122 C4123 C4133 4 5 4
  1. Schedule 1, entry for Alendronic acid with colecalciferol in the form Tablet 70 mg (as alendronate sodium) with 70 micrograms colecalciferol

omit from the column headed “Circumstances”:

C2646 C3070
C3933

substitute:

C4070 C4087
C4110
  1. Schedule 1, entry for Alendronic acid with colecalciferol in the form Tablet 70 mg (as alendronate sodium) with 140 micrograms colecalciferol

omit from the column headed “Circumstances” (twice occurring):

C2646 C3070
C3933

substitute:

C4122 C4123
C4133
  1. Schedule 1, entry for Alendronic acid with colecalciferol and calcium

omit from the column headed “Circumstances” (twice occurring):

C2646 C3070
C3933

substitute:

C4122 C4123
C4133
  1. Schedule 1, entry for Amlodipine with valsartan in the form Tablet 5 mg (as besylate)-80 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Valsartan/ Amlodipine Sandoz 80/5 NM MP NP C3307 28 5 28
  1. Schedule 1, entry for Amlodipine with valsartan and hydrochlorothiazide in the form Tablet 5 mg (as besylate)-160 mg-12.5 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Valsartan/ Amlodipine/HCT Sandoz 160/5/12.5 NM MP NP C3539 28 5 28
  1. Schedule 1, entry for Amoxycillin in the form Capsule 250 mg (as trihydrate)

(a)           omit:

GenRx Amoxycillin GX PDP 20 0 20

(b)           omit:

GenRx Amoxycillin GX MP NP MW 20 1 20
  1. Schedule 1, entry for Amoxycillin in the form Capsule 500 mg (as trihydrate)

(a)           omit:

GenRx Amoxycillin GX PDP 20 0 20

(b)           omit:

GenRx Amoxycillin GX MP NP MW 20 1 20
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 125 mg amoxycillin
    (as trihydrate) with 31.25 mg clavulanic acid (as potassium clavulanate) per 5 mL, 75 mL [Max Quantity 1; Number of Repeats 0]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

GA-Amclav 125/31.25 GM PDP C1836 C1837 1 0 1
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 125 mg amoxycillin
    (as trihydrate) with 31.25 mg clavulanic acid (as potassium clavulanate) per 5 mL, 75 mL [Max Quantity 1; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

GA-Amclav 125/31.25 GM MP NP C1836 C1837 1 1 1
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 400 mg amoxycillin
    (as trihydrate) with 57 mg clavulanic acid (as potassium clavulanate) per 5 mL, 60 mL [Max Quantity 1; Number of Repeats 0]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

GA-Amclav Forte 400/57 GM PDP C1836 C1837 1 0 1
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 400 mg amoxycillin
    (as trihydrate) with 57 mg clavulanic acid (as potassium clavulanate) per 5 mL, 60 mL [Max Quantity 1; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

GA-Amclav Forte 400/57 GM MP NP C1836 C1837 1 1 1
  1. Schedule 1, entry for Anastrozole

(a)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Pharmacy Choice Anastrozole RI MP NP C2213 30 5 30

(b)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

STADA Anastrozole TD MP NP C2213 30 5 30
  1. Schedule 1, entry for Apomorphine in the form Injection containing apomorphine hydrochloride 20 mg in 2 mL

(a)           omit from the column headed “Max Quantity”:           5              substitute:             360

(b)           omit from the column headed “Number of Repeats”:  0              substitute:             5

  1. Schedule 1, entry for Apomorphine in the form Injection containing apomorphine hydrochloride 50 mg in 5 mL

(a)           omit from the column headed “Max Quantity”:           5              substitute:             180

(b)           omit from the column headed “Number of Repeats”:  0              substitute:             5

  1. Schedule 1, entry for Apomorphine in the form Solution for subcutaneous infusion containing apomorphine hydrochloride 50 mg in 10 mL pre-filled syringe

(a)           omit from the column headed “Max Quantity”:           5              substitute:             180

(b)           omit from the column headed “Number of Repeats”:  0              substitute:             5

  1. Schedule 1, entry for Atenolol in the form Tablet 50 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Tenolten 50 DO MP NP 30 5 30
  1. Schedule 1, after entry for Atenolol in the form Tablet 50 mg [Terry White Chemists Atenolol]

insert in the columns in the order indicated:

Oral solution 50 mg in 10 mL, 300 mL Oral Atenolol-AFT AE MP NP C4076 1 5 1
  1. Schedule 1, entry for Auranofin in the form Capsule 3 mg

omit from the column headed “Responsible person”: BZ          substitute:             GH

  1. Schedule 1, entry for Betamethasone

omit:

Ointment 200 micrograms (as valerate) per g, 100 g Application Antroquoril FR MP NP C1422 2 0 1
Celestone-M MK MP NP C1422 2 0 1
  1. Schedule 1, entry for Bortezomib in the form Powder for injection 1 mg

omit all codes from the column headed “Circumstances” and substitute:

C4082 C4103
C4127 C4141
C4163
  1. Schedule 1, entry for Bortezomib in the form Powder for injection 3.5 mg

omit all codes from the column headed “Circumstances” and substitute:

C4079 C4080
C4081 C4126
C4161 C4162
  1. Schedule 1, entry for Cabazitaxel

omit all codes from the column headed “Circumstances” and substitute:

C4073 C4138
  1. Schedule 1, entry for Carbomer with Triglyceride Lipids

omit from the column headed “Form”:

Eye gel 2 mg-10 mg per g, 10 g, single dose units 0.6 g, 30

substitute:

Eye gel 2 mg-10 mg per g, single dose units 0.6 g, 30

  1. Schedule 1, entry for Carvedilol in the form Tablet 3.125 mg

omit:

GenRx Carvedilol GX MP NP C1735 C3234 30 0 30
  1. Schedule 1, entry for Carvedilol in the form Tablet 6.25 mg

omit:

GenRx Carvedilol GX MP NP C1735 C3234 60 5 60
  1. Schedule 1, entry for Carvedilol in the form Tablet 12.5 mg

omit:

GenRx Carvedilol GX MP NP C1735 C3234 60 5 60
  1. Schedule 1, entry for Cefaclor in the form Powder for oral suspension 125 mg (as monohydrate) per 5 mL, 100 mL

(a)           omit:

Cefaclor Sandoz SZ PDP 1 0 1

(b)           omit:

Cefaclor Sandoz SZ MP 1 1 1
  1. Schedule 1, entry for Cefaclor in the form Powder for oral suspension 250 mg (as monohydrate) per 5 mL, 75 mL

(a)           omit:

Cefaclor Sandoz SZ PDP 1 0 1

(b)           omit:

Cefaclor Sandoz SZ MP 1 1 1
  1. Schedule 1, entry for Cefepime in the form Powder for injection 2 g (as hydrochloride)

omit:

Maxipime BQ MP NP C1427 10 0 1
  1. Schedule 1, entry for Cephalexin in the form Granules for oral suspension 125 mg per 5 mL, 100 mL

(a)           omit:

GenRx Cephalexin GX PDP 1 0 1

(b)           omit:

GenRx Cephalexin GX MP NP 1 1 1
  1. Schedule 1, entry for Cephalexin in the form Granules for oral suspension 250 mg per 5 mL, 100 mL

(a)           omit:

GenRx Cephalexin GX PDP 1 0 1

(b)           omit:

GenRx Cephalexin GX MP NP 1 1 1
  1. Schedule 1, entry for Citalopram in each of the forms: Tablet 20 mg (as hydrobromide); and Tablet 40 mg (as hydrobromide)

omit:

GenRx Citalopram GX MP NP C1211 28 5 28
  1. Schedule 1, entry for Clarithromycin in the form Tablet 250 mg

omit:

GenRx Clarithromycin GX MP NP 14 1 14
  1. Schedule 1, entry for Clopidogrel with aspirin in the form Tablet 75 mg (as hydrogen sulfate)-100 mg

(a)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

APO-Clopidogrel/ Aspirin 75/100 TX MP NP C1722 C3219 C3880 30 5 30

(b)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Chem mart Clopidogrel/ Aspirin 75/100 CH MP NP C1722 C3219 C3880 30 5 30

(c)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Terry White Chemists  Clopidogrel/ Aspirin 75/100 TW MP NP C1722 C3219 C3880 30 5 30
  1. Schedule 1, entry for Clozapine in each of the forms: Tablet 25 mg; Tablet 50 mg; Tablet 100 mg; and Tablet 200 mg

omit from the column headed “Max Quantity” (all instances):                 100         substitute:             200

  1. Schedule 1, entry for Cyproterone in the form Tablet containing cyproterone acetate 50 mg [Max Quantity 20; Number of Repeats 5]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Cyproterone-PS FZ MP C1014 C1230 C1404 P1230 20 5 20
  1. Schedule 1, entry for Cyproterone in the form Tablet containing cyproterone acetate 50 mg [Max Quantity 100; Number of Repeats 5]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Cyproterone-PS FZ MP C1014 C1230 C1404 P1014 P1404 100 5 50
  1. Schedule 1, entry for Cyproterone in the form Tablet containing cyproterone acetate 100 mg

(a)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Cyproterone-PS 100 FZ MP C1014 C1404 50 5 50

(b)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Cyproterone Sandoz HX MP C1014 C1404 50 5 50
  1. Schedule 1, entry for Denosumab in the form Injection 60 mg in 1 mL pre-filled syringe

omit from the column headed “Circumstances”:

C3987  C4054

insert in numerical order:

C4094  C4145

  1. Schedule 1, entry for Denosumab in the form Injection 120 mg in 1.7 mL

omit from the column headed “Circumstances”:

C1035  C4051

insert in numerical order:

C4150  C4158

  1. Schedule 1, entry for Docetaxel

substitute:

Docetaxel Solution concentrate for I.V. infusion 140 mg in 7 mL Injection Oncotaxel 140 TA MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Solution concentrate for I.V. infusion 160 mg in 16 mL Injection DBL Docetaxel Concentrated Injection HH MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Powder for I.V. infusion 20 mg with solvent Injection Docetaxel SUN ZF MP C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Powder for I.V. infusion 80 mg with solvent Injection Docetaxel SUN ZF MP C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Solution concentrate for I.V. infusion 20 mg in 1 mL Injection Oncotaxel 20 TA MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 See Note 3 1 D(100)
Taxotere SW MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 See Note 3 1 D(100)
Solution concentrate for I.V. infusion 20 mg in 2 mL Injection DBL Docetaxel Concentrated Injection HH MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 See Note 3 1 D(100)
Docetaxel Ebewe HX MP C3888 C3916 C4078 C4140 C4155 C4160 See Note 3 See Note 3 See Note 3 1 D(100)
Docetaxel Sandoz SZ MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 See Note 3 1 D(100)
Solution concentrate for I.V. infusion 80 mg in 4 mL Injection Oncotaxel 80 TA MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Taxotere SW MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Solution concentrate for I.V. infusion 80 mg in 8 mL Injection DBL Docetaxel Concentrated Injection HH MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Docetaxel Ebewe HX MP C3888 C3916 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Docetaxel Sandoz SZ MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
Injection set containing 1 single use vial concentrate for I.V. infusion 80 mg (anhydrous) in 2 mL with solvent Injection Taxotere SW MP C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160 See Note 3 See Note 3 1 D(100)
  1. Schedule 1, entry for Etanercept

substitute:

Etanercept Injection 50 mg in 1 mL single use auto-injector, 4 Injection Enbrel PF MP
See Note 1
See Note 3 See Note 3 See Note 3 See Note 3 1 C(100)
MP
See Note 1
C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151 P3273 P3275 P3489 P3510 P3524 P3708 P3770 P3772 P3774 P3776 P3778 P3779 P4088 P4114 P4115 P4116 P4125 P4136 P4137 P4151 1 3 1
MP
See Note 1
C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151 P3771 P3773 P3775 P3777 P3780 P3781 1 5 1
Injections 50 mg in 1 mL single use pre-filled syringes, 4 Injection Enbrel PF MP
See Note 1
See Note 3 See Note 3 See Note 3 See Note 3 1 C(100)
MP
See Note 1
C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151 P3273 P3275 P3489 P3510 P3524 P3708 P3770 P3772 P3774 P3776 P3778 P3779 P4088 P4114 P4115 P4116 P4125 P4136 P4137 P4151 1 3 1
C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151 P3771 P3773 P3775 P3777 P3780 P3781 1 5 1
Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL Injection Enbrel PF MP
See Note 1
See Note 3 See Note 3 See Note 3 See Note 3 1 C(100)
MP
See Note 1
C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151 P3273 P3275 P3489 P3510 P3524 P3708 P3770 P3772 P3774 P3776 P3778 P3779 P4088 P4114 P4115 P4116 P4125 P4136 P4137 P4151 2 3 1
MP
See Note 1
C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151 P3771 P3773 P3775 P3777 P3780 P3781 2 5 1
  1. Schedule 1, entry for Ezetimibe with Simvastatin in each of the forms: Tablet 10 mg-10 mg; and Tablet 10 mg-20 mg

omit all codes from the column headed “Circumstances” and substitute:

C4068 C4069
C4085 C4086
C4096 C4097
C4120 C4121
C4147
  1. Schedule 1, entry for Ezetimibe with Simvastatin in each of the forms: Tablet 10 mg-40 mg; and Tablet 10 mg-80 mg

omit all codes from the column headed “Circumstances” and substitute:

C4068 C4069
C4085 C4086
C4096 C4097
C4120 C4121
  1. Schedule 1, entry for Famciclovir in the form Tablet 125 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Famciclovir-GA GM MP NP C3624 40 1 40
  1. Schedule 1, entry for Famciclovir in the form Tablet 250 mg [Max Quantity 20; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Famciclovir-GA GM MP NP C3622 C3623 C3624 P3624 20 1 20
  1. Schedule 1, entry for Famciclovir in the form Tablet 250 mg [Max Quantity 21; Number of Repeats 0]

(a)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Famciclovir-GA GM MP NP C3622 C3623 C3624 P3622 21 0 21

(b)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Famciclovir generichealth 250 GQ MP NP C3622 C3623 P3622 21 0 21
  1. Schedule 1, entry for Famciclovir in the form Tablet 250 mg [Max Quantity 56; Number of Repeats 5]

(a)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Famciclovir-GA GM MP NP C3622 C3623 C3624 P3623 56 5 56

(b)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Famciclovir generichealth 250 GQ MP NP C3622 C3623 P3623 56 5 56
  1. Schedule 1, entry for Famciclovir in the form Tablet 500 mg [Max Quantity 56; Number of Repeats 5]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Famciclovir-GA GM MP NP C3626 C3627 C3628 C3629 P3626 P3627 P3628 P3629 56 5 56
  1. Schedule 1, entry for Gemfibrozil in the form Tablet 600 mg [Max Quantity 60; Number of Repeats 5]

(a)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Gemfibrozil-GA GM MP C1540 C3047 P1540 60 5 60
NP C1540 60 5 60

(b)           omit:

Lipazil 600 mg GM MP C1540 C3047 P1540 60 5 60
NP C1540 60 5 60
  1. Schedule 1, entry for Gemfibrozil in the form Tablet 600 mg [Max Quantity 60; Number of Repeats 11]

(a)           insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Gemfibrozil-GA GM MP C1540 C3047 P3047 60 11 60

(b)           omit:

Lipazil 600 mg GM MP C1540 C3047 P3047 60 11 60
  1. Schedule 1, entry for Glucose Indicator―Blood

(a)           insert in the columns indicated after “Test strips, 50 (Glucocard 01 Sensor)”:

Test strips, 50 (GlucoDr) For external use GlucoDr OZ MP NP 2 5 1
MP P3035 2 11 1

(b)           omit:

Test strips, 50 (GlucoOz) For external use GlucoOz OZ MP NP 2 5 1
MP P3035 2 11 1
  1. Schedule 1, entry for Granisetron

substitute:

Granisetron Tablet 2 mg (as hydrochloride) Oral Kytril RO MP NP
See Note 1
C4102 C4118 See Note 2 P4118
See Note 2
2
See Note 2
0
See Note 2
1
MP NP
See Note 1
C4102 C4118 See Note 2 P4102
See Note 2
5
See Note 2
1
See Note 2
5
Concentrated injection 3 mg (as hydrochloride) in 3 mL Injection Granisetron Kabi PK MP NP
See Note 1
C4077 C4092
See Note 2
1
See Note 2
0
See Note 2
1
Kytril RO MP NP
See Note 1
C4077 C4092
See Note 2
1
See Note 2
0
See Note 2
1
  1. Schedule 1, after entry for Human menopausal gonadotrophin

insert:

Hyaluronic Acid Eye drops containing sodium hyaluronate 1 mg per mL, 10 mL Application to the eye Hylo-Fresh AE MP NP C4105 1 5 1
AO C4130 1 5 1
Eye drops containing sodium hyaluronate 2 mg per mL, 10 mL Application to the eye Hylo-Forte AE MP NP C4105 1 5 1
AO C4130 1 5 1
  1. Schedule 1, entry for Hydroxocobalamin

substitute:

Hydroxocobalamin Injection 1 mg (as acetate) in 1 mL Injection Vita-B12 GH MP NP C4111 C4134 C4135 3 0 3
Injection 1 mg (as chloride) in 1 mL Injection Hydroxo-B12 AS MP NP C4111 C4134 C4135 3 0 3
Neo-B12 HH MP NP C4111 C4134 C4135 3 0 3
  1. Schedule 1, entry for Imiquimod

(a)omit from the column headed “Pack Size” for the brand “Aldara”:             30         substitute:          1

(b)insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

APO-Imiquimod TX MP C2816 1 1 1
  1. Schedule 1, entry for Lamivudine in each of the forms: Tablet 150 mg; and Tablet 300 mg

omit from the column headed “Brand”:         Alphapharm Lamivudine             substitute:             Lamivudine Alphapharm

  1. Schedule 1, entry for Lamotrigine in the form Tablet 25 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Reedos 25 DO MP NP C1426 56 5 56
  1. Schedule 1, entry for Lamotrigine in the form Tablet 50 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Reedos 50 DO MP NP C1426 56 5 56
  1. Schedule 1, entry for Lamotrigine in the form Tablet 100 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Reedos 100 DO MP NP C1426 56 5 56
  1. Schedule 1, entry for Lamotrigine in the form Tablet 200 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Reedos 200 DO MP NP C1426 56 5 56
  1. Schedule 1, entry for Leflunomide in each of the forms: Tablet 10 mg; and Tablet 20 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Leflunomide-GA GM MP C2644 30 5 30
  1. Schedule 1, entry for Letrozole

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

STADA Letrozole TD MP NP C1608 C2691 C2692 30 5 30
  1. Schedule 1, entry for Lisinopril in each of the forms: Tablet 5 mg; Tablet 10 mg; and Tablet 20 mg

omit:

GenRx Lisinopril GX MP NP 30 5 30
  1. Schedule 1, entry for Loperamide

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Gastrex CR MP NP 12 0 12
  1. Schedule 1, entry for Meloxicam in each of the forms: Tablet 7.5 mg; and Tablet 15 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

APO-Meloxicam TX MP NP C1547 C1848 30 3 30
  1. Schedule 1, entry for Mirtazapine in the form Tablet 15 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

APO-Mirtazapine TX MP NP C1211 30 5 30
  1. Schedule 1, entry for Mycophenolic Acid

omit:

Mycophenolic Acid Tablet (enteric coated) containing mycophenolate sodium equivalent to 180 mg mycophenolic acid Oral Myfortic NV MP C1763 120 3 120
MP
See Note 1
C1650 C3355 240 5 120 C(100)
Tablet (enteric coated) containing mycophenolate sodium equivalent to 360 mg mycophenolic acid Oral Myfortic NV MP C1763 120 3 120
MP
See Note 1
C1650 C3355 240 5 120 C(100)

substitute:

Mycophenolic Acid Tablet (enteric coated) containing mycophenolate sodium equivalent to 180 mg mycophenolic acid Oral Myfortic NV MP C1763 C4131 P1763 120 3 120
MP C1763 C4131 P4131 120 5 120
MP
See Note 1
C4084 C4095 C4108 C4146 240 5 120 C(100)
Tablet (enteric coated) containing mycophenolate sodium equivalent to 360 mg mycophenolic acid Oral Myfortic NV MP C1763 C4131 P1763 120 3 120
MP C1763 C4131 P4131 120 5 120
MP
See Note 1
C4084 C4095 C4108 C4146 240 5 120 C(100)
  1. Schedule 1, entry for Naloxone

insert as first item in the columns in the order indicated:

Injection containing naloxone hydrochloride 400 micrograms in 1 mL pre-filled syringe Injection Naloxone minijet UC MP NP PDP 5 0 1
MP NP 10 0 1
  1. Schedule 1, after entry for Naproxen in the form Tablet 1 g (sustained release) [Proxen SR 1000] [Max Quantity 28; Number of Repeats 3]

insert in the columns in the order indicated:

Oral suspension 125 mg per mL, 474 mL Oral Phebra Naproxen Suspension PL MP NP C4124 C4128 C4129 C4159 P4129 1 0 1
C4124 C4128 C4129 C4159 P4124 P4128 P4159 1 3 1
  1. Schedule 1, omit entry for Neomycin with Bacitracin

  1. Schedule 1, entry for Nevirapine in the form Tablet 200 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Nevirapine Alphapharm AF MP
See Note 1
C3586 C3587 C3588 C3589 120 5 60 D(100)
  1. Schedule 1, entry for Octreotide in each of the forms: Injection 50 micrograms (as acetate) in 1 mL; Injection 100 micrograms (as acetate) in 1 mL; and Injection 500 micrograms (as acetate) in 1 mL

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Octreotide (SUN) ZF MP
See Note 1
C2622 C2623 C3407 C3408 90 11 5 D(100)
  1. Schedule 1, entry for Olanzapine in each of the forms: Wafer 15 mg; and Wafer 20 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Zypine ODT AF MP NP C1589 C2044 28 5 28
  1. Schedule 1, entry for Olmesartan with amlodipine in each of the forms: Tablet containing olmesartan medoxomil 20 mg with amlodipine
    5 mg (as besylate); Tablet containing olmesartan medoxomil 40 mg with amlodipine 5 mg (as besylate); and Tablet containing olmesartan medoxomil 40 mg with amlodipine 10 mg (as besylate)

omit from the column headed “Authorised Prescriber”:            MP         substitute:             MP NP

  1. Schedule 1, entry for Omeprazole

substitute:

Omeprazole Tablet 20 mg (as magnesium) Oral Acimax Tablets AL MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Losec Tablets AP MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omepral PM MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omeprazole Sandoz SZ MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Acimax Tablets AL MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Losec Tablets AP MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omepral PM MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omeprazole Sandoz SZ MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Tablet 20 mg Oral APO-Omeprazole TX MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Chem mart Omeprazole CH MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Meprazol SZ MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omeprazole-GA GM MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omeprazole generichealth GQ MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omeprazole-PS FZ MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omeprazole RBX RA MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omeprazole Winthrop WA MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Ozmep ZP MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Terry White Chemists Omeprazole TW MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
APO-Omeprazole TX MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Chem mart Omeprazole CH MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Meprazol SZ MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omeprazole-GA GM MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omeprazole generichealth GQ MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omeprazole-PS FZ MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omeprazole RBX RA MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omeprazole Winthrop WA MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Ozmep ZP MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Terry White Chemists Omeprazole TW MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Capsule 20 mg Oral APO-Omeprazole TX MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Maxor AF MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omeprazole Sandoz HX MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Omepro-GA GM MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Pemzo QA MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Pharmacor Omeprazole 20 CR MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
Probitor SZ MP NP C4074 C4075 C4089 C4152 P4074 30 1 30
APO-Omeprazole TX MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Maxor AF MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omeprazole Sandoz HX MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Omepro-GA GM MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Pemzo QA MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Pharmacor Omeprazole 20 CR MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Probitor SZ MP NP C4074 C4075 C4089 C4152 P4075 P4089 P4152 30 5 30
Tablet 10 mg (as magnesium) Oral Losec Tablets AP MP NP C1337 C1476 C1533 30 5 30
  1. Schedule 1, after entry for Paraffin in the form Eye ointment, compound, containing white soft paraffin with liquid paraffin, 3.5 g
    [Poly Visc] [Max Quantity 2; Number of Repeats 11]

insert in the columns in the order indicated:

Eye ointment, compound, containing liquid paraffin, light liquid paraffin, wool fat, white soft paraffin and retinyl palmitate, 5 g Application to the eye VitA-POS AE MP NP AO 2 5 1
MP P4072 2 11 1
  1. Schedule 1, entry for Pazopanib

substitute:

Pazopanib Tablet 200 mg (as hydrochloride) Oral Votrient GK MP C4067 C4109 C4112 C4148 P4112 30 5 30
C4067 C4109 C4112 C4148 P4148 90 2 90
C4067 C4109 C4112 C4148 P4067 P4109 90 5 90
Tablet 400 mg (as hydrochloride) Oral Votrient GK MP C4067 C4109 C4112 C4148 P4112 30 5 30
C4067 C4109 C4112 C4148 P4148 60 2 60
C4067 C4109 C4112 C4148 P4067 P4109 60 5 60
  1. Schedule 1, entry for Pravastatin in the form Tablet containing pravastatin sodium 10 mg

(a)           omit:

GenRx Pravastatin GX MP C1540 C3047 P1540 30 5 30
NP C1540 30 5 30

(b)           omit:

GenRx Pravastatin GX MP C1540 C3047 P3047 30 11 30
  1. Schedule 1, entry for Pravastatin in the form Tablet containing pravastatin sodium 20 mg

(a)           omit:

GenRx Pravastatin GX MP C1540 C3047 P1540 30 5 30
NP C1540 30 5 30

(b)           omit:

GenRx Pravastatin GX MP C1540 C3047 P3047 30 11 30
  1. Schedule 1, entry for Pravastatin in the form Tablet containing pravastatin sodium 40 mg

(a)           omit:

GenRx Pravastatin GX MP C1540 C3047 P1540 30 5 30
NP C1540 30 5 30

(b)           omit:

GenRx Pravastatin GX MP C1540 C3047 P3047 30 11 30
  1. Schedule 1, entry for Rabeprazole

substitute:

Rabeprazole Tablet containing rabeprazole sodium 10 mg (enteric coated) Oral APO-Rabeprazole TX MP NP C1337 C1533 28 5 28
Chem mart Rabeprazole CH MP NP C1337 C1533 28 5 28
Pariet JC MP NP C1337 C1533 28 5 28
Parzole 10 ZP MP NP C1337 C1533 28 5 28
Prabez AF MP NP C1337 C1533 28 5 28
Rabeprazole-GA GM MP NP C1337 C1533 28 5 28
Rabeprazole generichealth GQ MP NP C1337 C1533 28 5 28
Rabeprazole Pfizer FZ MP NP C1337 C1533 28 5 28
Rabeprazole Sandoz SZ MP NP C1337 C1533 28 5 28
Rabzole JS MP NP C1337 C1533 28 5 28
Terry White Chemists Rabeprazole TW MP NP C1337 C1533 28 5 28
Tablet containing rabeprazole sodium 20 mg (enteric coated) Oral APO-Rabeprazole TX MP NP C1177 C1337 C1533 P1177 30 2 30
Chem mart Rabeprazole CH MP NP C1177 C1337 C1533 P1177 30 2 30
Pariet JC MP NP C1177 C1337 C1533 P1177 30 2 30
Parzole 20 ZP MP NP C1177 C1337 C1533 P1177 30 2 30
Prabez AF MP NP C1177 C1337 C1533 P1177 30 2 30
Rabeprazole-GA GM MP NP C1177 C1337 C1533 P1177 30 2 30
Rabeprazole generichealth GQ MP NP C1177 C1337 C1533 P1177 30 2 30
Rabeprazole Pfizer FZ MP NP C1177 C1337 C1533 P1177 30 2 30
Rabeprazole Sandoz SZ MP NP C1177 C1337 C1533 P1177 30 2 30
Rabzole JS MP NP C1177 C1337 C1533 P1177 30 2 30
Terry White Chemists Rabeprazole TW MP NP C1177 C1337 C1533 P1177 30 2 30
APO-Rabeprazole TX MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Chem mart Rabeprazole CH MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Pariet JC MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Parzole 20 ZP MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Prabez AF MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Rabeprazole-GA GM MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Rabeprazole generichealth GQ MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Rabeprazole Pfizer FZ MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Rabeprazole Sandoz SZ MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Rabzole JS MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
Terry White Chemists Rabeprazole TW MP NP C1177 C1337 C1533 P1337 P1533 30 5 30
  1. Schedule 1, entry for Raloxifene

omit from the column headed “Circumstances”:          C2647   substitute:          C4071

  1. Schedule 1, entry for Ranitidine in the form Tablet 300 mg (as hydrochloride)

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Ranoxyl GM MP NP 30 5 30
  1. Schedule 1, entry for Riluzole

substitute:

Riluzole Tablet 50 mg Oral APO-Riluzole TX MP NP C1762 C2718 56 5 56
Rilutek SW MP NP C1762 C2718 56 5 56
Riluzole Sandoz SZ MP NP C1762 C2718 56 5 56
  1. Schedule 1, entry for Risedronic Acid in each of the forms: Tablet containing risedronate sodium 5 mg; Tablet containing risedronate sodium 35 mg; Tablet (enteric coated) containing risedronate sodium 35 mg; and Tablet containing risedronate sodium 150 mg

omit from the column headed “Circumstances” (all instances):

C2645 C2646
C3070

substitute:

C4117 C4122
C4123
  1. Schedule 1, entry for Risedronic Acid and Calcium

substitute”:

Risedronic Acid and Calcium Pack containing 4 tablets risedronate sodium 35 mg and 24 tablets calcium 500 mg (as carbonate) Oral Acris Combi AF MP NP C4117 C4122 C4123 1 5 1
Actonel Combi SW MP NP C4117 C4122 C4123 1 5 1
Pack containing 4 enteric coated tablets risedronate sodium 35 mg and 24 tablets calcium 500 mg (as carbonate) Oral Actonel EC Combi SW MP NP C4117 C4122 C4123 1 5 1
Risedronate Winthrop  EC Combi WA MP NP C4117 C4122 C4123 1 5 1
  1. Schedule 1, entry for Risedronic acid and calcium with colecalciferol

omit from the column headed “Circumstances” (all instances):

C2645 C2646
C3070

substitute:

C4117 C4122
C4123
  1. Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [APO-Risperidone; Max Quantiy 60; Number of Repeats 2]

omit from the column headed “Pack Quantity”:   60           substitute:             20

  1. Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [Risperdal; Max Quantiy 60; Number of Repeats 2]

omit from the column headed “Pack Quantity”:   60           substitute:             20

  1. Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [APO-Risperidone; Max Quantiy 60; Number of Repeats 5]

omit from the column headed “Pack Quantity”:                          60           substitute:             20

  1. Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [Risperdal; Max Quantiy 60; Number of Repeats 5]

omit from the column headed “Pack Quantity”:   60           substitute:             20

  1. Schedule 1, after entry for Rivaroxaban in the form Tablet 10 mg [Max Quantity 30; Number of Repeats 0]

insert in the columns in the order indicated:

Tablet 15 mg Oral Xarelto BN MP NP C4098 42 0 42
Tablet 20 mg Oral Xarelto BN MP NP C4099 C4132 28 5 28
  1. Schedule 1, entry for Simvastatin in the form Tablet 20 mg

(a)           omit:

GenRx Simvastatin GX MP C1540 C3047 P1540 30 5 30
NP C1540 30 5 30

(b)           omit:

GenRx Simvastatin GX MP C1540 C3047 P3047 30 11 30
  1. Schedule 1, entry for Simvastatin in the form Tablet 40 mg

(a)           omit:

GenRx Simvastatin GX MP C1540 C3047 P1540 30 5 30
NP C1540 30 5 30

(b)           omit:

GenRx Simvastatin GX MP C1540 C3047 P3047 30 11 30
  1. Schedule 1, entry for Simvastatin in the form Tablet 80 mg

(a)           omit:

GenRx Simvastatin GX MP C1540 C3047 P1540 30 5 30
NP C1540 30 5 30

(b)           omit:

GenRx Simvastatin GX MP C1540 C3047 P3047 30 11 30
  1. Schedule 1, entry for Strontium

omit from the column headed “Circumstances”:

C2647 C2758

substitute:

C4071 C4107
  1. Schedule 1, entry for Sumatriptan in the form Tablet 50 mg (as succinate)

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Sumatriptan RBX RA MP NP C3233 4 5 4
  1. Schedule 1, entry for Sunitinib

substitute:

Sunitinib Capsule 12.5 mg (as malate) Oral Sutent PF MP C3206 C3207 C4106 C4119 P3206 P3207 P4119 28 1 28
MP C3206 C3207 C4106 C4119 P4106 28 3 28
Capsule 25 mg (as malate) Oral Sutent PF MP C3206 C3207 C4106 C4119 P3206 P3207 P4119 28 1 28
MP C3206 C3207 C4106 C4119 P4106 28 3 28
Capsule 50 mg (as malate) Oral Sutent PF MP C3206 C3207 C4106 C4119 P3206 P3207 P4119 28 1 28
MP C3206 C3207 C4106 C4119 P4106 28 3 28
  1. Schedule 1, entry for Terbinafine in the form Tablet 250 mg (as hydrochloride) [Max Quantity 42; Number of Repeats 0]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Pharmacy Choice Terbinafine RI MP NP C2191 C2865 C3244 P2865 P3244 42 0 42
  1. Schedule 1, entry for Terbinafine in the form Tablet 250 mg (as hydrochloride) [Max Quantity 42; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

Pharmacy Choice Terbinafine RI MP NP C2191 C2865 C3244 P2191 42 1 42
  1. Schedule 1, entry for Teriparatide

omit from the column headed “Circumstances”:

C4031 C4032

substitute:

C4101 C4113
  1. Schedule 1, entry for Venlafaxine in each of the forms: Capsule (modified release) 75 mg (as hydrochloride); and Capsule (modified release) 150 mg (as hydrochloride)

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

STADA Venlafaxine SR TD MP NP C1211 28 5 28
  1. Schedule 1, entry for Zoledronic acid in the form Solution for I.V. infusion 5 mg (as monohydrate) in 100 mL

omit from the column headed “Circumstances”:

C3290 C3945
C3946 C3947

substitute:

C3290 C4100
C4149 C4157
  1. Schedule 3

omit:

HA Hamilton Pharmaceutical Pty Ltd  93 008 204 635
  1. Schedule 3, after details relevant to Responsible person code JJ

insert:

JS Janssen-Cilag Pty Ltd  47 000 129 975
  1. Schedule 3, after details relevant to Responsible person code RD

insert:

RI Dr Reddy's Laboratories (Australia) Pty Ltd  16 120 092 408
  1. Schedule 4, Part 1, after entry for Adrenaline

insert:

Aflibercept C4153

Subfoveal choroidal neovascularisation (CNV)

Initial treatment

Must be treated by a ophthalmologist;
The condition must be due to age-related macular degeneration (AMD);
The condition must be diagnosed by fluorescein angiography;

The treatment must be the sole PBS-subsidised therapy for this condition

Authority approval for initial treatment of each eye must be sought

The first authority application for each eye must be made in writing or by telephone

A written application must include:
(a) a completed authority prescription form;
(b) a completed Subfoveal Choroidal Neovascularisation (CNV) PBS Supporting Information Form; and

(c) a copy of the fluorescein angiogram

A telephone application must be made following submission by facsimile of a copy of a completed Subfoveal Choroidal Neovascularisation (CNV) - PBS Supporting Information Form and a copy of the fluorescein angiogram. The original documentation must be submitted to the Chief Executive Medicare by post after the application has been authorised

Where a fluorescein angiogram cannot be performed due to a contraindication as listed in the TGA-approved product information, details of the contraindication must be provided. A copy of the report of an alternative method of diagnosis must be included in the application, for example, optical coherence tomography (OCT) or red free photography

Compliance with Written or Telephone Authority Required procedures


C4154

Subfoveal choroidal neovascularisation (CNV)

Continuing treatment

Must be treated by a ophthalmologist;
The condition must be due to age-related macular degeneration (AMD);
The treatment must be the sole PBS-subsidised therapy for this condition;

Patient must have previously been granted an authority prescription for the same eye

Compliance with Written or Telephone Authority Required procedures


  1. Schedule 4, Part 1, entry for Alendronic Acid

substitute:

Alendronic Acid C3256 Symptomatic Paget disease of bone Compliance with Authority Required procedures - Streamlined Authority Code 3256
C4122

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;
Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122
C4123

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4123
C4133

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4133
  1. Schedule 4, Part 1, entry for Alendronic acid with colecalciferol

substitute:

Alendronic acid with colecalciferol C4070

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;
Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4070
C4087

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4087
C4110

Osteoporosis

Patient must be aged 70 years or older;
Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4110
C4122

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;
Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122
C4123

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4123
C4133

Osteoporosis

Patient must be aged 70 years or older;
Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4133
  1. Schedule 4, Part 1, entry for Alendronic acid with colecalciferol and calcium

substitute:

Alendronic acid with colecalciferol and calcium C4122

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;
Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122
C4123

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4123
C4133

Osteoporosis

Patient must be aged 70 years or older;
Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4133
  1. Schedule 4, Part 1, after entry for Atazanavir

insert:

Atenolol C4076 For a patient who is unable to take a solid dose form of atenolol

  1. Schedule 4, Part 1, entry for Bevacizumab [Circumstances Code C3894]

omit from the column headed “Circumstances and Purposes”:                performace       substitute:          performance

  1. Schedule 4, Part 1, entry for Bortezomib

substitute:

Bortezomib C4079

Multiple myeloma

Retreatment of Progressive disease - Initial PBS-subsidised treatment

The treatment must be as monotherapy; OR
The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must have progressive disease;
Patient must have previously been treated with PBS-subsidised bortezomib;
Patient must have experienced at least a partial response to the most recent course of PBS-subsidised bortezomib therapy;
Patient must not be receiving concomitant PBS-subsidised lenalidomide;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

Progressive disease is defined as at least 1 of the following:

(a) at least a 25% increase and an absolute increase of at least 5 g per L in serum M protein (monoclonal protein); or
(b) at least a 25% increase in 24-hour urinary light chain M protein excretion, and an absolute increase of at least 200 mg per 24 hours; or
(c) in oligo-secretory and non-secretory myeloma patients only, at least a 50% increase of the difference between involved free light chain and uninvolved free light chain; or
(d) at least a 25% relative increase and at least a 10% absolute increase in plasma cells in a bone marrow aspirate or on biopsy; or
(e) an increase in the size or number of lytic bone lesions (not including compression fractures); or
(f) at least a 25% increase in the size of an existing or the development of a new soft tissue plasmacytoma (determined by clinical examination or diagnostic imaging); or

(g) development of hypercalcaemia (corrected serum calcium greater than 2.65 mmol per L not attributable to any other cause)

Oligo-secretory and non-secretory patients are defined as having active disease with less than 10 g per L serum M protein

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or
(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or
(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application - Supporting Information Form which includes details of the basis of the current diagnosis of progressive disease and nomination of which disease activity parameters will be used to assess response; and
(3) diagnostic reports demonstrating the patient has achieved at least a partial response to the most recent course of PBS-subsidised bortezomib, if not previously provided; and

(4) a signed patient acknowledgment

To enable confirmation of eligibility for treatment current diagnostic reports of at least one of the following must be provided:

(a) the level of serum monoclonal protein; or
(b) Bence-Jones proteinuria - the results of 24-hour urinary light chain M protein excretion; or
(c) the serum level of free kappa and lambda light chains; or
(d) bone marrow aspirate or trephine; or
(e) if present, the size and location of lytic bone lesions (not including compression fractures); or
(f) if present, the size and location of all soft tissue plasmacytomas by clinical or radiographic examination i.e. MRI or CT-scan; or

(g) if present, the level of hypercalcaemia, corrected for albumin concentration

As these parameters will be used to determine response, results for either (a) or (b) or (c) should be provided for all patients. Where the patient has oligo-secretory or non-secretory multiple myeloma, either (c) or (d) or if relevant (e), (f) or (g) should be provided

Where the prescriber plans to assess response in patients with oligo-secretory or non-secretory multiple myeloma with free light chain assays, evidence of the oligo-secretory or non-secretory nature of the multiple myeloma (current serum M protein less than 10 g per L) must be provided

Compliance with Written Authority Required procedures
C4080

Multiple myeloma

Retreatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR
The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must have previously received 8 treatment cycles of bortezomib in the current treatment course;
Patient must have demonstrated at the completion of cycle 8 at least a partial response to bortezomib;
Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;
Patient must not have a gap of more than 10 months between the initial application and an application following completion of 8 treatment cycles;

Patient must not receive more than 3 cycles of bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and
(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and
(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or
(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or
(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 9, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

Compliance with Written Authority Required procedures
C4081

Multiple myeloma

Treatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must have previously received 8 treatment cycles of bortezomib for progressive disease;
Patient must have demonstrated at the completion of cycle 8 at least a partial response to bortezomib;
Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;
Patient must not have a gap of more than 10 months between the initial application and an application following completion of 8 treatment cycles;
Patient must not receive more than 3 cycles of bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and
(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and
(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels.
If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or
(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or
(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or
(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 9, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

Compliance with Written Authority Required procedures
C4082

Symptomatic multiple myeloma

Continuing PBS-subsidised treatment

Patient must have received an initial authority prescription for bortezomib for newly diagnosed symptomatic multiple myeloma and be ineligible for high dose chemotherapy;
Patient must not have demonstrated progressive disease at the time of application;
Patient must not have achieved a best confirmed response to bortezomib at the time of application;
Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;
The treatment must be in combination with a corticosteroid and melphalan or cyclophosphamide;
Patient must not receive more than 5 cycles of treatment with bortezomib under this restriction

Continuing PBS-subsidised supply will not be approved if there is a gap of more than 6 months between the initial application and this application

Compliance with Written or Telephone Authority Required procedures
C4103

Symptomatic multiple myeloma

Patient must be newly diagnosed;
Patient must be eligible for high dose chemotherapy and autologous stem cell transplantation;
Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;
The treatment must be in combination with chemotherapy;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma; and

(3) a signed patient acknowledgement

Compliance with Written Authority Required procedures
C4126

Multiple myeloma

Treatment of Progressive disease - Initial PBS-subsidised treatment

The condition must be confirmed by a histological diagnosis;

The treatment must be as monotherapy; OR
The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must have progressive disease after at least one prior therapy;
Patient must have undergone or be ineligible for a primary stem cell transplant;
Patient must have experienced treatment failure after a trial of at least four (4) weeks of thalidomide at a dose of at least 100 mg daily or have failed to achieve at least a minimal response after eight (8) or more weeks of thalidomide-based therapy for progressive disease;
Patient must not be receiving concomitant PBS-subsidised lenalidomide;
Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

Progressive disease is defined as at least 1 of the following:

(a) at least a 25% increase and an absolute increase of at least 5 g per L in serum M protein (monoclonal protein); or

(b) at least a 25% increase in 24-hour urinary light chain M protein excretion, and an absolute increase of at least 200 mg per 24 hours; or
(c) in oligo-secretory and non-secretory myeloma patients only, at least a 50% increase of the difference between involved free light chain and uninvolved free light chain; or
(d) at least a 25% relative increase and at least a 10% absolute increase in plasma cells in a bone marrow aspirate or on biopsy; or
(e) an increase in the size or number of lytic bone lesions (not including compression fractures); or
(f) at least a 25% increase in the size of an existing or the development of a new soft tissue plasmacytoma (determined by clinical examination or diagnostic imaging); or
(g) development of hypercalcaemia (corrected serum calcium greater than 2.65 mmol per L not attributable to any other cause)

Oligo-secretory and non-secretory patients are defined as having active disease with less than 10 g per L serum M protein

Thalidomide treatment failure is defined as:

(1) confirmed disease progression during thalidomide treatment or within 6 months of discontinuing thalidomide treatment; or
(2) severe intolerance or toxicity unresponsive to clinically appropriate dose adjustment

Severe intolerance due to thalidomide is defined as unacceptable somnolence or sedation interfering with activities of daily living

Toxicity from thalidomide is defined as peripheral neuropathy (Grade 2 or greater, interfering with function), drug-related seizures, serious Grade 3 or 4 drug-related dermatological reactions, such as Stevens-Johnson Syndrome, or other Grade 3 or 4 toxicity

Failure to achieve at least a minimal response after 8 or more weeks of thalidomide-based therapy for progressive disease is defined as:

(1) less than a 25% reduction in serum or urine M protein; or

(2) in oligo-secretory and non-secretory myeloma patients only, less than a 25% reduction in the difference between involved and uninvolved serum free light chain levels

If the dosing requirement for thalidomide cannot be met, the application must state the reasons why this criterion cannot be satisfied

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and
(2) a completed Multiple Myeloma bortezomib Authority Application - Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma, prior treatments including name(s) of drug(s) and date of most recent treatment cycle and record of prior stem cell transplant or ineligibility for prior stem cell transplant; details of thalidomide treatment failure; details of the basis of the diagnosis of progressive disease or failure to respond; and nomination of which disease activity parameters will be used to assess response; and
(3) duration of thalidomide and daily dose prescribed; and
(4) a signed patient acknowledgment

To enable confirmation of eligibility for treatment, current diagnostic reports of at least one of the following must be provided:

(a) the level of serum monoclonal protein; or

(b) Bence-Jones proteinuria - the results of 24-hour urinary light chain M protein excretion; or
(c) the serum level of free kappa and lambda light chains; or
(d) bone marrow aspirate or trephine; or
(e) if present, the size and location of lytic bone lesions (not including compression fractures); or
(f) if present, the size and location of all soft tissue plasmacytomas by clinical or radiographic examination i.e. MRI or CT-scan; or
(g) if present, the level of hypercalcaemia, corrected for albumin concentration

As these parameters will be used to determine response, results for either (a) or (b) or (c) should be provided for all patients. Where the patient has oligo-secretory or non-secretory multiple myeloma, either (c) or (d) or if relevant (e), (f) or (g) should be provided

Where the prescriber plans to assess response in patients with oligo-secretory or non-secretory multiple myeloma with free light chain assays, evidence of the oligo-secretory or non-secretory nature of the multiple myeloma (current serum M protein less than 10 g per L) must be provided

Compliance with Written Authority Required procedures
C4127

Symptomatic multiple myeloma

Initial PBS-subsidised treatment

Patient must be newly diagnosed;

Patient must have severe acute renal failure;
Patient must require dialysis; OR
Patient must be at high risk of requiring dialysis in the opinion of a nephrologist;
The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;
Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma, the name of the nephrologist who has reviewed the patient and the date of review, a copy of the current pathology reports reporting Glomerular Filtration Rate from an Approved Pathology Authority, and nomination of the disease activity parameter(s) that will be used to assess response; and
(3) a signed patient acknowledgement

Disease activity parameters include current diagnostic reports of at least one of the following:

(a) the level of serum monoclonal protein; or
(b) Bence-Jones proteinuria - the results of 24-hour urinary light chain M protein excretion; or
(c) in oligo-secretory and non-secretory myeloma patients only, the serum level of free kappa and lambda light chains; or
(d) bone marrow aspirate or trephine; or
(e) if present, the size and location of lytic bone lesions (not including compression fractures); or
(f) if present, the size and location of all soft tissue plasmacytomas by clinical or radiographic examination i.e. Magnetic Resonance Imaging (MRI) or computed tomography (CT) scan; or
(g) if present, the level of hypercalcaemia, corrected for albumin concentration

As these parameters will be used to determine response, results for either (a) or (b) or (c) should be provided for all patients

Where the patient has oligo-secretory or non-secretory multiple myeloma, either (c) or (d) or if relevant (e), (f) or (g) should be provided

Where the prescriber plans to assess response in patients with oligo-secretory or non-secretory multiple myeloma with free light chain assays, evidence of the oligo-secretory or non-secretory nature of the multiple myeloma (current serum M protein less than 10 g per L) must be provided

Compliance with Written Authority Required procedures
C4141

Symptomatic multiple myeloma

Continuing PBS-subsidised treatment

Patient must have received an initial authority prescription for bortezomib for newly diagnosed symptomatic multiple myeloma and have severe acute renal failure;
Patient must have demonstrated at least a partial response at the completion of cycle 4 at the time of application;
The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;
Patient must not receive more than 5 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form, which includes a copy of the current pathology reports reporting Glomerular Filtration Rate from an Approved Pathology authority; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are not being used to monitor disease activity, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or
(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or
(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or
(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Continuing PBS-subsidised supply will not be approved if there is a gap of more than 6 months between the initial application and this application

Compliance with Written or Telephone Authority Required procedures
C4161

Multiple myeloma

Retreatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR
The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must have previously received 4 treatment cycles of bortezomib in the current treatment course;
Patient must have demonstrated at the completion of cycle 4 at least a partial response to bortezomib;
Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;
Patient must not have a gap of more than 6 months between the initial application and subsequent applications;
Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and
(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and
(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or
(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or
(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or
(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 5, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

C4162

Multiple myeloma

Treatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;
Patient must have previously received 4 treatment cycles of bortezomib for progressive disease;
Patient must have demonstrated at the completion of cycle 4 at least a partial response to bortezomib;
Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;
Patient must not have a gap of more than 6 months between the initial application and subsequent applications;
Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and
(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or

(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or
(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or
(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 5, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

Compliance with Written Authority Required procedures
C4163

Symptomatic multiple myeloma

Initial PBS-subsidised treatment

Patient must be newly diagnosed;
Patient must be ineligible for high dose chemotherapy;
Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;
The treatment must be in combination with a corticosteroid and melphalan or cyclophosphamide;
Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and
(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma and ineligibility for high dose chemotherapy; and

(3) a signed patient acknowledgement

Compliance with Written Authority Required procedures
  1. Schedule 4, Part 1, entry for Cabazitaxel

substitute:

C4073

Where the patient is receiving treatment in the community setting or at/from a Private Hospital

Castration resistant metastatic carcinoma of the prostate

The treatment must be in combination with prednisone or prednisolone;

Patient must have failed treatment with docetaxel due to resistance or intolerance;

Patient must have a WHO performance status of 2 or less

Compliance with Authority Required procedures
C4138

Where the patient is receiving treatment at/from a Public Hospital

Castration resistant metastatic carcinoma of the prostate

The treatment must be in combination with prednisone or prednisolone;

Patient must have failed treatment with docetaxel due to resistance or intolerance;

Patient must have a WHO performance status of 2 or less

Compliance with Authority Required procedures - Streamlined Authority Code 4138
  1. Schedule 4, Part 1, entry for Denosumab

substitute:

Denosumab C4094

Osteoporosis

Patient must be female;
Patient must be aged 70 years or older;
Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4094
C4145

Established post-menopausal osteoporosis
Patient must have fracture due to minimal trauma;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4145
C4150

Bone metastases

The condition must be due to castration-resistant prostate cancer

Compliance with Authority Required procedures - Streamlined Authority Code 4150
C4158

Bone metastases

The condition must be due to breast cancer

Compliance with Authority Required procedures - Streamlined Authority Code 4158
  1. Schedule 4, Part 1, entry for Docetaxel

substitute:

Docetaxel C3888 Neoadjuvant treatment of a patient with a World Health Organisation performance status of 1 or less, with inoperable Stage III, IVa or IVb squamous cell carcinoma of the oral cavity, larynx, oropharynx or hypopharynx, in combination with cisplatin and fluorouracil Compliance with Authority Required procedures - Streamlined Authority Code 3888
C3892 Adjuvant treatment of operable breast cancer in combination with cyclophosphamide Compliance with Authority Required procedures - Streamlined Authority Code 3892
C3916 Adjuvant treatment of node-positive breast cancer in combination with an anthracycline and cyclophosphamide Compliance with Authority Required procedures - Streamlined Authority Code 3916
C3956 Treatment of HER2 positive breast cancer in combination with trastuzumab Compliance with Authority Required procedures - Streamlined Authority Code 3956
C4078

Locally advanced or metastatic non-small cell lung cancer

Compliance with Authority Required procedures - Streamlined Authority Code 4078


C4140

Advanced metastatic ovarian cancer

Patient must have failed prior therapy which included a platinum compound

Compliance with Authority Required procedures - Streamlined Authority Code 4140


C4155

Androgen independent (castration resistant) metastatic carcinoma of the prostate

Patient must have a Karnofsky performance status score of at least 60%;

The treatment must be used as first-line chemotherapy;
The treatment must be administered in three weekly cycles;
Patient must not receive more than 10 cycles of treatment with docetaxel under this restriction

Compliance with Authority Required procedures - Streamlined Authority Code 4155

C4160 Metastatic breast cancer Compliance with Authority Required procedures - Streamlined Authority Code 4160


  1. Schedule 4, Part 1, entry for Etanercept

(a)omit:

C4057 P4057 Chronic plaque psoriasis (Whole body) [Initial treatment — No prior biological agent]
Initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who:
(a) has severe chronic plaque psoriasis where lesions have been present for at least 6 months from the time of initial diagnosis; and
(b) has not received any prior PBS-subsidised treatment with etanercept for this condition; and
(c) whose parent or authorised guardian has signed a patient acknowledgement; and
(d) has failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 2 of the following 3 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 or 10 mg per square metre weekly (whichever is lowest) for at least 6 weeks; and/or
(iii) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks
If treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or where phototherapy is contraindicated, please provide details at the time of application
If intolerance to treatment with phototherapy, methotrexate or acitretin develops during the relevant period of use, which is of a severity to necessitate permanent treatment withdrawal, please provide details of the degree of this toxicity at the time of application
The following initiation criterion indicates failure to achieve an adequate response and must be demonstrated in all patients at the time of the application:
(a) 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
(b) A PASI assessment must be completed for each prior treatment course, preferably whilst still on treatment, but no longer than 1 month following cessation of each course of treatment
(c) The most recent PASI assessment must be no more than 1 month old at the time of application
Applications for authorisation must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:
(i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets 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) the parent or authorised guardian signed patient and prescriber acknowledgements
A maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment
A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this initial course of treatment.  Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept
An adequate response to treatment is defined as:
Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, when compared with the pre-etanercept treatment baseline value
Compliance with Written Authority Required procedures
Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has severe chronic plaque psoriasis and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course Compliance with Written or Telephone Authority Required procedures
C4058 P4058 Chronic plaque psoriasis (Whole body) [Re-Treatment — Received prior etanercept under PBS]
Treatment as systemic monotherapy (other than methotrexate) by a dermatologist for a patient under 18 years who has:
(a) a documented history of severe chronic plaque psoriasis; and
(b) received prior PBS-subsidised treatment with etanercept for this condition; and
(c) not failed PBS-subsidised therapy with etanercept for the treatment of this condition more than once in the current Treatment Cycle
Applications for authorisation must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:
(i) the completed current Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition; and
(ii) details of prior etanercept treatment, including date
A total maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment
A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this course of treatment. Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept
Compliance with Written Authority Required procedures
Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has a documented history of severe chronic plaque psoriasis, who has previously received PBS-subsidised treatment with etanercept for this condition, and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course Compliance with Written or Telephone Authority Required procedures
C4059 P4059 Chronic plaque psoriasis (Face, hand, foot) [Initial treatment — No prior biological agent]
Initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who:
(a) has 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) has not received any prior PBS-subsidised treatment with etanercept for this condition; and
(c) whose parent or authorised guardian has signed a patient acknowledgement; and
(d) has failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 2 of the following 3 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 or 10 mg per square metre weekly (whichever is lowest) for at least 6 weeks; and/or
(iii) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks
If treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or where phototherapy is contraindicated, please provide details at the time of application
If intolerance to treatment with phototherapy, methotrexate or acitretin develops during the relevant period of use, which is of a severity to necessitate permanent treatment withdrawal, please provide details of the degree of this toxicity at the time of application
The following initiation criterion indicates failure to achieve an adequate response and must be demonstrated in all patients at the time of the application:
(a) 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
(b) A PASI assessment must be completed for each prior treatment course, preferably whilst still on treatment, but no longer than 1 month following cessation of each course of treatment
(c) The most recent PASI assessment must be no more than 1 month old at the time of application
Applications for authorisation must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:
(i) 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) the parent or authorised guardian signed patient and prescriber acknowledgements
A maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment
A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated.  This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this initial course of treatment.  Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept
An adequate response to treatment is defined as:
A Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, when compared with the pre-etanercept treatment baseline value
Compliance with Written Authority Required procedures
Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course Compliance with Written or Telephone Authority Required procedures
C4060 P4060 Chronic plaque psoriasis (Face, hand, foot) [Re-Treatment — Received prior etanercept under PBS]
Treatment as systemic monotherapy (other than methotrexate) by a dermatologist for a patient under 18 years who has:
(a) a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and
(b) received prior PBS-subsidised treatment with etanercept for this condition; and
(c) not failed PBS-subsidised therapy with etanercept for the treatment of this condition more than once in the current Treatment Cycle
Applications for authorisation must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:
(i) 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
(ii) details of prior etanercept treatment, including date
A total maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment
A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this course of treatment. Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept
Compliance with Written Authority Required procedures
Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, who has previously received PBS-subsidised treatment with etanercept for this condition, and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course Compliance with Written or Telephone Authority Required procedures
  1. Schedule 4, Part 1, entry for Granisetron

substitute:

Granisetron C4077 P4077

Nausea and vomiting

The condition must be associated with cytotoxic chemotherapy being used to treat malignancy which occurs within 48 hours of chemotherapy administration

C4092 P4092

Nausea and vomiting

The condition must be associated with radiotherapy being used to treat malignancy

Compliance with Authority Required procedures - Streamlined Authority Code 4092

C4102 P4102

Nausea and vomiting

The condition must be associated with radiotherapy being used to treat malignancy.

Compliance with Authority Required procedures - Streamlined Authority Code 4102
C4118 P4118

Nausea and vomiting

The condition must be associated with cytotoxic chemotherapy being used to treat malignancy which occurs within 48 hours of chemotherapy administration

  1. Schedule 4, Part 1, after entry for High fat formula with vitamins, minerals and trace elements and low in protein and carbohydrate

insert:

Hyaluronic Acid C4105

Severe dry eye syndrome

Patient must be sensitive to preservatives in multi-dose eye drops.

Compliance with Authority Required procedures - Streamlined Authority Code 4105
C4130

Severe dry eye syndrome

Patient must be sensitive to preservatives in multi-dose eye drops.

Compliance with Authority Required procedures

  1. Schedule 4, Part 1, entry for Hydroxocobalamin

substitute:

Hydroxocobalamin C4111 Pernicious anaemia
C4134 Proven vitamin B12 deficiencies other than pernicious anaemia
C4135

Anaemias associated with vitamin B12 deficiency

Patient must have had a gastrectomy;

The treatment must be for prophylaxis

  1. Schedule 4, Part 1, entry for Mycophenolic Acid

insert in numerical order following existing text:

C4084

Prophylaxis of renal allograft rejection
Management

The treatment must be under the supervision and direction of a transplant unit

Compliance with Authority Required procedures - Streamlined Authority Code 4084

C4095

WHO Class III, IV or V lupus nephritis
Management

The condition must be proven by biopsy;

Must be treated by a nephrologist or in consultation with a nephrologist

The name of the consulting nephrologist must be included in the patient medical records

Compliance with Authority Required procedures - Streamlined Authority Code 4095


C4108

Prophylaxis of renal allograft rejection
Management

The treatment must be under the supervision and direction of a transplant unit

Compliance with Written or Telephone Authority Required procedures

C4131 P4131

WHO Class III, IV or V lupus nephritis
Maintenance

The condition must be proven by biopsy;

Patient must have received initiation treatment;
The treatment must be under the supervision and direction of a nephrologist reviewing the patient

The name of the nephrologist reviewing treatment and the date of the latest review, which must be within the last 12 months, must be included in the authority application

Compliance with Written or Telephone Authority Required procedures

C4146

WHO Class III, IV or V lupus nephritis
Management

The condition must be proven by biopsy;

Must be treated by a nephrologist or in consultation with a nephrologist

The name of the consulting nephrologist must be included in the patient medical records

Compliance with Written or Telephone Authority Required procedures

  1. Schedule 4, Part 1, entry for Naproxen

(a)omit:

C3647 P3647 Initial supply, for up to 4 months, for a palliative care patient where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent Compliance with Authority Required procedures - Streamlined Authority Code 3647
C3648 P3648 Continuing supply for a palliative care patient where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent Compliance with Authority Required procedures - Streamlined Authority Code 3648

(b)insert in numerical order following existing text:

C4124 P4124

Bone pain

The condition must be due to malignant disease;

Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Compliance with Authority Required procedures - Streamlined Authority Code 4124
C4128 P4128

Severe pain

Initial treatment

Patient must be undergoing palliative care;
Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent;
Patient must not receive more than 4 months treatment under this restriction

Compliance with Authority Required procedures - Streamlined Authority Code 4128
C4129 P4129

Severe pain

Continuing treatment

Patient must be undergoing palliative care;
Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Compliance with Authority Required procedures - Streamlined Authority Code 4129
C4159 P4159

Chronic arthropathies (including osteoarthritis)

The condition must have an inflammatory component;

Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Compliance with Authority Required procedures - Streamlined Authority Code 4159
  1. Schedule 4, Part 1, entry for Omeprazole

substitute:

Omeprazole C1337 Scleroderma oesophagus
C1476 Zollinger-Ellison syndrome
C1533 Gastro-oesophageal reflux disease
C4074 P4074

Peptic ulcer

Initial treatment

C4075 P4075 Zollinger-Ellison syndrome
C4089 P4089 Gastro-oesophageal reflux disease
C4152 P4152 Scleroderma oesophagus
  1. Schedule 4, Part 1, entry for Paraffin

insert in numerical order following existing text:

P4072

For use in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

  1. Schedule 4, Part 1, entry for Pazopanib

substitute:

Pazopanib C4067 P4067

Stage IV clear cell variant renal cell carcinoma (RCC)

Initial treatment

Patient must have been receiving treatment with pazopanib prior to 1 October 2012;
The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures

C4109 P4109

Stage IV clear cell variant renal cell carcinoma (RCC)

Continuing treatment beyond 3 months

Patient must have previously been issued with an authority prescription for pazopanib;
Patient must have stable or responding disease according to the Response Evaluation Criteria In Solid Tumours (RECIST);

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures

C4112 P4112

Stage IV clear cell variant renal cell carcinoma (RCC)

Continuing treatment beyond 3 months

Patient must have previously been issued with an authority prescription for pazopanib;
Patient must have stable or responding disease according to the Response Evaluation Criteria In Solid Tumours (RECIST);
Patient must require dose adjustment;

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures

C4148 P4148

Stage IV clear cell variant renal cell carcinoma (RCC)

Initial treatment

Patient must meet the Memorial Sloan Kettering Cancer Centre (MSKCC) low to intermediate risk group criteria;
Patient must have a WHO performance status of 2 or less;
The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Patients who have progressive disease on sunitinib are not eligible to receive PBS-subsidised pazopanib

Compliance with Authority Required procedures

  1. Schedule 4, Part 1, entry for Raloxifene

substitute:

Raloxifene C4071

Established post-menopausal osteoporosis
Patient must have fracture due to minimal trauma;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4071


  1. Schedule 4, Part 1, entry for Risedronic Acid

substitute:

Risedronic Acid C3256

Symptomatic Paget disease of bone

Compliance with Authority Required procedures - Streamlined Authority Code 3256

C4117

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4117


C4122

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122

C4123

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4123


  1. Schedule 4, Part 1, entry for Risedronic Acid and Calcium

substitute:

Risedronic Acid and Calcium C4117

Osteoporosis

Patient must be aged 70 years or older;
Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4117


C4122

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122


C4123

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4123


  1. Schedule 4, Part 1, entry for Risedronic acid and calcium with colecalciferol

substitute:

Risedronic acid and calcium with colecalciferol C4117

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4117


C4122

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122


C4123

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4123


  1. Schedule 4, Part 1, entry for Rivaroxaban

insert in numerical order following existing text:

C4098

Deep vein thrombosis

Initial treatment

Patient must have confirmed acute symptomatic deep vein thrombosis;
Patient must not have symptomatic pulmonary embolism

Compliance with Authority Required procedures - Streamlined Authority Code 4098

C4099

Deep vein thrombosis

Continuing treatment

Patient must have confirmed acute symptomatic deep vein thrombosis;
Patient must not have symptomatic pulmonary embolism

Compliance with Authority Required procedures - Streamlined Authority Code 4099

C4132

Prevention of recurrent venous thromboembolism

Continuing treatment

Patient must have a history of venous thromboembolism

Compliance with Authority Required procedures - Streamlined Authority Code 4132

  1. Schedule 4, Part 1, entry for Strontium

substitute:

Strontium C4071

Established post-menopausal osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4071


C4107

Osteoporosis

Patient must be female;

Patient must be aged 70 years or older;
Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4107


  1. Schedule 4, Part 1, entry for Sunitinib

substitute:

Sunitinib C3206 P3206

Initial PBS-subsidised treatment as monotherapy of a patient with World Health Organisation performance status of 2 or less with a metastatic or unresectable malignant gastrointestinal stromal tumour after failure of imatinib mesylate treatment due to resistance or intolerance, and where the application for authorisation includes:

(1) a completed copy of the appropriate Sunitinib Malate (Sutent) PBS Authority Application for Use in the Treatment of Gastrointestinal Stromal Tumour - Supporting Information Form; and

(2) a signed patient acknowledgement

Compliance with Written Authority Required procedures
C3207 P3207 Continuing PBS-subsidised treatment as monotherapy of a patient with World Health Organisation performance status of 2 or less with a metastatic or unresectable malignant gastrointestinal stromal tumour who has previously been issued with an authority prescription for sunitinib and who does not have progressive disease on sunitinib

Compliance with Written or Telephone Authority Required procedures

C4106 P4106

Stage IV clear cell variant renal cell carcinoma (RCC)
Continuing treatment beyond 3 months

Patient must have previously been issued with an authority prescription for sunitinib;

Patient must have stable or responding disease according to the Response Evaluation Criteria In Solid Tumours (RECIST);

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures

C4119 P4119

Stage IV clear cell variant renal cell carcinoma (RCC)

Initial treatment

Patient must meet the Memorial Sloan Kettering Cancer Centre (MSKCC) low to intermediate risk group criteria;
Patient must have a WHO performance status of 2 or less;

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Patients who have developed progressive disease on pazopanib are not eligible to receive PBS-subsidised sunitinib

Compliance with Authority Required procedures

  1. Schedule 4, Part 1, entry for Teriparatide

substitute:

Teriparatide C4101

Severe established osteoporosis

Initial treatment

Must be treated by a specialist; OR
Must be treated by a consultant physician;
Patient must be at very high risk of fracture;
Patient must have a bone mineral density (BMD) T-score of -3.0 or less;
Patient must have had 2 or more fractures due to minimal trauma;
Patient must have experienced at least 1 symptomatic new fracture after at least 12 months continuous therapy with an anti-resorptive agent at adequate doses;
The treatment must be the sole PBS-subsidised agent;
The treatment must not exceed a lifetime maximum of 18 months therapy

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

If treatment with anti-resorptive therapy is contraindicated according to the relevant TGA-approved Product Information, details of the contraindication must be provided at the time of application

If an intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use of one anti-resorptive agent, alternate anti-resorptive agents must be trialled so that the patient achieves the minimum requirement of 12 months continuous therapy. Details must be provided at the time of application

Anti-resorptive therapies for osteoporosis and their adequate doses which will be accepted for the purposes of administering this restriction are alendronate sodium 10 mg per day or 70 mg once weekly, risedronate sodium 5 mg per day or 35 mg once weekly or 150 mg once monthly, raloxifene hydrochloride 60 mg per day (women only), denosumab 60 mg once every 6 months, strontium ranelate 2 g per day and zoledronic acid 5 mg per annum

Details of prior anti-resorptive therapy, fracture history including the date(s), site(s), the symptoms associated with the fracture(s) which developed after at least 12 months continuous anti-resorptive therapy and the score of the qualifying BMD measurement must be provided at the time of application

Compliance with Authority Required procedures


4113

Severe established osteoporosis

Continuing treatment

Patient must have previously been issued with an authority prescription for this drug;
The treatment must not exceed a lifetime maximum of 18 months therapy

Compliance with Authority Required procedures

  1. Schedule 4, Part 1, entry for Zoledronic acid

(a)omit:

C3945 Treatment as the sole PBS-subsidised anti-resorptive agent for corticosteroid-induced osteoporosis in a patient currently on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy with a bone mineral density T-score of -1.5 or less, and where the duration and dose of corticosteroid therapy, and the date, site (femoral neck or lumbar spine) and score of the qualifying bone mineral density measurement, are documented in the patient's medical records when treatment is initiated, and where PBS-subsidised treatment is limited to 1 dose per patient each year Compliance with Authority Required procedures - Streamlined Authority Code 3945
C3946 Treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in a patient 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 documented in the patient's medical records when treatment is initiated, 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, and where PBS-subsidised treatment is limited to 1 dose per patient per year Compliance with Authority Required procedures - Streamlined Authority Code 3946

C3947 Treatment as the sole PBS-subsidised anti-resorptive agent for osteoporosis in a patient aged 70 years of age or older with a bone mineral density T-score of -3.0 or less, where the date, site (femoral neck or lumbar spine) and score of the qualifying bone mineral density measurement are documented in the patient's medical records when treatment is initiated, and where PBS-subsidised treatment is limited to 1 dose per patient each year Compliance with Authority Required procedures - Streamlined Authority Code 3947

(b)insert in numerical order following existing text:

C4100

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition;
Patient must not receive more than one PBS-subsidised treatment per year

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4100


C4149

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;
Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition;
Patient must not receive more than one PBS-subsidised treatment per year

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4149


C4157

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition;
Patient must not receive more than one PBS-subsidised treatment per year

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a 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

Compliance with Authority Required procedures - Streamlined Authority Code 4157


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1Note

All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003.

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