National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2017 (No. 10) (PB 92 of 2017) (Cth)

Case

PB 92 of 2017

National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2017
(No. 10)

National Health Act 1953

I, LISA LA RANCE, Assistant Secretary, Pricing and Policy Branch, Technology Assessment and Access Division, Department of Health, 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   28th November 2017

LISA LA RANCE

Assistant Secretary

Pricing and Policy Branch

Technology Assessment and Access Division

Department of Health


1          Name of Instrument

(1)        This Instrument is the National Health (Listing of Pharmaceutical    Benefits) Amendment Instrument 2017 (No. 10).

(2)        This Instrument may also be cited as PB 92 of 2017.

2          Commencement

This Instrument commences on 1 December 2017.

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. Schedule 1, after entry for Abiraterone in the form Tablet containing abiraterone acetate 250 mg

insert:

Tablet containing abiraterone acetate 500 mg Oral Zytiga JC MP C6944 60 2 60
  1. Schedule 1, entry for Allopurinol in the form Tablet 100 mg

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

a Allopurinol APOTEX GX MP NP 200 2 200
  1. Schedule 1, entry for Allopurinol in the form Tablet 300 mg

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

a Allopurinol APOTEX GX MP NP 60 2 60

(b)insert in the column headed “Schedule Equivalent” for all brands:             a

  1. Schedule 1, entry for Alprazolam in the form Tablet 250 micrograms

omit:

a Alprax 0.25 QA MP NP C6773 10 0 50
a Kalma 0.25 AF MP NP C6773 10 0 50

substitute:

a Kalma 0.25 AF MP NP C6773 10 0 10
MP NP C6773 10 0 50
a Alprax 0.25 QA MP NP C6773 10 0 50
  1. Schedule 1, entry for Alprazolam in the form Tablet 500 micrograms

omit:

a Kalma 0.5 AF MP NP C6773 10 0 50

substitute:

a Kalma 0.5 AF MP NP C6773 10 0 10
MP NP C6773 10 0 50
  1. Schedule 1, entry for Alprazolam in the form Tablet 1 mg

omit:

a Kalma 1 AF MP NP C6773 10 0 50

substitute:

a Kalma 1 AF MP NP C6773 10 0 10
MP NP C6773 10 0 50
  1. Schedule 1, entry for Amisulpride in the form Tablet 100 mg

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

a Pharmacor Amisulpride CR MP NP C4246 30 5 30
  1. Schedule 1, entry for Amisulpride in each of the forms: Tablet 200 mg; and Tablet 400 mg

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

a Pharmacor Amisulpride CR MP NP C4246 60 5 60
  1. Schedule 1, entry for Amoxycillin in each of the forms: Capsule 250 mg (as trihydrate); and Capsule 500 mg (as trihydrate)

(a)omit:

Chem mart Amoxycillin CH PDP 20 0 20

(b)omit:

Terry White Chemists Amoxycillin TW PDP 20 0 20

(c)omit:

Chem mart Amoxycillin CH MP NP MW 20 1 20

(d)omit:

Terry White Chemists Amoxycillin TW MP NP MW 20 1 20
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Tablet containing 500 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) [Maximum Quantity: 10; Number of Repeats: 0]

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

a AMOXICLAV AMNEAL 500/125 ED PDP C5833 C5894 10 0 10
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Tablet containing 500 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) [Maximum Quantity: 10; Number of Repeats: 1]

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

a AMOXICLAV AMNEAL 500/125 ED MP NP MW C5832 C5893 10 1 10
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Tablet containing 875 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) [Maximum Quantity: 10; Number of Repeats: 0]

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

a AMOXICLAV AMNEAL 875/125 ED PDP C5833 C5894 10 0 10
  1. Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Tablet containing 875 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) [Maximum Quantity: 10; Number of Repeats: 1]

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

a AMOXICLAV AMNEAL 875/125 ED MP NP C5832 C5893 10 1 10
  1. Schedule 1, entry for Apomorphine

omit:

Injection containing apomorphine hydrochloride 10 mg in 1 mL Injection Apomine PF MP C4833 C4860 360 5 5 D(100)
  1. Schedule 1, entry for Atorvastatin in the form Tablet 10 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 5]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4263 30 5 30
NP C4263 30 5 30
  1. Schedule 1, entry for Atorvastatin in the form Tablet 10 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 11]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4238 30 11 30
  1. Schedule 1, entry for Atorvastatin in the form Tablet 20 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 5]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4263 30 5 30
NP C4263 30 5 30
  1. Schedule 1, entry for Atorvastatin in the form Tablet 20 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 11]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4238 30 11 30
  1. Schedule 1, entry for Atorvastatin in the form Tablet 40 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 5]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4263 30 5 30
NP C4263 30 5 30
  1. Schedule 1, entry for Atorvastatin in the form Tablet 40 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 11]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4238 30 11 30
  1. Schedule 1, entry for Atorvastatin in the form Tablet 80 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 5]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4263 30 5 30
NP C4263 30 5 30
  1. Schedule 1, entry for Atorvastatin in the form Tablet 80 mg (as calcium) [Maximum Quantity: 30; Number of Repeats: 11]

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

a Pharmacor Atorvastatin CR MP C4238 C4263 P4238 30 11 30
  1. Schedule 1, entry for Auranofin in the form Tablet 3 mg

omit:

MP NP 100 3 100
  1. Schedule 1, entry for Baclofen in each of the forms: Tablet 10 mg; and Tablet 25 mg

(a)omit:

a Chem mart Baclofen CH MP NP 100 5 100

(b)omit:

a Terry White Chemists Baclofen TW MP NP 100 5 100
  1. Schedule 1, entry for Bimatoprost in the form Eye drops 300 micrograms per mL, 3 mL

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

a Bimtop QA MP AO 1 5 1
  1. Schedule 1, entry for Bosentan in each of the forms: Tablet 62.5 mg (as monohydrate); and Tablet 125 mg (as monohydrate)

omit:

a APO-BOSENTAN GX MP See Note 3 See Note 3 See Note 3 See
Note 3
60 D(100)
  1. Schedule 1, entry for Brentuximab vedotin

omit from the column headed “Circumstances”:          C4719   

insert in numerical order in the column headed “Circumstances”:         C7244

  1. Schedule 1, entry for Cephalexin in the form Granules for oral suspension 125 mg per 5 mL, 100 mL

(a)omit:

APO‑Cephalexin TX PDP 1 0 1

(b)omit:

Chem mart Cephalexin CH PDP 1 0 1

(c)omit:

Terry White Chemists Cephalexin TW PDP 1 0 1

(d)omit:

APO‑Cephalexin TX MP NP 1 1 1

(e)omit:

Chem mart Cephalexin CH MP NP 1 1 1

(f)omit:

Terry White Chemists Cephalexin TW 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:

APO‑Cephalexin TX PDP 1 0 1

(b)omit:

Chem mart Cephalexin CH PDP 1 0 1

(c)omit:

Terry White Chemists Cephalexin TW PDP 1 0 1

(d)omit:

APO‑Cephalexin TX MP NP 1 1 1

(e)omit:

Chem mart Cephalexin CH MP NP 1 1 1

(f)omit:

Terry White Chemists Cephalexin TW MP NP 1 1 1
  1. Schedule 1, entry for Clindamycin

omit from the column headed “Responsible Person” for the brand “Clindamycin-Link” (twice occurring):                                 LM                  substitute:             LI

  1. Schedule 1, entry for Dutasteride

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

a APO-Dutasteride TX MP NP C6202 30 5 30

(b)insert in the column headed “Schedule Equivalent” for the brand “Avodart”:         a

  1. Schedule 1, entry for Epoetin Lambda in all forms

(a)omit from the column headed “Listed Drug”:            Epoetin Lambda                     substitute:             Epoetin lambda

(b)omit from the column headed “Circumstances”:       C6245 C6261               substitute:             C6260 C6294

  1. Schedule 1, entry for Eribulin

insert in numerical order in the column headed “Circumstances”:         C7258 C7280

  1. Schedule 1, entry for Escitalopram in each of the forms: Tablet 10 mg (as oxalate); and Tablet 20 mg (as oxalate)

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

a Escitalopram Sandoz HX MP NP C4755 28 5 28
  1. Schedule 1, entry for Etanercept in the form Injection 50 mg in 1 mL single use auto-injector, 4 [Brand: Brenzys; Maximum Quantity: 1; Number of Repeats: 3]

(a)omit all codes from the column headed “Circumstances”, substitute:
C6808 C6836 C7168 C7174 C7177 C7179 C7181 C7205 C7209 C7217 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7264 C7276 C7288 C7289 C7296 C7300 C7308 C7309 C7317 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P6808 P6836 P7177 P7205 P7209 P7220 P7221 P7224 P7235 P7237 P7288 P7308 P7309 P7336

  1. Schedule 1, entry for Etanercept in the form Injection 50 mg in 1 mL single use auto-injector, 4 [Brand: Enbrel; Maximum Quantity: 1; Number of Repeats: 3]

(a)omit all codes from the column headed “Circumstances”, substitute:
C4457 C4458 C4482 C4483 C4503 C6808 C6811 C6814 C6818 C6819 C6822 C6823 C6830 C6836 C6843 C7169 C7170 C7174 C7177 C7179 C7180 C7181 C7205 C7209 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7251 C7264 C7287 C7288 C7289 C7300 C7307 C7308 C7309 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P4458 P4483 P4503 P6808 P6811 P6814 P6818 P6819 P6822 P6823 P6830 P6836 P6843 P7177 P7205 P7209 P7220 P7221 P7224 P7235 P7237 P7288 P7308 P7309 P7336

  1. Schedule 1, entry for Etanercept in the form Injection 50 mg in 1 mL single use auto-injector, 4 [Brand: Brenzys; Maximum Quantity: 1; Number of Repeats: 5]

(a)omit all codes from the column headed “Circumstances”, substitute:
C6808 C6836 C7168 C7174 C7177 C7179 C7181 C7205 C7209 C7217 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7264 C7276 C7288 C7289 C7296 C7300 C7308 C7309 C7317 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P7168 P7174 P7179 P7181 P7217 P7219 P7222 P7264 P7276 P7289 P7296 P7300 P7317 P7320

  1. Schedule 1, entry for Etanercept in the form Injection 50 mg in 1 mL single use auto-injector, 4 [Brand: Enbrel; Maximum Quantity: 1; Number of Repeats: 5]

(a)omit all codes from the column headed “Circumstances”, substitute:
C4457 C4458 C4482 C4483 C4503 C6808 C6811 C6814 C6818 C6819 C6822 C6823 C6830 C6836 C6843 C7169 C7170 C7174 C7177 C7179 C7180 C7181 C7205 C7209 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7251 C7264 C7287 C7288 C7289 C7300 C7307 C7308 C7309 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P4457 P4482 P7169 P7170 P7174 P7179 P7180 P7181 P7219 P7222 P7251 P7264 P7287 P7289 P7300 P7307 P7320

  1. Schedule 1, entry for Etanercept in the form Injections 50 mg in 1 mL single use pre-filled syringes, 4 [Brand: Brenzys;
    Maximum Quantity: 1; Number of Repeats: 3]

(a)omit all codes from the column headed “Circumstances”, substitute:
C6808 C6836 C7168 C7174 C7177 C7179 C7181 C7205 C7209 C7217 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7264 C7276 C7288 C7289 C7296 C7300 C7308 C7309 C7317 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P6808 P6836 P7177 P7205 P7209 P7220 P7221 P7224 P7235 P7237 P7288 P7308 P7309 P7336

  1. Schedule 1, entry for Etanercept in the form Injections 50 mg in 1 mL single use pre-filled syringes, 4 [Brand: Enbrel; Maximum Quantity: 1; Number of Repeats: 3]

(a)omit all codes from the column headed “Circumstances”, substitute:
C4457 C4458 C4482 C4483 C4503 C6808 C6811 C6814 C6818 C6819 C6822 C6823 C6830 C6836 C6843 C7169 C7170 C7174 C7177 C7179 C7180 C7181 C7205 C7209 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7251 C7264 C7287 C7288 C7289 C7300 C7307 C7308 C7309 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P4458 P4483 P4503 P6808 P6811 P6814 P6818 P6819 P6822 P6823 P6830 P6836 P6843 P7177 P7205 P7209 P7220 P7221 P7224 P7235 P7237 P7288 P7308 P7309 P7336

  1. Schedule 1, entry for Etanercept in the form Injections 50 mg in 1 mL single use pre-filled syringes, 4 [Brand: Brenzys;
    Maximum Quantity: 1; Number of Repeats: 5]

(a)omit all codes from the column headed “Circumstances”, substitute:
C6808 C6836 C7168 C7174 C7177 C7179 C7181 C7205 C7209 C7217 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7264 C7276 C7288 C7289 C7296 C7300 C7308 C7309 C7317 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P7168 P7174 P7179 P7181 P7217 P7219 P7222 P7264 P7276 P7289 P7296 P7300 P7317 P7320

  1. Schedule 1, entry for Etanercept in the form Injections 50 mg in 1 mL single use pre-filled syringes, 4 [Brand: Enbrel; Maximum Quantity: 1; Number of Repeats: 5]

(a)omit all codes from the column headed “Circumstances”, substitute:
C4457 C4458 C4482 C4483 C4503 C6808 C6811 C6814 C6818 C6819 C6822 C6823 C6830 C6836 C6843 C7169 C7170 C7174 C7177 C7179 C7180 C7181 C7205 C7209 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7251 C7264 C7287 C7288 C7289 C7300 C7307 C7308 C7309 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P4457 P4482 P7169 P7170 P7174 P7179 P7180 P7181 P7219 P7222 P7251 P7264 P7287 P7289 P7300 P7307 P7320

  1. Schedule 1, entry for Etanercept in the form Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent
    1 mL [Maximum Quantity: 2; Number of Repeats: 3]

(a)omit all codes from the column headed “Circumstances”, substitute:
C4457 C4458 C4482 C4483 C4503 C6808 C6811 C6814 C6818 C6819 C6822 C6823 C6830 C6836 C6843 C7169 C7170 C7174 C7177 C7179 C7180 C7181 C7205 C7209 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7251 C7264 C7287 C7288 C7289 C7300 C7307 C7308 C7309 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P4458 P4483 P4503 P6808 P6811 P6814 P6818 P6819 P6822 P6823 P6830 P6836 P6843 P7177 P7205 P7209 P7220 P7221 P7224 P7235 P7237 P7288 P7308 P7309 P7336

  1. Schedule 1, entry for Etanercept in the form Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent
    1 mL [Maximum Quantity: 2; Number of Repeats: 5]

(a)omit all codes from the column headed “Circumstances”, substitute:
C4457 C4458 C4482 C4483 C4503 C6808 C6811 C6814 C6818 C6819 C6822 C6823 C6830 C6836 C6843 C7169 C7170 C7174 C7177 C7179 C7180 C7181 C7205 C7209 C7219 C7220 C7221 C7222 C7224 C7235 C7237 C7251 C7264 C7287 C7288 C7289 C7300 C7307 C7308 C7309 C7320 C7336

(b)omit all codes from the column headed “Purposes”, substitute:
P4457 P4482 P7169 P7170 P7174 P7179 P7180 P7181 P7219 P7222 P7251 P7264 P7287 P7289 P7300 P7307 P7320

  1. Schedule 1, entry for Etoposide

omit:

Powder for I.V. infusion 100 mg (as phosphate) Injection Etopophos BQ MP See Note 3 See
Note 3
1 PB(100)
  1. Schedule 1, entry for Evolocumab in the form Injection 140 mg in 1 mL single use pre-filled pen

omit from the column headed “Circumstances”:          C6586

insert in numerical order in the column headed “Circumstances”:         C7329

  1. Schedule 1, omit entry for Foscarnet

  1. Schedule 1, entry for Gabapentin in each of the forms: Capsule 300 mg; Capsule 400 mg; Tablet 600 mg; and Tablet 800 mg

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

a APO-Gabapentin TX MP NP C4928 100 5 100
  1. Schedule 1, entry for Goserelin in the form Subcutaneous implant 3.6 mg (as acetate) in pre filled injection syringe

insert in numerical order in the column headed “Circumstances”:         C7164

  1. Schedule 1, entry for Hydroxocobalamin in the form Injection 1 mg (as acetate) in 1 mL

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

Cobal-B12 JU MP NP C5840 C5841 C5854 3 0 3
  1. Schedule 1, entry for Hyoscine

(a)insert in the column headed “Schedule Equivalent” for the brand “Buscopan”:      a

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

a HYOSCINE BUTYLBROMIDE SXP XC MP NP C6207 30 3 5
  1. Schedule 1, after entry for Ibandronic acid in the form Concentrated injection for I.V. infusion 6 mg (as ibandronate sodium monohydrate) in 6 mL

insert:

Ibrutinib Capsule 140 mg Oral Imbruvica JC MP C7260 C7337 90 5 90
  1. Schedule 1, entry for Icatibant

omit from the column headed “Circumstances”:          C4917 C4949  substitute:C7273 C7274

  1. Schedule 1, entry for Idelalisib in each of the forms: Tablet 100 mg; and Tablet 150 mg

omit from the column headed “Circumstances”:          C7051

insert in numerical order in the column headed “Circumstances”:         C7310

  1. Schedule 1, entry for Isotretinoin in the form Capsule 10 mg

omit:

Roaccutane RO MP C5224 60 3 60
  1. Schedule 1, entry for Lamotrigine in each of the forms: Tablet 25 mg; and Tablet 50 mg

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

a Sandoz Lamotrigine HX MP NP C5138 56 5 56
  1. Schedule 1, entry for Leflunomide in each of the forms: Tablet 10 mg; and Tablet 20 mg

omit:

a APO‑Leflunomide TX MP C5681 30 5 30
  1. Schedule 1, after entry for Mesalazine in the form Tablet 500 mg (prolonged release)

insert:

Tablet 800 mg (enteric coated) Oral Asacol EU MP NP C4824 180 5 90
  1. Schedule 1, entry for Milk powder—lactose free formula

omit:

Oral powder 900 g (S‑26 LF) Oral S‑26 LF AS MP NP C4324 C4336 P4324 5 0 1
MP NP C4324 C4336 P4336 5 5 1
Oral powder 900 g (Aptamil Gold+ De-Lact) Oral Aptamil Gold+ De-Lact NU MP NP C4324 C4336 P4324 5 0 1
MP NP C4324 C4336 P4336 5 5 1

substitute:

Oral powder 900 g (Aptamil Gold+ De-Lact) Oral Aptamil Gold+ De-Lact NU MP NP C7198 5 0 1
Oral powder 900 g (S-26 LF) Oral S-26 LF AS MP NP C4324 5 0 1
  1. Schedule 1, after entry for Milk powder—lactose free formula in the form Oral powder 900 g (S-26 LF)

insert:

Milk powder lactose intolerance formula Oral powder 900 g (S-26 Original LI) Oral S-26 Original LI AS MP NP C7257 5 0 1
  1. Schedule 1, entry for Mirtazapine in the form Tablet 45 mg

omit:

a Avanza MK MP NP C5650 30 5 30
  1. Schedule 1, entry for Olanzapine in each of the forms: Tablet 2.5 mg; Tablet 5 mg; Tablet 7.5 mg; and Tablet 10 mg

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

PRYZEX RW MP NP C5856 C5869 28 5 28
  1. Schedule 1, entry for Olanzapine in each of the forms: Tablet 5 mg (orally disintegrating); and Tablet 10 mg (orally disintegrating)

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

PRYZEX ODT RW MP NP C5856 C5869 28 5 28
  1. Schedule 1, entry for Pemetrexed in each of the forms: Powder for I.V. infusion 100 mg (as disodium); Powder for I.V. infusion 500 mg
    (as disodium); and Powder for I.V. infusion 1 g (as disodium)

omit from the column headed “Circumstances” (all instances):               C4789

insert in numerical order in the column headed “Circumstances” (all instances):               C7195

  1. Schedule 1, entry for Salbutamol in the form Nebuliser solution 2.5 mg (as sulfate) in 2.5 mL single dose units, 30

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

Salbutamol AN JU MP NP C6815 C6825 2 5 1
  1. Schedule 1, entry for Salbutamol in the form Nebuliser solution 5 mg (as sulfate) in 2.5 mL single dose units, 30

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

Salbutamol AN JU MP NP C6815 C6825 2 5 1
  1. Schedule 1, entry for Secukinumab in the form Injection 150 mg in 1 mL pre-filled pen [Maximum Quantity: 1; Number of Repeats: 2]

omit from the column headed “Circumstances”:          C6437

omit from the column headed “Circumstances”:          C6467

omit from the column headed “Circumstances”:          C6483

omit from the column headed “Circumstances”:          C6485 C6486 C6487

  1. Schedule 1, entry for Secukinumab in the form Injection 150 mg in 1 mL pre-filled pen [Maximum Quantity: 1; Number of Repeats: 5]

omit from the column headed “Circumstances”:          C6437

omit from the column headed “Circumstances”:          C6467

omit from the column headed “Circumstances”:          C6483

omit from the column headed “Circumstances”:          C6485 C6486 C6487

  1. Schedule 1, entry for Secukinumab in the form Injection 150 mg in 1 mL pre-filled pen [Maximum Quantity: 2; Number of Repeats: 2]

(a)omit from the column headed “Circumstances”:               C6437

omit from the column headed “Circumstances”:               C6467

omit from the column headed “Circumstances”:               C6483

omit from the column headed “Circumstances”:               C6485 C6486 C6487

(b)omit from the column headed “Purposes”:   P6487                 substitute:         P6415

  1. Schedule 1, entry for Secukinumab in the form Injection 150 mg in 1 mL pre-filled pen [Maximum Quantity: 2; Number of Repeats: 5]

(a)omit from the column headed “Circumstances”:               C6437

omit from the column headed “Circumstances”:               C6467

omit from the column headed “Circumstances”:               C6483

omit from the column headed “Circumstances”:               C6485 C6486 C6487

(b)omit from the column headed “Purposes”:   P6483 P6485 P6486 substitute: P6427 P6438 P6439

  1. Schedule 1, entry for Secukinumab in the form Injection 150 mg in 1 mL pre-filled pen [Maximum Quantity: 4; Number of Repeats: 0]

(a)omit from the column headed “Circumstances”:               C6437

omit from the column headed “Circumstances”:               C6467

omit from the column headed “Circumstances”:               C6483

omit from the column headed “Circumstances”:               C6485 C6486 C6487

(b)omit from the column headed “Purposes”:   P6437

omit from the column headed “Purposes”:   P6467

insert in numerical order in the column headed “Purposes”:         P6482 P6484

  1. Schedule 1, entry for Secukinumab in the form Injection 150 mg in 1 mL pre-filled pen [Maximum Quantity: 8; Number of Repeats: 0]

omit from the column headed “Circumstances”:          C6437

omit from the column headed “Circumstances”:          C6467

omit from the column headed “Circumstances”:          C6483

omit from the column headed “Circumstances”:          C6485 C6486 C6487

  1. Schedule 1, entry for Telmisartan in each of the forms: Tablet 40 mg; and Tablet 80 mg

(a)omit:

Chem mart Telmisartan CH MP NP 28 5 28

(b)omit:

Terry White Chemists Telmisartan TW MP NP 28 5 28
  1. Schedule 1, entry for Terbinafine in the form Tablet 250 mg (as hydrochloride) [Maximum Quantity: 42; Number of Repeats: 0]

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

a APO-Terbinafine TX MP NP C6395 C6404 C6453 P6404 P6453 42 0 42

(b)insert in the column headed “Schedule Equivalent” for all brands:             a

  1. Schedule 1, entry for Terbinafine in the form Tablet 250 mg (as hydrochloride) [Maximum Quantity: 42; Number of Repeats: 1]

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

a APO-Terbinafine TX MP NP C6395 C6404 C6453 P6395 42 1 42

(b)insert in the column headed “Schedule Equivalent” for all brands:             a

  1. Schedule 1, after entry for Vismodegib

insert:

Vitamins, minerals and trace elements formula Sachets containing oral powder 7 g, 30 (Phlexy-Vits) Oral Phlexy-Vits SB MP NP C7275 1 5 1
  1. Schedule 1, entry for Ziprasidone in each of the forms: Capsule 20 mg (as hydrochloride); Capsule 40 mg (as hydrochloride);
    Capsule 60 mg (as hydrochloride); and Capsule 80 mg (as hydrochloride)

(a)insert in the column headed “Schedule Equivalent” for all brands:             a

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

a ZIPROX RW MP NP C4246 C5742 60 5 60
  1. Schedule 3, details relevant to Responsible Person code BX

omit from the column headed “Responsible Person”:                 Baxter Healthcare Pty Ltd         substitute:             Baxter Healthcare Pty Limited

  1. Schedule 3, details relevant to Responsible Person code FK

omit from the column headed “Responsible Person”:                 A.Menarini Australia Pty Ltd     substitute:             A. Menarini Australia Pty Limited

  1. Schedule 3, after details relevant to Responsible Person code KY

insert:

LI Luminarie Pty Ltd  18 601 868 375
  1. Schedule 3

omit:

MI Meditech Int. Pty Ltd  17 069 879 465
  1. Schedule 3, details relevant to Responsible Person code NE

omit from the column headed “Responsible Person”:                 Norgine Pty Ltd            substitute:             Norgine Pty Limited

  1. Schedule 3

(a)omit:

OY Orion Laboratories Pty Ltd  56 009 293 136

(b)omit:

TE Takeda Pharmaceuticals Australia Pty Ltd  71 095 610 870
  1. Schedule 3, after details relevant to Responsible Person code XA

insert:

XC Southern Cross Pharma Pty Ltd  47 094 447 677
  1. Schedule 4, Part 1, entry for Brentuximab vedotin

(a)omit:

C4719

CD30 positive systemic anaplastic large cell lymphoma

Initial treatment

The treatment must be for curative intent; AND
Patient must have undergone appropriate prior front-line curative intent chemotherapy; AND
Patient must demonstrate relapsed or chemotherapy-refractory disease

Applications for authorisation of initial treatment must be in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Systemic anaplastic large cell lymphoma Brentuximab PBS Authority Application - Supporting Information Form which includes the following:
(i) a histology report including evidence of the tumour's CD30 positivity from a biopsy subsequent to the most recently delivered prior treatment with radiation, chemotherapy, biologics, immunotherapy or other agents;
(ii) The date of initial diagnosis of systemic anaplastic large cell lymphoma;
(iii) Dates of commencement and completion of front-line curative intent chemotherapy;
(iv) a declaration of whether the patient's disease is relapsed or refractory, and the date and means by which the patient's disease was assessed as being relapsed or refractory;
(v) a declaration of whether the patient has had, or is planned to have, a transplant

A maximum quantity and number of repeats to provide for an initial course of brentuximab vedotin of 4 cycles will be authorised as part of the initiating restriction

Compliance with Written Authority Required procedures

(b)insert in numerical order after existing text:

C7244

CD30 positive systemic anaplastic large cell lymphoma

Initial treatment

The treatment must be for curative intent; AND
Patient must have undergone appropriate prior front-line curative intent chemotherapy; AND
Patient must demonstrate relapsed or chemotherapy-refractory disease.

Applications for authorisation of initial treatment must be in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Systemic anaplastic large cell lymphoma Brentuximab PBS Authority Application - Supporting Information Form which includes the following:
(i) a histology report including evidence of the tumour's CD30 positivity from a biopsy subsequent to the most recently delivered prior treatment with radiation, chemotherapy, biologics, immunotherapy or other agents;
(ii) The date of initial diagnosis of systemic anaplastic large cell lymphoma;
(iii) Dates of commencement and completion of front-line curative intent chemotherapy; and
(iv) a declaration of whether the patient's disease is relapsed or refractory, and the date and means by which the patient's disease was assessed as being relapsed or refractory.

A maximum quantity and number of repeats to provide for an initial course of brentuximab vedotin of 4 cycles will be authorised as part of the initiating restriction.

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

substitute:

C6260

Anaemia associated with intrinsic renal disease

Patient must require transfusion; AND
Patient must have a haemoglobin level of less than 100 g per L; AND
Patient must have intrinsic renal disease, as assessed by a nephrologist.

Compliance with Authority Required procedures
C6294

Anaemia associated with intrinsic renal disease

Patient must require transfusion; AND
Patient must have a haemoglobin level of less than 100 g per L; AND
Patient must have intrinsic renal disease, as assessed by a nephrologist.

Compliance with Authority Required procedures - Streamlined Authority Code 6294
  1. Schedule 4, Part 1, entry for Eribulin

insert in numerical order after existing text:

C7258

Advanced (unresectable and/or metastatic) liposarcoma

Initial treatment

Patient must have an ECOG performance status of 2 or less; AND
The condition must be dedifferentiated, myxoid, round-cell or pleomorphic subtype; AND
Patient must have received prior chemotherapy treatment including an anthracycline and ifosfamide (unless contraindicated) for this condition; AND
The treatment must be the sole PBS-subsidised therapy for this condition.
Patient must be aged 18 years or older.

Compliance with Authority Required procedures - Streamlined Authority Code 7258
C7280

Advanced (unresectable and/or metastatic) liposarcoma

Continuing treatment

Patient must have previously received PBS-subsidised treatment with this drug for this condition; AND
Patient must not develop progressive disease while being treated with this drug for this condition; AND
The treatment must be the sole PBS-subsidised therapy for this condition.
Patient must be aged 18 years or older.

Compliance with Authority Required procedures - Streamlined Authority Code 7280
  1. Schedule 4, Part 1, entry for Etanercept

(a)omit:

C4610 P4610 Ankylosing spondylitis
Initial treatment – Initial 1 (new patients) or Initial 2 (change or recommencement for all patients) – balance of supply
Patient must have active, or a documented history of active, ankylosing spondylitis; AND
Patient must have received insufficient therapy with this drug under the Initial 1 (new patients) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug under the Initial 2 (change or recommencement for all patients) restriction to complete 16 weeks treatment; AND
The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions
Patient must be an adult
Must be treated by a rheumatologist
Compliance with Authority Required procedures


C4643 P4643 Ankylosing spondylitis
Continuing treatment – balance of supply
Patient must have a documented history of active ankylosing spondylitis; AND
Patient must have received insufficient therapy with this drug under the Continuing treatment restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restriction
Patient must be an adult
Must be treated by a rheumatologist
Compliance with Authority Required procedures


C4676 P4676

Severe active rheumatoid arthritis
Continuing Treatment – balance of supply

Patient must have received insufficient therapy with this drug under the Continuing treatment restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restriction

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis

Compliance with Authority Required procedures


C4766 P4766

Severe active rheumatoid arthritis
Initial treatment - Initial 1 (new patient or patient recommencing treatment after a break of more than 24 months) or Initial 2 (change or recommencement of treatment after break of less than 24 months) – balance of supply

Patient must have received insufficient therapy with this drug under the Initial 1 (new patient or patient recommencing treatment after break of more than 24 months) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug under the Initial 2 (change or recommencement of treatment after break of less than 24 months) restriction to complete 16 weeks treatment; AND
The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis

Compliance with Authority Required procedures


C4845 P4845

Severe psoriatic arthritis

Continuing treatment - balance of supply

Patient must have received insufficient therapy with this drug under the Continuing treatment restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restriction

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis

Compliance with Authority Required procedures
C4851 P4851

Severe psoriatic arthritis

Initial treatment - Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more) or Initial 2 (change or recommencement of treatment) - balance of supply

Patient must have received insufficient therapy with this drug under the Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug under the Initial 2 (change or recommencement of treatment) restriction to complete 16 weeks treatment; AND
The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis

Compliance with Authority Required procedures
C6423 P6423

Ankylosing spondylitis

Continuing treatment

Patient must have a documented history of active ankylosing spondylitis; AND
Patient must have received this drug as their most recent course of PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment in this treatment cycle; AND
Patient must have demonstrated an adequate response to treatment with this drug.
Patient must be an adult.
Must be treated by a rheumatologist.
An adequate response is defined as an improvement from baseline of at least 2 of the BASDAI and 1 of the following:
(a) an ESR measurement no greater than 25 mm per hour; or
(b) a CRP measurement no greater than 10 mg per L; or
(c) an ESR or CRP measurement reduced by at least 20% from baseline.
Where only 1 acute phase reactant measurement is supplied in the first application for PBS-subsidised treatment, that same marker must be measured and supplied in all subsequent continuing treatment applications.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Ankylosing Spondylitis PBS Authority Application - Supporting Information Form.

All measurements provided must be no more than 1 month old at the time of application.
A maximum of 24 weeks of treatment with this drug will be authorised under this criterion.
All applications for continuing treatment with this drug must include a measurement of response to the prior course of therapy. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course. If the application is the first application for continuing treatment following an initial treatment course it must be made following a minimum of 12 weeks of treatment with this drug. If the response assessment is not submitted within these timeframes, the patient will be deemed to have failed this course of treatment.

Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised bDMARD was approved in this cycle and the date of the first application under a new cycle.

Compliance with Written Authority Required procedures
C6430 P6430

Ankylosing spondylitis

Initial 2 (change or recommencement for all patients)

Patient must have a documented history of active ankylosing spondylitis; AND
Patient must have received prior PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment for this condition in this treatment cycle; AND
Patient must not have failed PBS-subsidised therapy with this drug for this condition in the current treatment cycle; AND
Patient must be eligible to receive further bDMARD therapy.
Patient must be an adult.
Must be treated by a rheumatologist.

Where the most recent course of PBS-subsidised bDMARD treatment was approved under either of the initial treatment restrictions (i.e. for patients with no prior PBS-subsidised bDMARD therapy or, under this restriction, for patients who have received previous PBS-subsidised bDMARD therapy) the patient must have been assessed for response to that course following a minimum of 12 weeks of treatment. These assessments must be provided to the Department of Human Services no later than 4 weeks from the date the course was ceased. If the response assessment is not submitted within these timeframes, the patient will be deemed to have failed this course of treatment.

Where the most recent course of PBS-subsidised treatment with this drug was approved under the continuing treatment criteria, patients must have been assessed for response, and the assessment must be submitted to the Department of Human Services no later than 4 weeks from the date that course was ceased.

The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Ankylosing Spondylitis PBS Authority Application - Supporting Information Form.
A maximum of 16 weeks of treatment with this drug will be approved under this criterion.

Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised bDMARD was approved in this cycle and the date of the first application under a new cycle.

Compliance with Written Authority Required procedures
C6437 P6437

Severe psoriatic arthritis

Initial treatment – Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more)

Patient must have severe active psoriatic arthritis; AND

Patient must have received no prior PBS-subsidised treatment with a biological agent for this condition; OR

Patient must have received no PBS-subsidised treatment with a biological agent for at least 5 years if they have previously received PBS-subsidised treatment with a biological agent for this condition; AND

Patient must have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months; AND

Patient must have failed to achieve an adequate response to sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months; OR

Patient must have failed to achieve an adequate response to leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months; AND

Patient must not receive more than 16 weeks of treatment under this restriction.

Patient must be an adult.

Must be treated by a rheumatologist; OR

Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.

Where treatment with methotrexate, sulfasalazine or leflunomide is contraindicated according to the relevant TGA-approved Product Information, details must be provided at the time of application.

Where intolerance to treatment with methotrexate, sulfasalazine or leflunomide developed during the relevant period of use, which was of a severity to necessitate permanent treatment withdrawal, details of the degree of this toxicity must be provided at the time of application.

The following initiation criteria indicate failure to achieve an adequate response and must be demonstrated in all patients at the time of the initial application:

an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L; and

either

(a) an active joint count of at least 20 active (swollen and tender) joints; or

(b) at least 4 active joints from the following list of major joints:

(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or

(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).

If the above requirement to demonstrate an elevated ESR or CRP 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 Psoriatic Arthritis PBS Authority Application - Supporting Information Form; and

(3) a signed patient acknowledgement.

Compliance with Written Authority Required procedures
C6439 P6439

Severe psoriatic arthritis

Continuing treatment

Patient must have a documented history of severe active psoriatic arthritis; AND

Patient must have received this drug as their most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle; AND

Patient must demonstrate, at the time of application, an adequate response to treatment with this drug; AND

Patient must not receive more than 24 weeks of treatment per continuing treatment course authorised under this restriction.

Patient must be an adult.

Must be treated by a rheumatologist; OR

Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.

An adequate response to treatment is defined as:

an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and

either of the following:

(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or

(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:

(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or

(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).

The same indices of disease severity used to establish baseline at the commencement of treatment with each initial treatment application must be provided for all subsequent continuing treatment applications.

All applications for continuing treatment with this drug must include a measurement of response to the most recent course of PBS-subsidised therapy. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course. If the application is the first application for continuing treatment with this drug, it must be accompanied by an assessment of response to a minimum of 12 weeks of treatment with the initial treatment course.

Where a response assessment is not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.

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

(1) a completed authority prescription form; and

(2) a completed Psoriatic Arthritis PBS Authority Application - Supporting Information Form.

Compliance with Written Authority Required procedures
C6445 P6445

Severe psoriatic arthritis

Initial treatment – Initial 2 (change or recommencement of treatment)

Patient must have a documented history of severe active psoriatic arthritis; AND

Patient must have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; AND

Patient must not have already failed, or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle; AND

Patient must not have failed, or ceased to respond to, PBS-subsidised treatment with this drug during the current Treatment Cycle; AND

Patient must not receive more than 16 weeks of treatment under this restriction.

Patient must be an adult.

Must be treated by a rheumatologist; OR

Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.

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

(1) a completed authority prescription form; and

(2) a completed Psoriatic Arthritis PBS Authority Application - Supporting Information Form.

Applications for a patient who has previously received PBS-subsidised treatment with this drug within this Treatment Cycle and who wishes to recommence therapy with this drug within this same Cycle, must be accompanied by evidence of a response to the patient's most recent course of PBS-subsidised treatment with this drug.

Where the most recent course of PBS-subsidised treatment was approved under either of the initial treatment restrictions (i.e. for patients with no prior PBS-subsidised biological therapy or, under this restriction, for patients who have received previous PBS-subsidised biological therapy), the patient must have been assessed for response following a minimum of 12 weeks of therapy. This assessment must have been submitted no later than 4 weeks from the date that course was ceased.

Where the most recent course of PBS-subsidised treatment with this drug was approved under the continuing treatment criteria, the patient must have been assessed for response, and the assessment submitted no later than 4 weeks from the date that course was ceased.

Where a response assessment was not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment.

An adequate response to treatment is defined as:

an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and

either of the following:

(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or

(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:

(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or

(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).

Compliance with Written Authority Required procedures
C6458 P6458

Active ankylosing spondylitis

Initial 1 (new patients)

The condition must be radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis; AND

Patient must not have received any PBS-subsidised treatment with either adalimumab, certolizumab pegol, etanercept, golimumab, infliximab or secukinumab in this treatment cycle; AND

Patient must have at least 2 of the following: (i) low back pain and stiffness for 3 or more months that is relieved by exercise but not by rest; or (ii) limitation of motion of the lumbar spine in the sagittal and the frontal planes as determined by a score of at least 1 on each of the lumbar flexion and lumbar side flexion measurements of the Bath Ankylosing Spondylitis Metrology Index (BASMI); or (iii) limitation of chest expansion relative to normal values for age and gender; AND

Patient must have failed to achieve an adequate response following treatment with at least 2 non-steroidal anti-inflammatory drugs (NSAIDs), whilst completing an appropriate exercise program, for a total period of 3 months.

Patient must be an adult.

Must be treated by a rheumatologist.

The application must include details of the NSAIDs trialled, their doses and duration of treatment.

If the NSAID dose is less than the maximum recommended dose in the relevant TGA-approved Product Information, the application must include the reason a higher dose cannot be used.

If treatment with NSAIDs is contraindicated according to the relevant TGA-approved Product Information, the application must provide details of the contraindication.

If intolerance to NSAID treatment develops during the relevant period of use which is of a severity to necessitate permanent treatment withdrawal, the application must provide details of the nature and severity of this intolerance.

The following criteria indicate failure to achieve an adequate response and must be demonstrated at the time of the initial application:

(a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 4 on a 0-10 scale; AND

(b) an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 10 mg per L.

The BASDAI must be determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment. The BASDAI must be no more than 1 month old at the time of initial application.

Both ESR and CRP measures should be provided with the initial treatment application and both must be no more than 1 month old. If the above requirement to demonstrate an elevated ESR or CRP cannot be met, the application must state the reason this criterion cannot be satisfied.

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

(a) a completed authority prescription form; and

(b) a completed Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which must include the following:

(i) a copy of the radiological report confirming Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis; and

(ii) a completed BASDAI Assessment Form; and

(iii) a completed Exercise Program Self Certification Form included in the supporting information form; and

(iv) a signed patient acknowledgment.

The assessment of the patient's response to the initial course of treatment must be made following a minimum of 12 weeks of treatment and submitted no later than 4 weeks from the cessation of that treatment course. If the response assessment is not submitted within these timeframes, the patient will be deemed to have failed this course of treatment.

A maximum of 16 weeks of treatment with this drug will be approved under this criterion.

Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) was approved in this cycle and the date of the first application under a new cycle.

Compliance with Written Authority Required procedures
C6807 P6807

Severe chronic plaque psoriasis

Continuing treatment, Whole body or Continuing treatment, Face, hand, foot - balance of supply

Patient must have received insufficient therapy with this drug under the Continuing treatment, Whole body restriction to complete 24 weeks treatment; OR
Patient must have received insufficient therapy with this drug under the Continuing treatment, Face, hand, foot restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restrictions; AND
The treatment must be as systemic monotherapy (other than methotrexate).
Must be treated by a dermatologist.

Compliance with Authority Required procedures

(b)omit:

C6821 P6821

Severe chronic plaque psoriasis

Initial 1, Whole body or Face, hand, foot (new patient or patient recommencing treatment after a break of 5 years or more) or Initial 2, Whole body or Face, hand, foot (change or recommencement of treatment after a break of less than 5 years) - balance of supply

Patient must have received insufficient therapy with this drug under the Initial 1, Whole body (new patient or patient recommencing treatment after a break of 5 years or more) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug under the Initial 2, Whole body (change or recommencement of treatment after a break of less than 5 years ) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug under the Initial 1, Face, hand, foot (new patient or patient recommencing treatment after a break of 5 years or more) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug under the Initial 2, Face, hand, foot (change or recommencement of treatment after a break of less than 5 years) restriction to complete 16 weeks treatment; AND
The treatment must be as systemic monotherapy (other than methotrexate); AND
The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions.
Must be treated by a dermatologist.

Compliance with Authority Required procedures

(c)omit:

C6833 P6833

Severe active rheumatoid arthritis

Continuing treatment

Patient must have a documented history of severe active rheumatoid arthritis; AND
Patient must have demonstrated an adequate response to treatment with this drug; AND
Patient must have received this drug as their most recent course of PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment; AND
Patient must not receive more than 24 weeks of treatment per continuing treatment course authorised under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis.
For the purposes of this restriction bDMARD means abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab or tofacitinib.
An adequate response to treatment is defined as:
an ESR no greater than 25 mm per hour or a CRP level no greater than 15 mg per L or either marker reduced by at least 20% from baseline;
AND either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
Where the baseline active joint count is based on total active joints (i.e. more than 20 active joints), response will be determined according to the reduction in the total number of active joints. Where the baseline is determined on total number of major joints, the response must be demonstrated on the total number of major joints. If only an ESR or CRP level is provided with the initial application, the same marker will be used to determine response.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Rheumatoid Arthritis PBS Authority Application - Supporting Information Form.
All applications for continuing treatment with this drug must include a measurement of response to the prior course of therapy. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course. If the application is the first application for continuing treatment with this drug, it must be accompanied by an assessment of response to a minimum of 12 weeks of treatment with an initial treatment course.
Where a response assessment is not undertaken and submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
If a patient fails to demonstrate a response to treatment with this drug under this restriction they will not be eligible to receive further PBS-subsidised treatment with this drug for this condition.

Compliance with Written Authority Required procedures
C6834 P6834

Severe chronic plaque psoriasis

Initial treatment – Initial 2, Whole body (change or recommencement of treatment after a break of less than 5 years)

Patient must have a documented history of severe chronic plaque psoriasis; AND
Patient must have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; AND
Patient must not have already failed, or ceased to respond to, PBS-subsidised treatment with 3 biological agents for this condition within this Treatment Cycle; AND
Patient must not have failed, or ceased to respond to, PBS-subsidised therapy with this drug for the treatment of this condition in the current Treatment Cycle; AND
The treatment must be as systemic monotherapy (other than methotrexate); AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a dermatologist.
For the purposes of this restriction 'biological agent' means adalimumab, etanercept, infliximab, ixekizumab, secukinumab or ustekinumab.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis 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 biological treatment, including dosage, date and duration of treatment.
Applications for patients who have demonstrated a response to PBS-subsidised treatment with this drug within this Treatment Cycle and who wish to recommence treatment with this drug within the same Cycle following a break in therapy, will only be approved where evidence of the patient's response to their most recent course of PBS-subsidised treatment with this drug has been submitted within 1 month of cessation of treatment.
An adequate response to treatment is defined as:
A Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, or is sustained at this level, when compared with the prebiological treatment baseline value for this Treatment Cycle.

Compliance with Written Authority Required procedures

(d)omit:

C6837 P6837

Severe active rheumatoid arthritis

Initial treatment - Initial 1 (new patient or patient recommencing treatment after a break of more than 24 months)

Patient must have severe active rheumatoid arthritis; AND
Patient must have received no PBS-subsidised treatment with a biological disease modifying anti-rheumatic drug (bDMARD) for this condition in the previous 24 months; AND
Patient must not have failed previous PBS-subsidised treatment with this drug for this condition, and have not already failed, or ceased to respond to, PBS-subsidised bDMARD treatment for this condition 5 times; AND
Patient must have failed, in the 24 months immediately prior to the date of the application, to achieve an adequate response to a trial of at least 6 months of intensive treatment with disease modifying anti-rheumatic drugs (DMARDs) which must include at least 3 months continuous treatment with each of at least 2 DMARDs, one of which must be methotrexate at a dose of at least 20 mg weekly and one of which must be: (i) hydroxychloroquine at a dose of at least 200 mg daily; or (ii) leflunomide at a dose of at least 10 mg daily; or (iii) sulfasalazine at a dose of at least 2 g daily; OR
Patient must have failed, in the 24 months immediately prior to the date of the application, to achieve an adequate response to a trial of at least 6 months of intensive treatment with DMARDs which, if methotrexate is contraindicated according to the Therapeutic Goods Administration (TGA)-approved Product Information or cannot be tolerated at a 20 mg weekly dose, must include at least 3 months continuous treatment with each of at least 2 of the following DMARDs: (i) hydroxychloroquine at a dose of at least 200 mg daily; and/or (ii) leflunomide at a dose of at least 10 mg daily; and/or (iii) sulfasalazine at a dose of at least 2 g daily; OR
Patient must have failed, in the 24 months immediately prior to the date of the application, to achieve an adequate response to a trial of at least 6 months of intensive treatment with DMARDs which, if 3 or more of methotrexate, hydroxychloroquine, leflunomide and sulfasalazine are contraindicated according to the relevant TGA-approved Product Information or cannot be tolerated at the doses specified above, must include at least 3 months continuous treatment with each of at least 2 DMARDs, with one or more of the following DMARDs being used in place of the DMARDS which are contraindicated or not tolerated: (i) azathioprine at a dose of at least 1 mg/kg per day; and/or (ii) cyclosporin at a dose of at least 2 mg/kg/day; and/or (iii) sodium aurothiomalate at a dose of 50 mg weekly; AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis.
For the purposes of this restriction bDMARD means abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab or tofacitinib.
If methotrexate is contraindicated according to the TGA-approved product information or cannot be tolerated at a 20 mg weekly dose,the application must include details of the contraindication or intolerance including severity to methotrexate. The maximum tolerated dose of methotrexate must be documented in the application, if applicable.
The application must include details of the DMARDs trialled, their doses and duration of treatment, and all relevant contraindications and/or intolerances including severity.
The requirement to trial at least 2 DMARDs for periods of at least 3 months each can be met using single agents sequentially or by using one or more combinations of DMARDs.
If the requirement to trial 6 months of intensive DMARD therapy with at least 2 DMARDs cannot be met because of contraindications and/or intolerances of a severity necessitating permanent treatment withdrawal to all of the DMARDs specified above, details of the contraindication or intolerance including severity and dose for each DMARD must be provided in the authority application.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Rheumatoid Arthritis PBS Authority Application - Supporting Information Form; and
(3) a signed patient acknowledgement.
Assessment of a patient's response to an initial 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 continuing treatment, must be submitted 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 within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
Applications for a patient who has received PBS-subsidised treatment with this drug and who wishes to re-commence therapy with this drug, must be accompanied by evidence of a response to the patient's most recent course of PBS-subsidised treatment with this drug, within the timeframes specified below.
Where the most recent course of PBS-subsidised treatment with this drug was approved under either of the initial 1 or 2 treatment restrictions, the patient must have been assessed for response following a minimum of 12 weeks of therapy. This assessment must be submitted no later than 4 weeks from the date that course was ceased.
Where the most recent course of PBS-subsidised treatment with this drug was approved under the continuing treatment criteria, the patient must have been assessed for response, and the assessment must be submitted no later than 4 weeks from the date that course was ceased.
If a patient fails to demonstrate a response to treatment with this drug under this restriction they will not be eligible to receive further PBS-subsidised treatment with this drug for this condition.
The following criteria indicate failure to achieve an adequate response and must be demonstrated in all patients at the time of the initial application:
an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L; AND either
(a) a total active joint count of at least 20 active (swollen and tender) joints; or
(b) at least 4 active joints from the following list of major joints:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
The joint count and ESR and/or CRP must be determined at the completion of the 6 month intensive DMARD trial, but prior to ceasing DMARD therapy. All measures must be no more than one month old at the time of initial application.
If the above requirement to demonstrate an elevated ESR or CRP cannot be met, the application must state the reasons why this criterion cannot be satisfied.
Where the baseline joint count is based on total active joints (i.e. more than 20 active joints), response will be determined according to the reduction in the total number of active joints. Where the baseline is determined on total number of major joints, the response must be demonstrated on the total number of major joints. If only an ESR or CRP is provided with the initial application, the same marker will be used to determine response.

Compliance with Written Authority Required procedures
C6840 P6840

Severe chronic plaque psoriasis

Continuing treatment, Face, hand, foot

Patient must have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; AND
Patient must have received this drug as their most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle; AND
Patient must have demonstrated an adequate response to their most recent course of treatment with this drug; AND
The treatment must be as systemic monotherapy (other than methotrexate); AND
Patient must not receive more than 24 weeks of treatment per continuing treatment course authorised under this restriction.
Patient must be aged 18 years or older.
Must be treated by a dermatologist.
For the purposes of this restriction 'biological agent' means adalimumab, etanercept, infliximab, ixekizumab, secukinumab or ustekinumab.
An adequate response to treatment is defined as the plaque or plaques assessed prior to biological treatment showing:
(i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, as compared to the pre-biological treatment baseline values; or
(ii) a reduction by 75% or more in the skin area affected, or sustained at this level, as compared to the pre-biological treatment baseline value.
All applications for continuing treatment with this drug must include a measurement of response to the most recent course of PBS-subsidised therapy. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course. If the application is the first application for continuing treatment with this drug, it must be accompanied by an assessment of response to a minimum of 12 weeks of treatment with the initial treatment course.
Where a response assessment is not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:
(i) the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams including the date of the assessment of the patient's condition.
The most recent PASI assessment must be no more than 1 month old at the time of application.
Approval will be based on the PASI assessment of response to the most recent course of treatment with this drug.
The PASI assessment for continuing treatment must be performed on the same affected area assessed at baseline.

Compliance with Written Authority Required procedures
C6841 P6841

Severe chronic plaque psoriasis

Initial treatment – Initial 2, Face, hand, foot (change or recommencement of treatment after a break of less than 5 years)

Patient must have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; AND
Patient must have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; AND
Patient must not have already failed, or ceased to respond to, PBS-subsidised treatment with 3 biological agents for this condition within this Treatment Cycle; AND
Patient must not have failed, or ceased to respond to, PBS-subsidised therapy with this drug for the treatment of this condition in the current Treatment Cycle; AND
The treatment must be as systemic monotherapy (other than methotrexate); AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a dermatologist.
For the purposes of this restriction 'biological agent' means adalimumab, etanercept, infliximab, ixekizumab, secukinumab or ustekinumab.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis 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 biological treatment, including dosage, date and duration of treatment.
Applications for patients who have demonstrated a response to PBS-subsidised treatment with this drug within this Treatment Cycle and who wish to recommence treatment with this drug within the same Cycle following a break in therapy, will only be approved where evidence of the patient's response to their most recent course of PBS-subsidised treatment with this drug has been submitted within 1 month of cessation of treatment.
An adequate response to treatment is defined as the plaque or plaques assessed prior to biological treatment showing:
(i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, as compared to the pre-biological treatment baseline values; or
(ii) a reduction by 75% or more in the skin area affected, or sustained at this level, as compared to the pre-biological treatment baseline value.

Compliance with Written Authority Required procedures
C6842 P6842

Severe chronic plaque psoriasis

Continuing treatment, Whole body

Patient must have a documented history of severe chronic plaque psoriasis; AND
Patient must have received this drug as their most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle; AND
Patient must have demonstrated an adequate response to their most recent course of treatment with this drug; AND
The treatment must be as systemic monotherapy (other than methotrexate); AND
Patient must not receive more than 24 weeks of treatment per continuing treatment course authorised under this restriction.
Patient must be aged 18 years or older.
Must be treated by a dermatologist.
For the purposes of this restriction 'biological agent' means adalimumab, etanercept, infliximab, ixekizumab, secukinumab or ustekinumab.
An adequate response to treatment is defined as:
A Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, or is sustained at this level, when compared with the prebiological treatment baseline value for this Treatment Cycle.
All applications for continuing treatment with this drug must include a measurement of response to the most recent course of PBS-subsidised therapy. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course. If the application is the first application for continuing treatment with this drug, it must be accompanied by an assessment of response to a minimum of 12 weeks of treatment with the initial treatment course.
Where a response assessment is not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:
(i) the completed Psoriasis Area and Severity Index (PASI) calculation sheet including the date of the assessment of the patient's condition.
The most recent PASI assessment must be no more than 1 month old at the time of application.
Approval will be based on the PASI assessment of response to the most recent course of treatment with this drug.

Compliance with Written Authority Required procedures

(e)omit:

C6844 P6844

Severe active rheumatoid arthritis

Initial treatment - Initial 2 (change or re-commencement of treatment after break of less than 24 months)

Patient must have a documented history of severe active rheumatoid arthritis; AND
Patient must have received prior PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment for this condition and are eligible to receive further bDMARD therapy; AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis.
For the purposes of this restriction bDMARD means abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab or tofacitinib.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Rheumatoid Arthritis PBS Authority Application - Supporting Information Form.
Applications for a patient who has received PBS-subsidised treatment with this drug and who wishes to re-commence therapy with this drug, must be accompanied by evidence of a response to the patient's most recent course of PBS-subsidised treatment with this drug, within the timeframes specified below.
Where the most recent course of PBS-subsidised treatment with this drug was approved under either of the initial 1 or 2 treatment restrictions, the patient must have been assessed for response following a minimum of 12 weeks of therapy. This assessment must be submitted no later than 4 weeks from the date that course was ceased.
Where the most recent course of PBS-subsidised treatment with this drug was approved under the continuing treatment criteria, the patient must have been assessed for response, and the assessment must be submitted no later than 4 weeks from the date that course was ceased.
Where a response assessment is not undertaken and submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
If a patient fails to demonstrate a response to a treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug for this condition.
A patient who has demonstrated a response to a course of rituximab must have a PBS-subsidised biological therapy treatment-free period of at least 22 weeks, immediately following the second infusion, before swapping to an alternate bDMARD
An adequate response to treatment is defined as:
an ESR no greater than 25 mm per hour or a CRP level no greater than 15 mg per L or either marker reduced by at least 20% from baseline;
AND either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).

Compliance with Written Authority Required procedures

(f)insert in numerical order after existing text:

C7168 P7168

Active ankylosing spondylitis

Subsequent continuing treatment

Must be treated by a rheumatologist.
Patient must have received this drug as their most recent course of PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment in this treatment cycle; AND
Patient must have demonstrated an adequate response to treatment with this drug.
Patient must be aged 18 years or older.
An adequate response is defined as an improvement from baseline of at least 2 of the BASDAI and 1 of the following:
(a) an ESR measurement no greater than 25 mm per hour; or
(b) a CRP measurement no greater than 10 mg per L; or
(c) an ESR or CRP measurement reduced by at least 20% from baseline.
Where only 1 acute phase reactant measurement is supplied in the first application for PBS-subsidised treatment, that same marker must be measured and supplied in all subsequent continuing treatment applications.
A maximum of 24 weeks of treatment with this drug will be authorised under this criterion.
The measurement of response to the prior course of therapy must be documented in the patient's medical notes.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised bDMARD was issued in this cycle and the date of the first application under a new cycle.

Compliance with Authority Required procedures - Streamlined Authority Code 7168
C7169 P7169

Active ankylosing spondylitis

Continuing treatment – balance of supply

Must be treated by a rheumatologist.
Patient must be aged 18 years or older.
Patient must have received insufficient therapy with this drug for this condition under the first continuing treatment restriction to complete 24 weeks treatment; OR
Patient must have received insufficient therapy with this drug for this condition under the subsequent continuing Authority Required (in writing) treatment restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restrictions.

Compliance with Authority Required procedures
C7170 P7170

Active ankylosing spondylitis

Subsequent continuing treatment

Must be treated by a rheumatologist.
Patient must have received this drug as their most recent course of PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment in this treatment cycle; AND
Patient must have demonstrated an adequate response to treatment with this drug.
Patient must be 18 years or older.
An adequate response is defined as an improvement from baseline of at least 2 of the BASDAI and 1 of the following:
(a) an ESR measurement no greater than 25 mm per hour; or
(b) a CRP measurement no greater than 10 mg per L; or
(c) an ESR or CRP measurement reduced by at least 20% from baseline.
Where only 1 acute phase reactant measurement is supplied in the first application for PBS-subsidised treatment, that same marker must be measured and supplied in all subsequent continuing treatment applications.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Ankylosing Spondylitis PBS Authority Application - Supporting Information Form.
A maximum of 24 weeks of treatment with this drug will be authorised under this criterion.
Each application for continuing treatment with this drug must include a measurement of response to the prior course of therapy. If the response assessment is not submitted, the patient will be deemed to have failed this course of treatment.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised biological agent was issued in this cycle and the date of the first application under a new cycle.

Compliance with Written Authority Required procedures
C7174 P7174

Ankylosing spondylitis

First continuing treatment

Patient must have received this drug as their most recent course of PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment for this condition in this treatment cycle; AND
Patient must have demonstrated an adequate response to treatment with this drug.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist.
An adequate response is defined as an improvement from baseline of at least 2 of the BASDAI and 1 of the following:
(a) an ESR measurement no greater than 25 mm per hour; or
(b) a CRP measurement no greater than 10 mg per L; or
(c) an ESR or CRP measurement reduced by at least 20% from baseline.
Where only 1 acute phase reactant measurement is supplied in the first application for PBS-subsidised treatment, that same marker must be used to determine response for all subsequent continuing treatments.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Ankylosing Spondylitis PBS Authority Application - Supporting Information Form.
All measurements provided must be no more than 1 month old at the time of application.
A maximum of 24 weeks of treatment with this drug will be authorised under this criterion.
The application for first continuing treatment following an initial treatment course must be made following a minimum of 12 weeks of treatment with this drug. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course.
If the response assessment is not submitted within these timeframes, the patient will be deemed to have failed this course of treatment.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised bDMARD was issued in this cycle and the date of the first application under a new cycle.

Compliance with Written Authority Required procedures
C7177 P7177

Severe psoriatic arthritis

Initial treatment - Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more) or Initial 2 (change or recommencement of treatment after a break of less than 5 years) - balance of supply

Patient must have received insufficient therapy with this drug for this condition under the Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug for this condition under the Initial 2 (change or recommencement of treatment after a break of less than 5 years) restriction to complete 16 weeks treatment; AND
The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

Compliance with Authority Required procedures
C7179 P7179

Severe active rheumatoid arthritis

Continuing treatment – balance of supply

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis.
Patient must have received insufficient therapy with this drug for this condition under the first continuing treatment restriction to complete 24 weeks treatment; OR
Patient must have received insufficient therapy with this drug for this condition under the subsequent continuing Authority Required (in writing) treatment restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restrictions.
Patient must be aged 18 years or older.

Compliance with Authority Required procedures
C7180 P7180

Severe active rheumatoid arthritis

Subsequent continuing treatment

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis.
Patient must be aged 18 years or older.
Patient must have demonstrated an adequate response to treatment with this drug; AND
Patient must have received this drug as their most recent course of PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment for this condition; AND
Patient must not receive more than 24 weeks of treatment per subsequent continuing treatment course authorised under this restriction.
For the purposes of this restriction bDMARD means abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab or tofacitinib.
An adequate response to treatment is defined as:
an ESR no greater than 25 mm per hour or a CRP level no greater than 15 mg per L or either marker reduced by at least 20% from baseline;
AND either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
Where the baseline active joint count is based on total active joints (i.e. more than 20 active joints), response will be determined according to the reduction in the total number of active joints. Where the baseline is determined on total number of major joints, the response must be demonstrated on the total number of major joints. If only an ESR or CRP level is provided with the initial application, the same marker will be used to determine response.
The authority application must be made in writing and must include:(1) a completed authority prescription form; and(2) a completed Rheumatoid Arthritis PBS Authority Application - Supporting Information Form.
All applications for subsequent continuing treatment with this product must include a measurement of response to the prior course of therapy.
Where a response assessment is not undertaken, the patient will be deemed to have failed to respond to treatment with this drug.
If a patient fails to demonstrate a response to treatment with this drug under this restriction they will not be eligible to receive further PBS-subsidised treatment with this drug for this condition.

Compliance with Written Authority Required procedures
C7181 P7181

Severe psoriatic arthritis

First continuing treatment

Patient must have received this drug as their most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle; AND
Patient must demonstrate, at the time of application, an adequate response to treatment with this drug; AND
Patient must not receive more than 24 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.
For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.
An adequate response to treatment is defined as:
an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and
either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
The same indices of disease severity used to establish baseline at the commencement of treatment with each initial treatment application must be used for all subsequent continuing treatments.
The application for first continuing treatment with this drug must be accompanied by an assessment of response to a minimum of 12 weeks of treatment with the initial treatment course. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course.
Where a response assessment is not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this Treatment Cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised biological agent was approved in this Cycle and the date of the first application under the new Cycle.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Psoriatic Arthritis PBS Authority Application - Supporting Information Form.

Compliance with Written Authority Required procedures
C7205 P7205

Ankylosing spondylitis

Initial treatment– Initial 1 (new patients or recommencement of treatment after a break of 5 years or more) or Initial 2 (change or recommencement of treatment after a break of less than 5 years) – balance of supply

Patient must have received insufficient therapy with this drug for this condition under the Initial 1 (new patient or recommencement of treatment after a break of 5 years or more) restriction to complete 16 weeks treatment; OR
Patient must have received insufficient therapy with this drug for this condition under the Initial 2 (change or recommencement of treatment after a break of less than 5 years) restriction to complete 16 weeks treatment; AND
The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist.

Compliance with Authority Required procedures
C7209 P7209

Severe active rheumatoid arthritis

Initial treatment - Initial 2 (change or re-commencement of treatment after break of less than 24 months)

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis.
Patient must have received prior PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment for this condition and are eligible to receive further bDMARD therapy; AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
For the purposes of this restriction bDMARD means abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab or tofacitinib.
The authority application must be made in writing and must include:(a) a completed authority prescription form; and(b) a completed Rheumatoid Arthritis PBS Authority Application - Supporting Information Form.
Applications for a patient who has received PBS-subsidised treatment with this drug and who wishes to re-commence therapy with this drug, must be accompanied by evidence of a response to the patient's most recent course of PBS-subsidised treatment with this drug, within the timeframes specified below.
Where the most recent course of PBS-subsidised treatment with this drug was approved under either of the initial 1 or 2 treatment restrictions, the patient must have been assessed for response following a minimum of 12 weeks of therapy. This assessment must be submitted no later than 4 weeks from the date that course was ceased.
Where the most recent course of PBS-subsidised treatment with this drug was approved under the first continuing or subsequent continuing treatment criteria, the patient must have been assessed for response.
Where a response assessment is not undertaken, the patient will be deemed to have failed to respond to treatment with this drug.
If a patient fails to demonstrate a response to a treatment with this drug under this restriction they will not be eligible to receive further PBS-subsidised treatment with this drug for this condition.
A patient who has demonstrated a response to a course of rituximab must have a PBS-subsidised biological therapy treatment-free period of at least 22 weeks, immediately following the second infusion, before swapping to an alternate bDMARD.
An adequate response to treatment is defined as:
an ESR no greater than 25 mm per hour or a CRP level no greater than 15 mg per L or either marker reduced by at least 20% from baseline;
AND either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).

Compliance with Written Authority Required procedures
C7217 P7217

Severe psoriatic arthritis

Subsequent continuing treatment

Patient must have received this drug as their most recent course of PBS-subsidised biological agent treatment for this condition in this treatment cycle; AND
Patient must have demonstrated an adequate response to treatment with this drug; AND
Patient must not receive more than 24 weeks of treatment per continuing treatment course under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.
For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.
An adequate response to treatment is defined as:
an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and
either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
The same indices of disease severity used to establish baseline at the commencement of treatment with each initial treatment application must be used to determine response for all subsequent continuing treatments.
The measurement of response to the prior course of therapy must be documented in the patient's medical notes.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised biological agent was issued in this cycle and the date of the first application under a new cycle.

Compliance with Authority Required procedures - Streamlined Authority Code 7217
C7219 P7219

Severe psoriatic arthritis

Continuing treatment - balance of supply

Patient must have received insufficient therapy with this drug for this condition under the first continuing treatment restriction to complete 24 weeks treatment; OR
Patient must have received insufficient therapy with this drug for this condition under the subsequent continuing Authority Required (in writing) treatment restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restrictions.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

Compliance with Authority Required procedures
C7220 P7220

Severe psoriatic arthritis

Initial treatment – Initial 2 (change or recommencement of treatment after a break of less than 5 years)

Patient must have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; AND
Patient must not have already failed, or ceased to respond to, PBS-subsidised treatment with 3 biological agents for this condition within this Treatment Cycle; AND
Patient must not failed, or ceased to respond to, PBS-subsidised treatment with this drug for this condition during the current Treatment Cycle; AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.
For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Psoriatic Arthritis PBS Authority Application - Supporting Information Form.
Applications for a patient who has previously received PBS-subsidised treatment with this drug within this Treatment Cycle and who wishes to recommence therapy with this drug within this same Cycle, must be accompanied by evidence of a response to the patient's most recent course of PBS-subsidised treatment with this drug.
Where the most recent course of PBS-subsidised treatment was approved under either of the initial treatment restrictions (i.e. for patients with no prior PBS-subsidised biological therapy or, under this restriction, for patients who have received previous PBS-subsidised biological therapy with this biological agent), the patient must have been assessed for response following a minimum of 12 weeks of therapy. This assessment must have been submitted to the Department of Human Services no later than 4 weeks from the date that course was ceased.
Where the most recent course of PBS-subsidised treatment with this drug was accessed under the continuing treatment criteria, the patient must have been assessed for response, and the assessment submitted, where applicable to the Department of Human Services.
Where this is the initial course of treatment with a particular biological agent (change of treatment) the assessment of the patient's response to this initial course of treatment must be made following a minimum of 12 weeks of treatment and submitted to the Department of Human Services no later than 4 weeks from the cessation of the treatment course.
Where a response assessment was not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised biological agent was issued in this cycle and the date of the first application under a new cycle.
An adequate response to treatment is defined as:
an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and
either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).

Compliance with Written Authority Required procedures
C7221 P7221

Ankylosing spondylitis

Initial 2 (change or recommencement of treatment after a break of less than 5 years)

Patient must have received prior PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment for this condition in this treatment cycle; AND
Patient must not have failed PBS-subsidised therapy with this drug for this condition in the current treatment cycle; AND
Patient must be eligible to receive further bDMARD therapy.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist.
Where the most recent course of PBS-subsidised bDMARD treatment was approved under either of the initial treatment restrictions (i.e. for patients with no prior PBS-subsidised bDMARD therapy or, under this restriction, for patients who have received previous PBS-subsidised bDMARD therapy) the patient must have been assessed for response to that course following a minimum of 12 weeks of treatment. These assessments must be provided to the Department of Human Services no later than 4 weeks from the date the course was ceased. If the response assessment is not submitted within these timeframes, the patient will be deemed to have failed this course of treatment.
Where the most recent course of PBS-subsidised treatment with this drug was approved under the first continuing or subsequent continuing treatment criteria, patients must have been assessed for response.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Ankylosing Spondylitis PBS Authority Application - Supporting Information Form.
A maximum of 16 weeks of treatment with this drug will be approved under this criterion.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised bDMARD was issued in this cycle and the date of the first application under a new cycle.

Compliance with Written Authority Required procedures
C7222 P7222

Severe active rheumatoid arthritis

First Continuing treatment

Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of rheumatoid arthritis.
Patient must have demonstrated an adequate response to treatment with this drug; AND
Patient must have received this drug as their most recent course of PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) treatment for this condition; AND
Patient must not receive more than 24 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
For the purposes of this restriction bDMARD means abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab or tofacitinib.
An adequate response to treatment is defined as:
an ESR no greater than 25 mm per hour or a CRP level no greater than 15 mg per L or either marker reduced by at least 20% from baseline;
AND either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
Where the baseline active joint count is based on total active joints (i.e. more than 20 active joints), response will be determined according to the reduction in the total number of active joints. Where the baseline is determined on total number of major joints, the response must be demonstrated on the total number of major joints. If only an ESR or CRP level is provided with the initial application, the same marker will be used to determine response.
The authority application must be made in writing and must include:(1) a completed authority prescription form; and(2) a completed Rheumatoid Arthritis PBS Authority Application - Supporting Information Form.
The application for first continuing treatment with this drug must be accompanied by an assessment of response to a minimum of 12 weeks of treatment with an initial treatment course. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course.
Where a response assessment is not undertaken and submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
If a patient fails to demonstrate a response to treatment with this drug under this restriction they will not be eligible to receive further PBS-subsidised treatment with this drug for this condition.

Compliance with Written Authority Required procedures
C7224 P7224

Severe psoriatic arthritis

Initial treatment - Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more)

Patient must have received no prior PBS-subsidised treatment with a biological agent for this condition; OR
Patient must have received no PBS-subsidised treatment with a biological agent for at least 5 years if they have previously received PBS-subsidised treatment with a biological agent for this condition; AND
Patient must have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months; AND
Patient must have failed to achieve an adequate response to sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months; OR
Patient must have failed to achieve an adequate response to leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months; AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.
For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.
Where treatment with methotrexate, sulfasalazine or leflunomide is contraindicated according to the relevant TGA-approved Product Information, details must be provided at the time of application.
Where intolerance to treatment with methotrexate, sulfasalazine or leflunomide developed during the relevant period of use, which was of a severity to necessitate permanent treatment withdrawal, details of the degree of this toxicity must be provided at the time of application.
The following initiation criteria indicate failure to achieve an adequate response and must be demonstrated in all patients at the time of the initial application:
an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L; and
either
(a) an active joint count of at least 20 active (swollen and tender) joints; or
(b) at least 4 active joints from the following list of major joints:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
If the above requirement to demonstrate an elevated ESR or CRP 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 Psoriatic Arthritis PBS Authority Application - Supporting Information Form; and
(3) a signed patient acknowledgement.
The assessment of the patient's response to this initial course of treatment must be made following a minimum of 12 weeks of treatment and submitted to the Department of Human Services no later than 4 weeks from the cessation of the treatment course. If the response assessment is not submitted within these timeframes, the patient will be deemed to have failed this course of treatment.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this Treatment Cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised biological agent was approved in this Cycle and the date of the first application under the new Cycle.

Compliance with Written Authority Required procedures
C7235 P7235

Active ankylosing spondylitis

Initial 1 (new patients or recommencement of treatment after a break of 5 years or more)

The condition must be radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis; AND
Patient must not have received any PBS-subsidised treatment for this condition with a biological disease modifying anti-rheumatic drug (bDMARD) in this treatment cycle; AND
Patient must have at least 2 of the following: (i) low back pain and stiffness for 3 or more months that is relieved by exercise but not by rest; or (ii) limitation of motion of the lumbar spine in the sagittal and the frontal planes as determined by a score of at least 1 on each of the lumbar flexion and lumbar side flexion measurements of the Bath Ankylosing Spondylitis Metrology Index (BASMI); or (iii) limitation of chest expansion relative to normal values for age and gender; AND
Patient must have failed to achieve an adequate response following treatment with at least 2 non-steroidal anti-inflammatory drugs (NSAIDs), whilst completing an appropriate exercise program, for a total period of 3 months.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist.
The application must include details of the NSAIDs trialled, their doses and duration of treatment.
If the NSAID dose is less than the maximum recommended dose in the relevant TGA-approved Product Information, the application must include the reason a higher dose cannot be used.
If treatment with NSAIDs is contraindicated according to the relevant TGA-approved Product Information, the application must provide details of the contraindication.
If intolerance to NSAID treatment develops during the relevant period of use which is of a severity to necessitate permanent treatment withdrawal, the application must provide details of the nature and severity of this intolerance.
The following criteria indicate failure to achieve an adequate response and must be demonstrated at the time of the initial application:
(a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 4 on a 0-10 scale; AND
(b) an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 10 mg per L.
The BASDAI must be determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment. The BASDAI must be no more than 1 month old at the time of initial application.
Both ESR and CRP measures should be provided with the initial treatment application and both must be no more than 1 month old. If the above requirement to demonstrate an elevated ESR or CRP cannot be met, the application must state the reason this criterion cannot be satisfied.
The authority application must be made in writing and must include:
(a) a completed authority prescription form; and
(b) a completed Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which must include the following:
(i) a copy of the radiological report confirming Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis; and
(ii) a completed BASDAI Assessment Form; and
(iii) a completed Exercise Program Self Certification Form included in the supporting information form; and
(iv) a signed patient acknowledgment.
The assessment of the patient's response to the initial course of treatment must be made following a minimum of 12 weeks of treatment and submitted no later than 4 weeks from the cessation of that treatment course. If the response assessment is not submitted within these timeframes, the patient will be deemed to have failed this course of treatment.
A maximum of 16 weeks of treatment with this drug will be approved under this criterion.
Patients who fail to demonstrate a response to treatment with this drug under this restriction will not be eligible to receive further PBS-subsidised treatment with this drug in this treatment cycle. Patients may re-trial this drug after a minimum of 5 years have elapsed between the date the last prescription for a PBS-subsidised biological disease modifying anti-rheumatic drug (bDMARD) was approved in this cycle and the date of the first application under a new cycle.

  1. Schedule 4, Part 1, entry for Evolocumab

(a)omit:

C6586

Familial homozygous hypercholesterolaemia

Grandfathering treatment

Patient must have previously received non-PBS-subsidised treatment with this drug for this condition prior to 1 December 2016; AND

The treatment must be in conjunction with dietary therapy and exercise; AND

The condition must have been confirmed by genetic testing; OR

The condition must have been confirmed by a Dutch Lipid Clinic Network Score of at least 7; AND

Patient must have had an LDL cholesterol level in excess of 3.3 millimoles per litre after at least 3 months of treatment at a maximum tolerated dose of an HMG CoA reductase inhibitor (statin), in conjunction with dietary therapy and exercise, prior to initiation of treatment with this drug; OR

Patient must have had an LDL cholesterol level in excess of 3.3 millimoles per litre after having developed a clinically important product-related adverse event during treatment with an HMG CoA reductase inhibitor (statin) necessitating a withdrawal of statin treatment, prior to initiation of treatment with this drug; OR

Patient must have had an LDL cholesterol level in excess of 3.3 millimoles per litre prior to initiation of treatment with this drug, and must be contraindicated to treatment with an HMG CoA reductase inhibitor (statin).

Must be treated by a consultant physician or in consultation with a consultant physician.

The date of the consultation with a consultant physician must be no more than 6 months prior to the application for a PBS authority. The full name of the consultant physician consulted and the date of consultation are to be provided at the time of application.

The qualifying LDL cholesterol level prior to initiation of treatment with this drug must be provided at the time of application. With the exception of patients contraindicated to a statin, the agent, dose and duration of statin treatment must be provided at the time of application.

A clinically important product-related adverse event is defined as follows:

(i) Severe myalgia (muscle symptoms without creatine kinase elevation) which is proven to be temporally associated with statin treatment; or

(ii) Myositis (clinically important creatine kinase elevation, with or without muscle symptoms) demonstrated by results twice the upper limit of normal on a single reading or a rising pattern on consecutive measurements and which is unexplained by other causes; or

(iii) Unexplained, persistent elevations of serum transaminases (greater than 3 times the upper limit of normal) during treatment with a statin.

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

a) A completed authority prescription form; and

b) A completed Familial homozygous hypercholesterolaemia Initial PBS 'Grandfather' Authority Application - Supporting Information Form; and

c) The date of consultation and the full name of the consultant physician; and

d) A copy of the qualifying Dutch Lipid Clinic Network Score or a copy of the result of genetic testing; and

e) The result of LDL cholesterol level and one of the following where appropriate: statin treatment details including agent, dose and treatment duration; or details of adverse event or contraindication to treatment with a statin as defined in the TGA-approved Product Information.

Compliance with Written Authority Required procedures

(b)insert in numerical order after existing text:

C7329

Familial homozygous hypercholesterolaemia

Grandfathering treatment

Patient must have previously received non-PBS-subsidised treatment with this drug for this condition prior to 1 December 2016; AND

The treatment must be in conjunction with dietary therapy and exercise; AND

The condition must have been confirmed by genetic testing; OR

The condition must have been confirmed by a Dutch Lipid Clinic Network Score of at least 7; AND

Patient must have had an LDL cholesterol level in excess of 3.3 millimoles per litre after at least 3 months of treatment at a maximum tolerated dose of an HMG CoA reductase inhibitor (statin), in conjunction with dietary therapy and exercise, prior to initiation of treatment with this drug; OR

Patient must have had an LDL cholesterol level in excess of 3.3 millimoles per litre after having developed a clinically important product-related adverse event during treatment with an HMG CoA reductase inhibitor (statin) necessitating a withdrawal of statin treatment, prior to initiation of treatment with this drug; OR

Patient must have had an LDL cholesterol level in excess of 3.3 millimoles per litre prior to initiation of treatment with this drug, and must be contraindicated to treatment with an HMG CoA reductase inhibitor (statin).

Must be treated by a consultant physician or in consultation with a consultant physician.

The date of the consultation with a consultant physician must be no more than 6 months prior to the application for a PBS authority. The full name of the consultant physician consulted and the date of consultation are to be provided at the time of application.

The qualifying LDL cholesterol level prior to initiation of treatment with this drug must be provided at the time of application. With the exception of patients contraindicated to a statin, the agent, dose and duration of statin treatment must be provided at the time of application.

A clinically important product-related adverse event is defined as follows:

(i) Severe myalgia (muscle symptoms without creatine kinase elevation) which is proven to be temporally associated with statin treatment; or

(ii) Myositis (clinically important creatine kinase elevation, with or without muscle symptoms) demonstrated by results twice the upper limit of normal on a single reading or a rising pattern on consecutive measurements and which is unexplained by other causes; or

(iii) Unexplained, persistent elevations of serum transaminases (greater than 3 times the upper limit of normal) during treatment with a statin.

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

a) A completed authority prescription form; and

b) A completed Familial homozygous hypercholesterolaemia Initial PBS 'Grandfather' Authority Application - Supporting Information Form; and

c) The date of consultation and the full name of the consultant physician; and

d) A copy of the qualifying Dutch Lipid Clinic Network Score or a copy of the result of genetic testing; and

e) The result of LDL cholesterol level and one of the following where appropriate: statin treatment details including agent, dose and treatment duration; or details of adverse event or contraindication to treatment with a statin as defined in the TGA-approved Product Information.

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

  1. Schedule 4, Part 1, entry for Goserelin

insert in numerical order after existing text:

C7164

Anticipated premature ovarian failure

Patient must be receiving treatment with an alkylating agent for a malignancy or an autoimmune disorder that has a high risk of causing premature ovarian failure; AND

Patient must not receive more than 6 months' of treatment for this condition in a lifetime.

Patient must be pre-menopausal.

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

(a)omit from the column headed “Circumstances and Purposes” for Circumstances Code C5257:
Where the patient is receiving treatment at/from a private hospital

(b)omit from the column headed “Circumstances and Purposes” for Circumstances Code C5291:
Where the patient is receiving treatment at/from a public hospital

  1. Schedule 4, Part 1, after entry for Ibandronic acid

insert:

Ibrutinib C7260

Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)

Continuing treatment

The treatment must be as monotherapy; AND

Patient must have previously received PBS-subsidised treatment with this drug for this condition; AND

Patient must not develop disease progression while receiving PBS-subsidised treatment with this drug for this condition.

Compliance with Authority Required procedures
C7337

Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)

Initial treatment

The treatment must be as monotherapy; AND

The condition must have relapsed or be refractory to at least one prior therapy; AND

Patient must have a WHO performance status of 0 or 1; AND

Patient must not have previously received PBS-subsidised treatment with this drug for this condition; AND

Patient must be considered unsuitable for treatment or retreatment with a purine analogue.

A patient is considered unsuitable for treatment or retreatment with a purine analogue as demonstrated by at least one of the following:

a) Failure to respond (stable disease or disease progression on treatment), or a progression-free interval of less than 3 years from treatment with a purine analogue-based therapy and anti-CD20-containing chemoimmunotherapy regimen after at least two cycles;

b) Age is 70 years or older;

c) Age is 65 years or older and the presence of comorbidities (Cumulative Illness Rating Scale of 6 or greater, or creatinine clearance of less than 70 mL/min) that might place the patient at an unacceptable risk for treatment-related toxicity with purine analogue-based therapy, provided they have received one or more prior treatment including at least two cycles of an alkylating agent-based (or purine analogue-based) anti-CD20 antibody-containing chemoimmunotherapy regimen;

d) History of purine analogue-associated autoimmune anaemia or autoimmune thrombocytopenia;

e) Evidence of one or more 17p chromosomal deletions demonstrated by fluorescence in situ hybridisation (FISH).

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

substitute:

C7273

Anticipated emergency treatment of an acute attack of hereditary angioedema

Initial

Patient must have confirmed diagnosis of C1-esterase inhibitor deficiency; AND

Patient must have been assessed to be at significant risk of an acute attack of hereditary angioedema; AND

The condition must be assessed by a clinical immunologist; OR

The condition must be assessed by a respiratory physician; OR

The condition must be assessed by a specialist allergist; OR

The condition must be assessed by a general physician experienced in the management of patients with hereditary angioedema.

The name of the specialist consulted must be provided at the time of application for initial supply.

The date of the pathology report and name of the Approved Pathology Authority must be provided at the time of application.

Increased maximum quantities will be limited to 12 injections per authority prescription.

Compliance with Authority Required procedures
C7274

Anticipated emergency treatment of an acute attack of hereditary angioedema

Continuing

Patient must have previously received PBS-subsidised treatment with this drug for this condition.

Increased maximum quantities will be limited to 12 injections per authority prescription.

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

(a)omit:

C7051

Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)

Initial treatment

Patient must not have previously received PBS-subsidised treatment with this drug for this condition; AND
The treatment must be in combination with rituximab; AND
The condition must have relapsed or be refractory to at least one prior therapy; AND
The condition must be CD20 positive; AND
Patient must have a total cumulative illness rating scale (CIRS) score of greater than 6 (excluding CLL-induced illness or organ damage); AND
Patient must be inappropriate for chemo-immunotherapy.
A patient can be considered inappropriate for chemo-immunotherapy when one or more of the following are experienced:
1. Severe neutropenia defined as absolute neutrophil count of less than or equal to 1.0 x 109/L; or
2. Severe thrombocytopenia defined as platelet count of less than or equal to 50 x 109/L; or
3. Evidence of one or more 17p chromosomal deletions demonstrated by fluorescence in situ hybridisation (FISH).
Full blood count results must be no more than 1 month old at the time of application.
The authority application must be made in writing and must include:
a) A completed authority prescription form;
b) A completed CLL/SLL PBS Authority Application - Supporting information form; and
c) Pathology report indicating that the patient can be considered inappropriate for chemo-immunotherapy due to one or more of the following:
1) Recent severe neutropenia; or
2) Recent severe thrombocytopenia; or
3) Presence of 17p chromosomal deletion using fluorescence in situ hybridisation (FISH).

Compliance with Written Authority Required procedures

(b)insert in numerical order after existing text:

C7310

Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)

Initial treatment

Patient must not have previously received PBS-subsidised treatment with this drug for this condition; AND

The treatment must be in combination with rituximab; AND

The condition must have relapsed or be refractory to at least one prior therapy; AND

The condition must be CD20 positive; AND

Patient must have a total cumulative illness rating scale (CIRS) score of greater than 6 (excluding CLL-induced illness or organ damage); AND

Patient must be inappropriate for chemo-immunotherapy.

A patient can be considered inappropriate for chemo-immunotherapy when one or more of the following are experienced:

1. Severe neutropenia defined as absolute neutrophil count of less than or equal to 1.0 x 109/L; or

2. Severe thrombocytopenia defined as platelet count of less than or equal to 50 x 109/L; or

3. Evidence of one or more 17p chromosomal deletions demonstrated by fluorescence in situ hybridisation (FISH).

Full blood count results must be no more than 1 month old at the time of application.

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

a) A completed authority prescription form;

b) A completed CLL/SLL PBS Authority Application - Supporting information form; and

c) Pathology report indicating that the patient can be considered inappropriate for chemo-immunotherapy due to one or more of the following:

1) Recent severe neutropenia; or

2) Recent severe thrombocytopenia; or

3) Presence of 17p chromosomal deletion using fluorescence in situ hybridisation (FISH).

Compliance with Written Authority Required procedures
  1. Schedule 4, Part 1, entry for Milk powder—lactose free formula

(a)omit from the column headed “Purposes Code” for Circumstances Code C4324:     P4324

(b)omit:

C4336 P4336

Chronic lactose intolerance

Patient must be up to the age of 12 months;
The condition must be proven to be lactose intolerance;
Lactose intolerance must have been proven by either:

(a) relief of symptoms on supervised withdrawal of lactose from the diet for 3 or 4 days and subsequent re‑emergence of symptoms on rechallenge with lactose containing formulae or milk or food; or
(b) not less than 0.5% reducing substance in stool exudate tested with copper sulfate diagnostic compound tablet; or
(c) hydrogen breath test

The date of birth of the patient must be included in the authority application

Compliance with Authority Required procedures

(c)insert in numerical order after existing text:

C7198

Acute lactose intolerance

Patient must be up to the age of 12 months.

The date of birth of the patient must be provided at the time of application.

Compliance with Authority Required procedures
  1. Schedule 4, Part 1, after entry for Milk powder—lactose free formula

insert:

Milk powder lactose intolerance formula C7257

Acute lactose intolerance

Patient must be up to the age of 12 months.

The date of birth of the patient must be provided at the time of application.

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

(a)omit:

C4789

Mesothelioma

The treatment must be in combination with cisplatin
The patient's body surface area (BSA) must be documented in the patient's medical records at the time the treatment cycle is initiated

Doses greater than 500 mg per metre squared BSA are not PBS-subsidised

Compliance with Authority Required procedures - Streamlined Authority Code 4789

(b)insert in numerical order after existing text:

C7195

Mesothelioma

The treatment must be in combination with platinum-based chemotherapy.

The patient's body surface area (BSA) must be documented in the patient's medical records at the time the treatment cycle is initiated

Doses greater than 500 mg per metre squared BSA are not PBS-subsidised

Compliance with Authority Required procedures - Streamlined Authority Code 7195
  1. Schedule 4, Part 1, entry for Secukinumab

(a)omit:

C6437 P6437

Severe psoriatic arthritis

Initial treatment – Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more)

Patient must have severe active psoriatic arthritis; AND
Patient must have received no prior PBS-subsidised treatment with a biological agent for this condition; OR
Patient must have received no PBS-subsidised treatment with a biological agent for at least 5 years if they have previously received PBS-subsidised treatment with a biological agent for this condition; AND
Patient must have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months; AND
Patient must have failed to achieve an adequate response to sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months; OR
Patient must have failed to achieve an adequate response to leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months; AND
Patient must not receive more than 16 weeks of treatment under this restriction.
Patient must be an adult.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.
For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.
Where treatment with methotrexate, sulfasalazine or leflunomide is contraindicated according to the relevant TGA-approved Product Information, details must be provided at the time of application.
Where intolerance to treatment with methotrexate, sulfasalazine or leflunomide developed during the relevant period of use, which was of a severity to necessitate permanent treatment withdrawal, details of the degree of this toxicity must be provided at the time of application.
The following initiation criteria indicate failure to achieve an adequate response and must be demonstrated in all patients at the time of the initial application:
an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L; and
either
(a) an active joint count of at least 20 active (swollen and tender) joints; or
(b) at least 4 active joints from the following list of major joints:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
If the above requirement to demonstrate an elevated ESR or CRP 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 Psoriatic Arthritis PBS Authority Application - Supporting Information Form; and

(3) a signed patient acknowledgement.

Compliance with Written Authority Required procedures

(b)omit:

C6467 P6467

Severe psoriatic arthritis

initial treatment - Initial 2 (change or recommencing treatment after a break of less than 5 years )

Patient must have a documented history of severe active psoriatic arthritis; AND

Patient must have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; AND

Patient must not have already failed, or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle; AND

Patient must not have failed, or ceased to respond to, PBS-subsidised treatment with this drug during the current Treatment Cycle; AND

Patient must not receive more than 16 weeks of treatment under this restriction.

Patient must be aged 18 years or older.

Must be treated by a rheumatologist; OR

Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.

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

(1) a completed authority prescription form; and

(2) a completed Psoriatic Arthritis PBS Authority Application - Supporting Information Form.

Applications for a patient who has previously received PBS-subsidised treatment with this drug within this Treatment Cycle and who wishes to recommence therapy with this drug within this same Cycle, must be accompanied by evidence of a response to the patient's most recent course of PBS-subsidised treatment with this drug.

Where the most recent course of PBS-subsidised treatment was approved under either of the initial treatment restrictions (i.e. for patients with no prior PBS-subsidised biological therapy or, under this restriction, for patients who have received previous PBS-subsidised biological therapy), the patient must have been assessed for response following a minimum of 12 weeks of therapy. This assessment must have been submitted no later than 4 weeks from the date that course was ceased.

Where the most recent course of PBS-subsidised treatment with this drug was approved under the continuing treatment criteria, the patient must have been assessed for response, and the assessment submitted no later than 4 weeks from the date that course was ceased.

Where a response assessment was not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment.

An adequate response to treatment is defined as:

an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and

either of the following:

(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or

(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:

(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or

(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).

Compliance with Written Authority Required procedures

(c)omit:

C6483 P6483

Severe active psoriatic arthritis

Initial 3 (grandfather treatment) or Continuing treatment - balance of supply

Patient must have received insufficient therapy with this drug under the Initial 3 (grandfather patients) restriction to complete maximum of 24 weeks treatment; AND
Patient must have received insufficient therapy with this drug under the Continuing treatment restriction to complete 24 weeks treatment; AND
The treatment must provide no more than the balance of up to 24 weeks treatment available under the above restriction.
Must be treated by a rheumatologist; OR

Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

Compliance with Authority Required procedures

(d)omit:

C6485 P6485

Severe active psoriatic arthritis

Initial 3 - grandfather treatment

Patient must have a documented history of severe active psoriatic arthritis; AND
Patient must have received non-PBS treatment with this drug for this condition prior to 1 October 2016; AND
Patient must be receiving treatment with this drug for this condition at the time of application; AND
Patient must have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months; AND
Patient must have failed to achieve an adequate response to sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months; OR
Patient must have failed to achieve an adequate response to leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months; AND
Patient must have demonstrated an adequate response to treatment with this drug; AND
Patient must not receive more than 24 weeks of treatment under this restriction.
Patient must be aged 18 years or older.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.
An adequate response to treatment is defined as:
an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and
either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
The same indices of disease severity used to establish baseline at the commencement of treatment with each initial treatment application must be provided for all subsequent continuing treatment applications.
The assessment of the patient's response to this PBS-subsidised course of therapy must be made within the 4 weeks prior to completion of the course of treatment. It is recommended that an application is submitted to the Department of Human Services no less than 2 weeks prior to the date the next dose is due in order to ensure continuity of treatment for those patients who meet the continuation criteria.
Where an assessment is not submitted to the Department of Human Services within these timeframes, patients will be deemed to have failed to response, or to have failed to sustain a response to treatment with this drug.
Patients may qualify for PBS-subsidised treatment under this restriction once only. Further applications for treatment with this drug will be assessed under the continuing treatment restriction.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Psoriatic Arthritis PBS Authority Application - Supporting Information Form; and
(3) a signed patient acknowledgement; and
(4) the date of commencement of this drug; and

(5) results of the baseline patient assessment prior to commencing treatment with this drug.

Compliance with Written Authority Required procedures
C6486 P6486

Severe psoriatic arthritis

Continuing treatment

Patient must have a documented history of severe active psoriatic arthritis; AND

Patient must have received this drug as their most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle; AND
Patient must demonstrate, at the time of application, an adequate response to treatment with this drug; AND
Patient must not receive more than 24 weeks of treatment per continuing treatment course authorised under this restriction.
Patient must be an adult.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.
For the purposes of this restriction 'biological agent' means adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, secukinumab or ustekinumab.
An adequate response to treatment is defined as:
an erythrocyte sedimentation rate (ESR) no greater than 25 mm per hour or a C-reactive protein (CRP) level no greater than 15 mg per L or either marker reduced by at least 20% from baseline; and
either of the following:
(a) a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints; or
(b) a reduction in the number of the following major active joints, from at least 4, by at least 50%:
(i) elbow, wrist, knee and/or ankle (assessed as swollen and tender); and/or
(ii) shoulder and/or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth).
The same indices of disease severity used to establish baseline at the commencement of treatment with each initial treatment application must be provided for all subsequent continuing treatment applications.
All applications for continuing treatment with this drug must include a measurement of response to the most recent course of PBS-subsidised therapy. This assessment must be submitted no later than 4 weeks from the cessation of that treatment course. If the application is the first application for continuing treatment with this drug, it must be accompanied by an assessment of response to a minimum of 12 weeks of treatment with the initial treatment course.
Where a response assessment is not submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with this drug.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Psoriatic Arthritis PBS Authority Application - Supporting Information Form.

Compliance with Written Authority Required procedures
C6487 P6487

Severe psoriatic arthritis

Initial treatment - Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more) or Initial 2 (change or recommencing treatment after a break of less than 5 years) - balance of supply

Patient must have received insufficient therapy with this drug under the Initial 1 (new patient or patient recommencing treatment after a break of 5 years or more) restriction to complete maximum of 16 weeks of treatment; OR
Patient must have received insufficient therapy with this drug under the Initial 2 (change or recommencing treatment after a break of less than 5 years) restriction to complete maximum of 16 weeks of treatment; AND
The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions.
Must be treated by a rheumatologist; OR
Must be treated by a clinical immunologist with expertise in the management of psoriatic arthritis.

Compliance with Authority Required procedures
  1. Schedule 4, Part 1, after entry for Vismodegib

insert:

Vitamins, minerals and trace elements formula C7275

Dietary management of conditions requiring a highly restrictive therapeutic diet

Patient must have insufficient vitamin and mineral intake due to a specific diagnosis requiring a highly restrictive therapeutic diet; AND
Patient must be unable to adequately meet vitamin, mineral and trace element needs with other proprietary vitamin and mineral preparations.
Patient must be aged 3 years or older.

  1. Schedule 5, after entry for Esomeprazole and Clarithromycin and Amoxycillin

insert:

Etanercept GRP-21357 Injections 50 mg in 1 mL single use pre-filled syringes, 4 Injection Brenzys
Enbrel
GRP-21359 Injection 50 mg in 1 mL single use auto-injector, 4 Injection Brenzys
Enbrel
  1. Schedule 5, entry for Hydroxocobalamin in the form Injection 1 mg (as acetate) in 1 mL [GRP-17689]

insert in alphabetical order in the column headed “Brand”:   Cobal-B12

  1. Schedule 5, entry for Olanzapine in the form Tablet 2.5 mg [GRP-15492]

insert in alphabetical order in the column headed “Brand”:   PRYZEX

  1. Schedule 5, entry for Olanzapine in the form Tablet 5 mg [GRP-15921]

insert in alphabetical order in the column headed “Brand”:   PRYZEX

  1. Schedule 5, entry for Olanzapine in the form Tablet 7.5 mg [GRP-15884]

insert in alphabetical order in the column headed “Brand”:   PRYZEX

  1. Schedule 5, entry for Olanzapine in the form Tablet 10 mg [GRP-15513]

insert in alphabetical order in the column headed “Brand”:   PRYZEX

  1. Schedule 5, after entry for Olanzapine in the form Tablet 10 mg (as benzoate) [GRP-15513]

insert:

GRP-15797

Tablet 5 mg (orally disintegrating)

Oral

APO-Olanzapine ODT
Olanzapine AN ODT
Olanzapine ODT-DRLA
Olanzapine ODT generichealth 5
Olanzapine Sandoz ODT 5
Ozin ODT 5
PRYZEX ODT

Wafer 5 mg

Oral

Zypine ODT
Zyprexa Zydis

GRP-15723

Tablet 10 mg (orally disintegrating)

Oral

APO-Olanzapine ODT
Olanzapine AN ODT
Olanzapine ODT-DRLA
Olanzapine ODT generichealth 10
Olanzapine Sandoz ODT 10
Ozin ODT 10
PRYZEX ODT

Wafer 10 mg

Oral

Zypine ODT
Zyprexa Zydis

  1. Schedule 5, entry for Salbutamol in the form Nebuliser solution 2.5 mg (as sulfate) in 2.5 mL single dose units, 30 [GRP-21535]

insert in alphabetical order in the column headed “Brand”:   Salbutamol AN

  1. Schedule 5, entry for Salbutamol in the form Nebuliser solution 5 mg (as sulfate) in 2.5 mL single dose units, 30 [GRP-21361]

insert in alphabetical order in the column headed “Brand”:   Salbutamol AN

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