National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2020 (No. 8) (PB 78 of 2020) (Cth)

Case

PB 78 of 2020

National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2020 (No. 8)

National Health Act 1953

________________________________________________________________________

I, THEA DANIEL, Assistant Secretary, Pricing and PBS 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  26 August 2020

THEA DANIEL

Assistant Secretary

Pricing and PBS 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 2020 (No. 8).

(2)This Instrument may also be cited as PB 78 of 2020.

  1. Commencement

This Instrument commences on 1 September 2020.

  1. 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 500 mg

insert:

Acalabrutinib Capsule 100 mg Oral Calquence AP MP C10652 C10668 C10669 56 5 56
  1. Schedule 1, entry for Adefovir 

(a)omit from the column headed “Schedule Equivalent” for the brand “APO-Adefovir”: a

(b)omit:

a Hepsera GI MP NP C4490 C4510 60 5 30 D(100)
  1. Schedule 1, entry for Amitriptyline in each of the forms: Tablet containing amitriptyline hydrochloride 10 mg; Tablet containing amitriptyline hydrochloride 25 mg; and Tablet containing amitriptyline hydrochloride 50 mg         

(a)omit:

a Chem mart Amitriptyline CH MP NP 50 2 50

(b)omit:

a Terry White Chemists Amitriptyline TW MP NP 50 2 50
  1. Schedule 1, entry for Amoxicillin with clavulanic acid in the form Tablet containing 500 mg amoxicillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate)

(a)omit:

a Moxiclav Duo 500/125 LN MP NP C5832 C5893 C10405 P5832 P5893 10 0 10
MW C5832 C5893 10 0 10
PDP C5833 C5894 10 0 10

(b)omit:

a Moxiclav Duo 500/125 LN MP NP C5832 C5893 C10405 P10405 20 0 10
  1. Schedule 1, entry for Amoxicillin with clavulanic acid in the form Tablet containing 875 mg amoxicillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) 

(a)omit:

a Moxiclav Duo Forte 875/125 LN MP NP C5832 C5893 C10413 P5832 P5893 10 0 10
PDP C5833 C5894 10 0 10

(b)omit:

a Moxiclav Duo Forte 875/125 LN MP NP C5832 C5893 C10413 P10413 20 0 10
  1. Schedule 1, entry for Atenolol in the form Tablet 50 mg

(a)omit:

a Chem mart Atenolol CH MP NP 30 5 30

(b)omit:

a Terry White Chemists Atenolol TW MP NP 30 5 30
  1. Schedule 1, entry for Atorvastatin in each of the forms: Tablet 10 mg (as calcium);Tablet 20 mg (as calcium); Tablet 40 mg (as calcium);and Tablet 80 mg (as calcium) 

(a)omit:

a Terry White Chemists Atorvastatin TW MP NP 30 5 30

(b)omit:

a Terry White Chemists Atorvastatin TW MP P7598 30 11 30
  1. Schedule 1, entry for Bleomycin in the form Powder for injection containing bleomycin sulfate 15,000 I.U.

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Bleomycin Sulfate

  1. Schedule 1, entry for Budesonide with formoterol in the form Powder for oral inhalation in breath actuated device containing budesonide
    200 micrograms with formoterol fumarate dihydrate 6 micrograms per dose, 120 doses 

omit from the column headed “Responsible Person” for the brand “DuoResp Spiromax” (all instances): TB               substitute: AF

  1. Schedule 1, entry for Budesonide with formoterol in the form Powder for oral inhalation in breath actuated device containing budesonide
    400 micrograms with formoterol fumarate dihydrate 12 micrograms per dose, 60 doses, 2

omit from the column headed “Responsible Person” for the brand “DuoResp Spiromax”: TB     substitute: AF

  1. Schedule 1, entry for Calcitriol

omit from the column headed “Responsible Person” for the brand “Rocaltrol”: RO   substitute: IX

  1. Schedule 1, entry for Carboplatin in each of the forms: Solution for I.V. injection 150 mg in 15 mL; and Solution for I.V. injection 450 mg in
    45 mL

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Carboplatin

  1. Schedule 1, entry for Cefalotin

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Cephalothin 

  1. Schedule 1, entry for Cefazolin

substitute:

Cefazolin Powder for injection 500 mg (as sodium) Injection Cefazolin-AFT AE MP NP C5826 C5867 C5881 C5890 10 0 5
Powder for injection 1 g (as sodium) Injection Cefazolin-AFT AE MP NP C5861 C5882 C5883 C5891 10 0 5
Powder for injection 2 g (as sodium) Injection Cephazolin Alphapharm AF MP NP C5826 C5867 C5881 C5890 10 0 1
MP NP C5826 C5867 C5881 C5890 10 0 10
  1. Schedule 1, entry for Cefotaxime in each of the forms: Powder for injection 1 g (as sodium); and Powder for injection 2 g (as sodium)

omit from the column headed “Brand”: Hospira Pty Limited      substitute: DBL Cefotaxime

  1. Schedule 1, entry for Ceftriaxone

substitute:

Ceftriaxone Powder for injection 500 mg
(as sodium)
Injection Ceftriaxone-AFT AE MP NP C5826 C5855 C5881 C5890 P5855 1 0 1
MP NP C5826 C5855 C5881 C5890 P5826 P5881 P5890 5 0 1
Powder for injection 1 g
(as sodium)
Injection a Ceftriaxone-AFT AE MP NP C5830 C5862 C5868 5 0 1
a Ceftriaxone Alphapharm AF MP NP C5830 C5862 C5868 5 0 5
MP NP C5830 C5862 C5868 5 0 10
Powder for injection 2 g
(as sodium)
Injection a Ceftriaxone-AFT AE MP NP C5826 C5881 C5890 5 0 1
a Ceftriaxone Alphapharm AF MP NP C5826 C5881 C5890 5 0 5
MP NP C5826 C5881 C5890 5 0 10
  1. Schedule 1, entry for Ciprofloxacin in the form Tablet 500 mg (as hydrochloride)

omit:

a Ciproxin 500 BN MP NP C5614 C5615 C5687 C5688 C5689 C5722 C5780 14 0 14
  1. Schedule 1, entry for Citalopram in the form Tablet 20 mg (as hydrobromide) 

(a)omit:

a Chem mart Citalopram CH MP NP C4755 28 5 28

(b)omit:

a Terry White Chemists Citalopram TW MP NP C4755 28 5 28
  1. Schedule 1, entry for Clindamycin

(a)omit:

a Chem mart Clindamycin CH PDP C5487 24 0 24

(b)omit:

a Terry White Chemists Clindamycin TW PDP C5487 24 0 24

(c)omit:

a Chem mart Clindamycin CH MP NP MW C5470 48 1 24

(d)omit:

a Terry White Chemists Clindamycin TW MP NP MW C5470 48 1 24
  1. Schedule 1, entry for Crizotinib in each of the forms: Capsule 200 mg; and Capsule 250 mg

(a)omit from the column headed “Circumstances”: C6994

(b)omit from the column headed “Circumstances”: C10595

(c)insert in numerical order in the column headed “Circumstances”: C10650 C10665

  1. Schedule 1, entry for Deferiprone in each of the forms: Oral solution 100 mg per mL, 250 mL; Tablet 500 mg; and Tablet 1000 mg   

omit from the column headed “Responsible Person”: TX            substitute: EU 

  1. Schedule 1, entry for Desferrioxamine in each of the forms: Powder for injection containing desferrioxamine mesilate 500 mg; and Powder for injection containing desferrioxamine mesilate 2 g

omit from the column headed “Brand”: Hospira Pty Limited                   substitute: DBL Desferrioxamine Mesilate

  1. Schedule 1, entry for Donepezil in each of the forms: Tablet containing donepezil hydrochloride 5 mg; and Tablet containing donepezil hydrochloride 10 mg

(a)omit:

a Chem mart Donepezil CH MP C10099 C10100 C10107 C10108 C10110 P10107 P10110 28 1 28

(b)omit:

a Terry White Chemists Donepezil TW MP C10099 C10100 C10107 C10108 C10110 P10107 P10110 28 1 28

(c)omit:

a Chem mart Donepezil CH MP C10099 C10100 C10107 C10108 C10110 P10099 P10100 P10108 28 5 28
NP C10108 28 5 28

(d)omit:

a Terry White Chemists Donepezil TW MP C10099 C10100 C10107 C10108 C10110 P10099 P10100 P10108 28 5 28
NP C10108 28 5 28
  1. Schedule 1, entry for Entrectinib

(a)omit from the column headed “Circumstances”: C10597 C10614

(b)insert in numerical order in the column headed “Circumstances”: C10658 C10672

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

(a)omit:

a Chem mart Escitalopram CH MP NP C4755 28 5 28

(b)omit:

a Terry White Chemists Escitalopram TW MP NP C4755 28 5 28
  1. Schedule 1, entry for Heparin in the form Injection 5,000 units (as sodium) in 0.2 mL

omit from the column headed “Brand”: Hospira Pty Limited    substitute: DBL Heparin Sodium 

  1. Schedule 1, entry for Ibrutinib [Maximum Quantity: 90; Number of Repeats: 5]

(a)omit from the column headed “Circumstances”: C7871

(b)insert in numerical order in the column headed “Circumstances”: C10647

(c)omit from the column headed “Purposes”: P7871

(d)insert in numerical order in the column headed “Purposes”: P10647

  1. Schedule 1, entry for Ibrutinib [Maximum Quantity: 120; Number of Repeats: 5]

(a)omit from the column headed “Circumstances”: C7871

(b)insert in numerical order in the column headed “Circumstances”: C10647

  1. Schedule 1, after entry for Imipramine in the form Tablet containing imipramine hydrochloride 25 mg

insert:

Tablet containing imipramine hydrochloride 25 mg USP Oral Imipramine (Leading) QY MP NP 50 2 100
  1. Schedule 1, entry for Lurasidone in each of the forms: Tablet containing lurasidone hydrochloride 40 mg; and Tablet containing lurasidone hydrochloride 80 mg               

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

a Ardix Lurasidone RX MP NP C4246 30 5 30
  1. Schedule 1, entry for Meloxicam in the form Tablet 7.5 mg 

(a)omit:

Chem mart Meloxicam 7.5 mg CH MP NP C4907 C4962 30 3 30

(b)omit:

Terry White Chemists Meloxicam 7.5 mg TW MP NP C4907 C4962 30 3 30
  1. Schedule 1, entry for Meloxicam in the form Tablet 15 mg 

(a)omit:

Chem mart Meloxicam 15 mg CH MP NP C4907 C4962 30 3 30

(b)omit:

Terry White Chemists Meloxicam 15 mg TW MP NP C4907 C4962 30 3 30
  1. Schedule 1, entry for Metformin in the form Tablet (extended release) containing metformin hydrochloride 500 mg

omit from the column headed “Brand”: Diabex XR       substitute: Diabex XR 500

  1. Schedule 1, entry for Metformin in the form Tablet containing metformin hydrochloride 500 mg

(a)omit:

a Chem mart Metformin CH MP NP 100 5 100

(b)omit:

a Terry White Chemists Metformin TW MP NP 100 5 100
  1. Schedule 1, entry for Metformin in the form Tablet containing metformin hydrochloride 1 g 

(a)omit:

a Chem mart Metformin 1000 CH MP NP 90 5 90

(b)omit:

a Terry White Chemists Metformin 1000 TW MP NP 90 5 90
  1. Schedule 1, entry for Methotrexate in the form Injection 5 mg in 2 mL vial

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Methotrexate

  1. Schedule 1, entry for Methotrexate in the form Injection 50 mg in 2 mL vial

omit from the column headed “Brand” (all instances): Hospira Pty Limited      substitute: DBL Methotrexate

  1. Schedule 1, entry for Methotrexate in each of the forms: Solution concentrate for I.V. infusion 500 mg in 20 mL vial; and Solution concentrate for I.V. infusion 1000 mg in 10 mL vial         

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Methotrexate

  1. Schedule 1, after entry for Methylphenidate in the form Capsule containing methylphenidate hydrochloride 40 mg (modified release)

insert:

Capsule containing methylphenidate hydrochloride 60 mg (modified release) Oral Ritalin LA NV MP NP C6298 30 5 30
  1. Schedule 1, entry for Metoprolol in the form Tablet containing metoprolol tartrate 50 mg

(a)omit:

b Chem mart Metoprolol CH MP NP 100 5 100

(b)omit:

b Terry White Chemists Metoprolol TW MP NP 100 5 100
  1. Schedule 1, entry for Metoprolol in the form Tablet containing metoprolol tartrate 100 mg

(a)omit:

b Chem mart Metoprolol CH MP NP 60 5 60

(b)omit:

b Terry White Chemists Metoprolol TW MP NP 60 5 60
  1. Schedule 1, entry for Mirtazapine in the form Tablet 30 mg

(a)omit:

a Chem mart Mirtazapine CH MP NP C5650 30 5 30

(b)omit:

a Terry White Chemists Mirtazapine TW MP NP C5650 30 5 30
  1. Schedule 1, entry for Mirtazapine in the form Tablet 45 mg 

(a)omit:

a Chem mart Mirtazapine CH MP NP C5650 30 5 30

(b)omit:

a Terry White Chemists Mirtazapine TW MP NP C5650 30 5 30
  1. Schedule 1, entry for Morphine in each of the forms: Injection containing morphine sulfate pentahydrate 10 mg in 1 mL; and Injection containing morphine sulfate pentahydrate 15 mg in 1 mL

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Morphine Pentahydrate

  1. Schedule 1, entry for Morphine in the form Injection containing morphine sulfate pentahydrate 30 mg in 1 mL

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Morphine Pentahydrate

  1. Schedule 1, entry for Nebivolol in the form Tablet 1.25 mg (as hydrochloride)

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

a Nebivolol Sandoz SZ MP NP C5324 56 5 28
  1. Schedule 1, entry for Nebivolol in each of the forms: Tablet 5 mg (as hydrochloride); and Tablet 10 mg (as hydrochloride) 

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

a Nebivolol Sandoz SZ MP NP C5324 28 5 28
  1. Schedule 1, entry for Nifedipine in the form Tablet 30 mg (controlled release) 

omit:

a Adalat Oros 30 BN MP NP 30 5 30
  1. Schedule 1, entry for Nifedipine in the form Tablet 60 mg (controlled release) 

omit:

a Adalat Oros 60 BN MP NP 30 5 30
  1. Schedule 1, entry for Osimertinib in the form Tablet 40 mg

omit from the column headed “Circumstances”: C8537               substitute: C10666

  1. Schedule 1, entry for Osimertinib in the form Tablet 80 mg

omit from the column headed “Circumstances”: C8524 C8537                    substitute: C10663 C10666

  1. Schedule 1, entry for Paroxetine

(a)omit:

a Chem mart Paroxetine CH MP NP C4755 C6277 C6636 30 5 30

(b)omit:

a Terry White Chemists Paroxetine TW MP NP C4755 C6277 C6636 30 5 30
  1. Schedule 1, entry for Pembrolizumab

(a)omit from the column headed “Circumstances”: C9868 

(b)omit from the column headed “Circumstances”: C9924

(c)omit from the column headed “Circumstances”: C10088 C10142 C10159 C10181

(d)insert in numerical order in the column headed “Circumstances”: C10675 C10676 C10678 C10679 C10681 C10682 C10683 C10685 C10687 C10688 C10689 C10693 C10695 C10696 C10697 C10701 C10702 C10704 C10705

  1. Schedule 1, entry for Perindopril in the form Tablet containing perindopril erbumine 2 mg

(a)omit:

Chem mart Perindopril CH MP NP 30 5 30

(b)omit:

Terry White Chemists Perindopril TW MP NP 30 5 30
  1. Schedule 1, entry for Perindopril in the form Tablet containing perindopril erbumine 4 mg

(a)omit:

Chem mart Perindopril CH MP NP 30 5 30

(b)omit:

Terry White Chemists Perindopril TW MP NP 30 5 30
  1. Schedule 1, entry for Perindopril in the form Tablet containing perindopril erbumine 8 mg

(a)omit:

Chem mart Perindopril CH MP NP 30 5 30

(b)omit:

Terry White Chemists Perindopril TW MP NP 30 5 30
  1. Schedule 1, entry for Phenoxymethylpenicillin in the form Oral suspension 150 mg (as benzathine) per 5 mL, 100 mL

omit from the column headed “Responsible Person”: AS            substitute: AF

  1. Schedule 1, entry for Promethazine 

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Promethazine Hydrochloride

  1. Schedule 1, entry for Quetiapine in the form Tablet 25 mg (as fumarate)

(a)omit:

a Chem mart Quetiapine CH MP NP C7893 C7916 C7927 60 0 60

(b)omit:

a Terry White Chemists Quetiapine TW MP NP C7893 C7916 C7927 60 0 60
  1. Schedule 1, entry for Quetiapine in the form Tablet 100 mg (as fumarate)

(a)omit:

a Chem mart Quetiapine CH MP NP C4246 C5611 C5639 90 5 90

(b)omit:

a Terry White Chemists Quetiapine TW MP NP C4246 C5611 C5639 90 5 90
  1. Schedule 1, entry for Quetiapine in the form Tablet 200 mg (as fumarate)

(a)omit:

a Chem mart Quetiapine CH MP NP C4246 C5611 C5639 60 5 60

(b)omit:

a Terry White Chemists Quetiapine TW MP NP C4246 C5611 C5639 60 5 60
  1. Schedule 1, entry for Quetiapine in the form Tablet 300 mg (as fumarate)

(a)omit:

a Chem mart Quetiapine CH MP NP C4246 C5611 C5639 60 5 60

(b)omit:

a Terry White Chemists Quetiapine TW MP NP C4246 C5611 C5639 60 5 60
  1. Schedule 1, entry for Rosuvastatin in each of the forms: Tablet 5 mg (as calcium); Tablet 10 mg (as calcium); Tablet 20 mg (as calcium); and Tablet 40 mg (as calcium)   

(a)omit:

a Chem mart Rosuvastatin CH MP NP 30 5 30

(b)omit:

a Terry White Chemists Rosuvastatin TW MP NP 30 5 30

(c)omit:

a Chem mart Rosuvastatin CH MP P7598 30 11 30

(d)omit:

a Terry White Chemists Rosuvastatin TW MP P7598 30 11 30
  1. Schedule 1, entry for Roxithromycin in the form Tablet 150 mg

(a)omit:

a Chem mart Roxithromycin CH MP NP PDP 10 0 10

(b)omit:

a Terry White Chemists Roxithromycin TW MP NP PDP 10 0 10

(c)omit:

a Chem mart Roxithromycin CH MP NP P10404 20
CN10404
0
CN10404
10

(d)omit:

a Terry White Chemists Roxithromycin TW MP NP P10404 20
CN10404
0
CN10404
10
  1. Schedule 1, entry for Roxithromycin in the form Tablet 300 mg

(a)omit:

a Chem mart Roxithromycin CH MP NP PDP 5 0 5

(b)omit:

a Terry White Chemists Roxithromycin TW MP NP PDP 5 0 5

(c)omit:

a Chem mart Roxithromycin CH MP NP P10404 10
CN10404
0
CN10404
5

(d)omit:

a Terry White Chemists Roxithromycin TW MP NP P10404 10
CN10404
0
CN10404
5
  1. Schedule 1, entry for Salbutamol in the form Pressurised inhalation 100 micrograms (as sulfate) per dose with dose counter, 200 doses (CFC-free formulation) 

(a)omit from the column headed “Brand”: Ventolin       substitute: Ventolin CFC-Free with dose counter

(b)omit from the column headed “Brand”: Zempreon            substitute: Zempreon CFC-Free with dose counter

  1. Schedule 1, entry for Simvastatin in each of the forms: Tablet 10 mg; Tablet 20 mg; Tablet 40 mg; and Tablet 80 mg

(a)omit:

a Chem mart Simvastatin CH MP NP 30 5 30

(b)omit:

a Terry White Chemists Simvastatin TW MP NP 30 5 30

(c)omit:

a Chem mart Simvastatin CH MP P7598 30 11 30

(d)omit:

a Terry White Chemists Simvastatin TW MP P7598 30 11 30
  1. Schedule 1, entry for Tiotropium in the form Capsule containing powder for oral inhalation 13 micrograms (as bromide) (for use in Zonda device)

omit from the column headed “Responsible Person”: TB            substitute: AF

  1. Schedule 1, entry for Tobramycin in the form Injection 80 mg in 2 mL

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Tobramycin

  1. Schedule 1, entry for Tramadol in the form Capsule containing tramadol hydrochloride 50 mg

(a)omit:

a Chem mart Tramadol CH MP NP C10442 C10444 P10442 10 0 20
PDP C10442 C10446 P10442 10 0 20
a Terry White Chemists Tramadol TW MP NP C10442 C10444 P10442 10 0 20
PDP C10442 C10446 P10442 10 0 20

(b)omit:

a Chem mart Tramadol CH MP NP C10442 C10444 P10444 20 0 20
PDP C10442 C10446 P10446 20 0 20
a Terry White Chemists Tramadol TW MP NP C10442 C10444 P10444 20 0 20
PDP C10442 C10446 P10446 20 0 20
  1. Schedule 1, entry for Tramadol in each of the forms: Tablet (sustained release) containing tramadol hydrochloride 100 mg; Tablet (sustained release) containing tramadol hydrochloride 150 mg; and Tablet (sustained release) containing tramadol hydrochloride 200 mg 

omit:

a Chem mart Tramadol SR CH MP NP C10445 20 0 20
a Terry White Chemists Tramadol SR TW MP NP C10445 20 0 20
  1. Schedule 1, entry for Vancomycin in the form Powder for injection 1 g (1,000,000 I.U.) (as hydrochloride)

omit from the column headed “Brand” (all instances): Hospira Pty Limited      substitute: DBL Vancomycin Hydrochloride

  1. Schedule 1, entry for Vinblastine

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Vinblastine 

  1. Schedule 1, entry for Vincristine

omit from the column headed “Brand”: Hospira Pty Limited       substitute: DBL Vincristine Sulfate 

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

omit from the column headed “Responsible Person” for the Code “EU”: Emerge Health Pty Ltd             substitute: Chiesi Australia Pty Ltd

  1. Schedule 4, Part 1, after entry for Abiraterone

insert:

Acalabrutinib C10652 Relapsed or refractory chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)
Continuing treatment of relapsed or refractory CLL/SLL
The treatment must be the sole PBS-subsidised therapy for this condition; 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
C10668 Relapsed or refractory chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)
Initial treatment
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The condition must have relapsed or be refractory to at least one prior therapy; AND
Patient must have a WHO performance status of 1 or less; 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; AND
Patient must not have received treatment with another Bruton's tyrosine kinase (BTK) inhibitor for any line of treatment of CLL/SLL (untreated or relapsed/refractory disease); OR
Patient must have developed intolerance to another Bruton's tyrosine kinase (BTK) inhibitor of a severity necessitating permanent treatment withdrawal when being treated for relapsed or refractory CLL/SLL.
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 a Medical Benefits Schedule listed test.
Compliance with Authority Required procedures
C10669 Relapsed or refractory chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)
Grandfather treatment (initial treatment in a patient commenced on non-PBS-subsidised treatment)
Patient must have previously received non-PBS-subsidised treatment with this drug for relapsed or refractory CLL/SLL prior to 1 September 2020; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The condition must have relapsed or be refractory to at least one prior therapy prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must have a WHO performance status of 1 or less prior to starting non-PBS treatment with this drug; AND
Patient must have been considered unsuitable for treatment or retreatment with a purine analogue prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must be considered unsuitable for treatment or retreatment with a purine analogue; AND
Patient must not have received treatment with another Bruton's tyrosine kinase (BTK) inhibitor for any line of treatment of CLL/SLL (untreated or relapsed/refractory disease) prior to initiating non-PBS-subsidised treatment with this drug for this condition; OR
Patient must have developed intolerance to another Bruton's tyrosine kinase (BTK) inhibitor of a severity necessitating permanent treatment withdrawal when being treated for relapsed or refractory CLL/SLL prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while receiving treatment with this drug for this condition.
A patient is considered unsuitable for treatment or retreatment with a purine analogue as demonstrated by at least one of the following being met prior to commencing non-PBS-subsidised treatment with this drug for this condition:
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 a Medical Benefits Schedule listed test.
Compliance with Authority Required procedures
  1. Schedule 4, Part 1, entry for Crizotinib

(a)omit:

C6994 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
The treatment must be as monotherapy; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
Patient must have a WHO performance status of 2 or less.
Patient must have evidence of an anaplastic lymphoma kinase (ALK) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed ALK-Positive Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form, which includes details of ALK gene rearrangement in tumour material by FISH testing.
Compliance with Written Authority Required procedures

(b)omit:

C10595 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
The treatment must be as monotherapy; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
Patient must have a WHO performance status of 2 or less; AND
Patient must have evidence of c-ROS proto-oncogene 1 (ROS1) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing; AND
Patient must not have received prior treatment with a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor for this condition; OR
Patient must have developed intolerance to a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor necessitating permanent treatment withdrawal.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed ROS1-Positive Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form, which includes details of ROS1 gene rearrangement in tumour material.
Compliance with Written Authority Required procedures

(c)insert in numerical order after existing text:

C10650 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
The treatment must be as monotherapy; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
Patient must have a WHO performance status of 2 or less; AND
Patient must have evidence of c-ROS proto-oncogene 1 (ROS1) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing; AND
Patient must not have received prior treatment with a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor for this condition; OR
Patient must have developed intolerance to a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor necessitating permanent treatment withdrawal.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form.
Compliance with Written Authority Required procedures
C10665 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
The treatment must be as monotherapy; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
Patient must have a WHO performance status of 2 or less.
Patient must have evidence of an anaplastic lymphoma kinase (ALK) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form.
Compliance with Written Authority Required procedures
  1. Schedule 4, Part 1, entry for Entrectinib

(a)omit:

C10597 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
The treatment must be as monotherapy; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
Patient must have a WHO performance status of 2 or less; AND
Patient must not have received prior treatment with a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor for this condition; OR
Patient must have developed intolerance to a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor necessitating permanent treatment withdrawal; AND
Patient must have evidence of c-ROS proto-oncogene 1 (ROS1) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed ROS1-Positive Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form, which includes details of ROS1 gene rearrangement in tumour material.
Compliance with Written Authority Required procedures
C10614 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Grandfather treatment
Patient must have previously received non-PBS-subsidised treatment with this drug for this condition prior to 1 August 2020; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
The treatment must be as monotherapy; AND
Patient must have had a WHO performance status of 2 or less prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while being treated with this drug for this condition; AND
Patient must not have received prior treatment with a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor for this condition prior to initiating non-PBS-subsidised treatment with this drug for this condition; OR
Patient must have developed intolerance to a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor necessitating permanent treatment withdrawal prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must have evidence of c-ROS proto-oncogene 1 (ROS1) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing prior to initiating non-PBS subsidised treatment with this drug for this condition.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed ROS1-Positive Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form, which includes details of ROS1 gene rearrangement in tumour material.
A patient may qualify for PBS-subsidised treatment under this restriction once only.
For continuing PBS-subsidised treatment, a Grandfathered patient must qualify under the Continuing treatment criteria.
Compliance with Written Authority Required procedures

(b)insert in numerical order after existing text:

C10658 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
The treatment must be as monotherapy; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
Patient must have a WHO performance status of 2 or less; AND
Patient must not have received prior treatment with a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor for this condition; OR
Patient must have developed intolerance to a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor necessitating permanent treatment withdrawal; AND
Patient must have evidence of c-ROS proto-oncogene 1 (ROS1) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form.
Compliance with Written Authority Required procedures
C10672 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Grandfather treatment
Patient must have previously received non-PBS-subsidised treatment with this drug for this condition prior to 1 August 2020; AND
The condition must be non-squamous type non-small cell lung cancer (NSCLC) or not otherwise specified type NSCLC; AND
The treatment must be as monotherapy; AND
Patient must have had a WHO performance status of 2 or less prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while being treated with this drug for this condition; AND
Patient must not have received prior treatment with a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor for this condition prior to initiating non-PBS-subsidised treatment with this drug for this condition; OR
Patient must have developed intolerance to a c-ROS proto-oncogene 1 (ROS1) receptor tyrosine kinase inhibitor necessitating permanent treatment withdrawal prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must have evidence of c-ROS proto-oncogene 1 (ROS1) gene rearrangement in tumour material, defined as 15% (or greater) positive cells by fluorescence in situ hybridisation (FISH) testing prior to initiating non-PBS subsidised treatment with this drug for this condition.
The authority application must be made in writing and must include:
(1) a completed authority prescription form; and
(2) a completed Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form.
A patient may qualify for PBS-subsidised treatment under this restriction once only.
For continuing PBS-subsidised treatment, a Grandfathered patient must qualify under the Continuing treatment criteria.
Compliance with Written Authority Required procedures
  1. Schedule 4, Part 1, entry for Ibrutinib

(a)omit:

C7871 P7871 Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)
Initial treatment
The treatment must be the sole PBS-subsidised therapy for this condition; 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

(b)insert in numerical order after existing text:

C10647 P10647 Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)
Initial treatment
The treatment must be the sole PBS-subsidised therapy for this condition; 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 not have received treatment with another Bruton's tyrosine kinase (BTK) inhibitor for any line of treatment of CLL/SLL (untreated or relapsed/refractory disease); OR
Patient must have developed intolerance to another Bruton's tyrosine kinase (BTK) inhibitor of a severity necessitating permanent treatment withdrawal when being treated for relapsed or refractory CLL/SLL; 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 Osimertinib

substitute:

Osimertinib C10663 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
The treatment must be as monotherapy; AND
Patient must have a WHO performance status of 2 or less; AND
The condition must have progressed on or after prior epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) therapy as first line treatment for this condition; AND
Patient must have evidence of EGFR T790M mutation in tumour material at the point of progression on or after first line EGFR TKI treatment.
Authority applications for initial treatment must be made in writing and must include:
(a) a completed authority prescription form;
(b) a completed Non-Small-Cell Lung Cancer Authority Application - Supporting Information Form;
(c) details of the pathology report from an Approved Pathology Authority confirming evidence of EGFR T790M mutation in tumour material while on or after first line EGFR TKI treatment; and
(d) date of commencement of first line EGFR TKI treatment and date of progression whilst on or after first line EGFR TKI treatment.
Compliance with Written Authority Required procedures
C10666 Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
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 have developed disease progression while receiving treatment with this drug for this condition.
Compliance with Authority Required procedures
  1. Schedule 4, Part 1, entry for Pembrolizumab

(a)omit:

C9868 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Continuing treatment
Patient must have previously received PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while being treated with this drug for this condition; AND
The treatment must not exceed a total of 35 cycles or up to 24 months of treatment under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 9868

(b)omit:

C9924 Unresectable Stage III or Stage IV malignant melanoma
Continuing treatment
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must have previously been issued with an authority prescription for this drug for this condition; AND
Patient must have stable or responding disease.
Compliance with Authority Required procedures - Streamlined Authority Code 9924

(c)omit:

C10088 Unresectable Stage III or Stage IV malignant melanoma
Initial treatment 2 - 3 weekly treatment regimen
The condition must be negative for a BRAF V600 mutation; AND
Patient must not have received prior treatment with ipilimumab or a PD-1 (programmed cell death-1) inhibitor for the treatment of unresectable Stage III or Stage IV malignant melanoma; AND
Patient must not have experienced disease progression whilst on adjuvant PD-1 inhibitor treatment or disease recurrence within 6 months of completion of adjuvant PD-1 inhibitor treatment if treated for resected Stage IIIB, IIIC, IIID or IV melanoma; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The treatment must not exceed a total of 6 doses under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10088
C10142 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Grandfather treatment
Patient must have previously received non-PBS subsidised treatment with this drug for this condition prior to 1 December 2019; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for non-small cell lung cancer; AND
Patient must not have had been treated for this condition in the metastatic setting prior to initiating non-PBS subsidised treatment with this drug for this condition; AND
Patient must have stable or responding disease; AND
Patient must have had a WHO performance status of 0 or 1 prior to initiation of non-PBS-subsidised treatment with this drug for this condition; AND
The condition must not have evidence of an activating epidermal growth factor receptor (EGFR) gene or an anaplastic lymphoma kinase (ALK) gene rearrangement or a c-ROS proto-oncogene 1 (ROS1) gene arrangement in tumour material; AND
The treatment must not exceed a total of 35 cycles or up to 24 months of treatment under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10142
C10159 Unresectable Stage III or Stage IV malignant melanoma
Initial treatment 1 - 3 weekly treatment regimen
The condition must be positive for a BRAF V600 mutation; AND
The condition must have progressed following treatment with a BRAF inhibitor (with or without a MEK inhibitor) in the unresectable or metastatic setting unless contraindicated or not tolerated according to the TGA approved Product Information; OR
Patient must have experienced disease recurrence whilst receiving a BRAF inhibitor with MEK inhibitor as an adjuvant treatment for resected Stage IIIB, IIIC or IIID melanoma; OR
Patient must have experienced disease recurrence within 6 months of completion of adjuvant BRAF inhibitor with MEK inhibitor treatment; AND
Patient must not have been treated with an adjuvant programmed cell death-1 (PD-1) inhibitor for resected Stage IIIB, IIIC, IIID or IV melanoma; OR
Patient must have experienced disease recurrence after at least 6 months from completion of an adjuvant PD-1 inhibitor for resected Stage IIIB, IIIC, IIID or IV melanoma, followed by disease progression after treatment with a BRAF inhibitor (with or without MEK inhibitor) in the unresectable or metastatic setting unless contraindicated or not tolerated according to the TGA approved Product Information; AND
Patient must not have received prior treatment with ipilimumab or a PD-1 (programmed cell death-1) inhibitor for the treatment of unresectable Stage III or Stage IV malignant melanoma; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The treatment must not exceed a total of 6 doses under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10159
C10181 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment
Patient must not have previously been treated for this condition in the metastatic setting; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for non-small cell lung cancer; AND
Patient must have a WHO performance status of 0 or 1; AND
The condition must not have evidence of an activating epidermal growth factor receptor (EGFR) gene or an anaplastic lymphoma kinase (ALK) gene rearrangement or a c-ROS proto-oncogene 1 (ROS1) gene arrangement in tumour material; AND
The treatment must not exceed a total of 7 doses under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10181

(d)insert in numerical order after existing text:

C10675 Resected Stage IIIB, Stage IIIC or Stage IIID malignant melanoma
Grandfather treatment - 6 weekly treatment regimen
Patient must have previously received non-PBS-subsidised drug for adjuvant treatment following complete surgical resection prior to 1 May 2020; AND
Patient must have a WHO performance status of 1 or less prior to starting non-PBS treatment with this drug; AND
Patient must not have evidence of recurrence; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must not have received prior PBS-subsidised treatment for this condition; AND
Patient must have commenced non-PBS-subsidised treatment within 12 weeks of complete surgical resection; AND
Patient must not receive more than 12 months of combined PBS-subsidised and non-PBS-subsidised adjuvant therapy.
A patient may qualify for PBS-subsidised treatment under this restriction once only.
For continuing PBS-subsidised treatment, a Grandfathered patient must qualify under the Continuing treatment criteria.
Compliance with Authority Required procedures
C10676 Resected Stage IIIB, Stage IIIC or Stage IIID malignant melanoma
Continuing treatment - 6 weekly treatment regimen
Patient must have previously been issued with an authority prescription for this drug for adjuvant treatment following complete surgical resection; AND
Patient must not have experienced disease recurrence; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must not receive more than 12 months of combined PBS-subsidised and non-PBS-subsidised adjuvant therapy.
Compliance with Authority Required procedures
C10678 Relapsed or refractory primary mediastinal B-cell lymphoma
Grandfather treatment (initial treatment of a patient commenced on non-PBS-subsidised treatment)
Patient must have received treatment with this drug for this condition prior to 1 September 2020; AND
The condition must be diagnosed as primary mediastinal B-cell lymphoma through histological investigation combined with at least one of: (i) positron emission tomography - computed tomography (PET-CT) scan, (ii) PET scan, (iii) CT scan, with the results retained in the patient's medical records; AND
Patient must have been treated with rituximab-based chemotherapy prior to initiating treatment with this drug for this condition; AND
Patient must have been experiencing relapsed/refractory disease prior to initiating treatment with this drug for this condition; AND
Patient must have been autologous stem cell transplant (ASCT) ineligible following a single line of treatment prior to initiating treatment with this drug for this condition; OR
Patient must have undergone an autologous stem cell transplant (ASCT) prior to initiating treatment with this drug for this condition; OR
Patient must have been treated with at least 2 chemotherapy treatment lines for this condition, one of which must have included rituximab-based chemotherapy, prior to initiating treatment with this drug for this condition; AND
Patient must not have received treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for this condition prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while receiving treatment with this drug for this condition; AND
The treatment must not exceed a total of 35 cycles in a lifetime; AND
The treatment must not exceed a total of 7 doses under this restriction.
Applications for authorisation of initial treatment must be in writing and must include:
(a) a completed authority prescription form;
(b) a completed primary mediastinal B-cell lymphoma pembrolizumab PBS Authority Application for Grandfathered patients, which includes:
(i) confirmation that histology results and PET/CT scans support a diagnosis of primary mediastinal B-cell lymphoma and are retained on the patient's medical records;
(ii) details of prior treatments for this condition
Compliance with Written Authority Required procedures
C10679 Relapsed or refractory primary mediastinal B-cell lymphoma
Continuing treatment
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; AND
The treatment must not exceed a total of 35 cycles in a lifetime.
Compliance with Authority Required procedures
C10681 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment - 3 weekly treatment regimen
Patient must not have previously been treated for this condition in the metastatic setting; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for non-small cell lung cancer; AND
Patient must have a WHO performance status of 0 or 1; AND
The condition must not have evidence of an activating epidermal growth factor receptor (EGFR) gene or an anaplastic lymphoma kinase (ALK) gene rearrangement or a c-ROS proto-oncogene 1 (ROS1) gene arrangement in tumour material; AND
The treatment must not exceed a total of 7 doses under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10681
C10682 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Continuing treatment - 3 weekly treatment regimen
Patient must have previously received PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while being treated with this drug for this condition; AND
The treatment must not exceed a total of 35 cycles or up to 24 months of treatment under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10682
C10683 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Grandfather treatment - 6 weekly treatment regimen
Patient must have previously received non-PBS subsidised treatment with this drug for this condition prior to 1 December 2019; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for non-small cell lung cancer; AND
Patient must not have had been treated for this condition in the metastatic setting prior to initiating non-PBS subsidised treatment with this drug for this condition; AND
Patient must have stable or responding disease; AND
Patient must have had a WHO performance status of 0 or 1 prior to initiation of non-PBS-subsidised treatment with this drug for this condition; AND
The condition must not have evidence of an activating epidermal growth factor receptor (EGFR) gene or an anaplastic lymphoma kinase (ALK) gene rearrangement or a c-ROS proto-oncogene 1 (ROS1) gene arrangement in tumour material; AND
The treatment must not exceed a total of 18 cycles or up to 24 months of treatment under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10683
C10685 Resected Stage IIIB, Stage IIIC or Stage IIID malignant melanoma
Grandfather treatment - 3 weekly treatment regimen
Patient must have previously received non-PBS-subsidised drug for adjuvant treatment following complete surgical resection prior to 1 May 2020; AND
Patient must have a WHO performance status of 1 or less prior to starting non-PBS treatment with this drug; AND
Patient must not have evidence of recurrence; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must not have received prior PBS-subsidised treatment for this condition; AND
Patient must have commenced non-PBS-subsidised treatment within 12 weeks of complete surgical resection; AND
Patient must not receive more than 12 months of combined PBS-subsidised and non-PBS-subsidised adjuvant therapy.
A patient may qualify for PBS-subsidised treatment under this restriction once only.
For continuing PBS-subsidised treatment, a Grandfathered patient must qualify under the Continuing treatment criteria.
Compliance with Authority Required procedures
C10687 Resected Stage IIIB, Stage IIIC or Stage IIID malignant melanoma
Initial treatment - 3 weekly treatment regimen
The treatment must be adjuvant to complete surgical resection; AND
Patient must have a WHO performance status of 1 or less; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must not have received prior PBS-subsidised treatment for this condition; AND
The treatment must commence within 12 weeks of complete resection; AND
Patient must not receive more than 12 months of combined PBS-subsidised and non-PBS-subsidised adjuvant therapy.
Compliance with Authority Required procedures
C10688 Resected Stage IIIB, Stage IIIC or Stage IIID malignant melanoma
Initial treatment - 6 weekly treatment regimen
The treatment must be adjuvant to complete surgical resection; AND
Patient must have a WHO performance status of 1 or less; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must not have received prior PBS-subsidised treatment for this condition; AND
The treatment must commence within 12 weeks of complete resection; AND
Patient must not receive more than 12 months of combined PBS-subsidised and non-PBS-subsidised adjuvant therapy.
Compliance with Authority Required procedures
C10689 Unresectable Stage III or Stage IV malignant melanoma
Initial treatment - 6 weekly treatment regimen
Patient must not have received prior treatment with ipilimumab or a PD-1 (programmed cell death-1) inhibitor for the treatment of unresectable Stage III or Stage IV malignant melanoma; AND
Patient must not have experienced disease progression whilst on adjuvant PD-1 inhibitor treatment or disease recurrence within 6 months of completion of adjuvant PD-1 inhibitor treatment if treated for resected Stage IIIB, IIIC, IIID or IV melanoma; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The treatment must not exceed a total of 3 doses under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10689
C10693 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Continuing treatment - 6 weekly treatment regimen
Patient must have previously received PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while being treated with this drug for this condition; AND
The treatment must not exceed a total of 18 cycles or up to 24 months of treatment under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10693
C10695 Resected Stage IIIB, Stage IIIC or Stage IIID malignant melanoma
Continuing treatment - 3 weekly treatment regimen
Patient must have previously been issued with an authority prescription for this drug for adjuvant treatment following complete surgical resection; AND
Patient must not have experienced disease recurrence; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must not receive more than 12 months of combined PBS-subsidised and non-PBS-subsidised adjuvant therapy.
Compliance with Authority Required procedures
C10696 Unresectable Stage III or Stage IV malignant melanoma
Initial treatment - 3 weekly treatment regimen
Patient must not have received prior treatment with ipilimumab or a PD-1 (programmed cell death-1) inhibitor for the treatment of unresectable Stage III or Stage IV malignant melanoma; AND
Patient must not have experienced disease progression whilst on adjuvant PD-1 inhibitor treatment or disease recurrence within 6 months of completion of adjuvant PD-1 inhibitor treatment if treated for resected Stage IIIB, IIIC, IIID or IV melanoma; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The treatment must not exceed a total of 6 doses under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10696
C10697 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Grandfather treatment - 3 weekly treatment regimen
Patient must have previously received non-PBS subsidised treatment with this drug for this condition prior to 1 December 2019; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for non-small cell lung cancer; AND
Patient must not have had been treated for this condition in the metastatic setting prior to initiating non-PBS subsidised treatment with this drug for this condition; AND
Patient must have stable or responding disease; AND
Patient must have had a WHO performance status of 0 or 1 prior to initiation of non-PBS-subsidised treatment with this drug for this condition; AND
The condition must not have evidence of an activating epidermal growth factor receptor (EGFR) gene or an anaplastic lymphoma kinase (ALK) gene rearrangement or a c-ROS proto-oncogene 1 (ROS1) gene arrangement in tumour material; AND
The treatment must not exceed a total of 35 cycles or up to 24 months of treatment under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10697
C10701 Unresectable Stage III or Stage IV malignant melanoma
Continuing treatment - 6 weekly treatment regimen
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must have previously been issued with an authority prescription for this drug for this condition; AND
Patient must have stable or responding disease.
Compliance with Authority Required procedures - Streamlined Authority Code 10701
C10702 Relapsed or refractory primary mediastinal B-cell lymphoma
Initial treatment
The condition must be diagnosed as primary mediastinal B-cell lymphoma through histological investigation combined with at least one of: (i) positron emission tomography - computed tomography (PET-CT) scan, (ii) PET scan, (iii) CT scan, with the results retained in the patient's medical records; AND
Patient must have been treated with rituximab-based chemotherapy for this condition; AND
Patient must be experiencing relapsed/refractory disease; AND
Patient must be autologous stem cell transplant (ASCT) ineligible following a single line of treatment; OR
Patient must have undergone an autologous stem cell transplant (ASCT); OR
Patient must have been treated with at least 2 chemotherapy treatment lines for this condition, one of which must include rituximab-based chemotherapy; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for this condition; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The treatment must not exceed a total of 7 doses under this restriction.
Applications for authorisation of initial treatment must be in writing and must include:
(a) a completed authority prescription form;
(b) a completed primary mediastinal B-cell lymphoma pembrolizumab PBS Authority Application, which includes:
(i) confirmation that histology results with PET/CT scans support a diagnosis of primary mediastinal B-cell lymphoma and are retained on the patient's medical records;
(ii) details of prior treatments for this condition.
Compliance with Written Authority Required procedures
C10704 Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Initial treatment - 6 weekly treatment regimen
Patient must not have previously been treated for this condition in the metastatic setting; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for non-small cell lung cancer; AND
Patient must have a WHO performance status of 0 or 1; AND
The condition must not have evidence of an activating epidermal growth factor receptor (EGFR) gene or an anaplastic lymphoma kinase (ALK) gene rearrangement or a c-ROS proto-oncogene 1 (ROS1) gene arrangement in tumour material; AND
The treatment must not exceed a total of 4 doses under this restriction.
Compliance with Authority Required procedures - Streamlined Authority Code 10704
C10705 Unresectable Stage III or Stage IV malignant melanoma
Continuing treatment - 3 weekly treatment regimen
The treatment must be the sole PBS-subsidised therapy for this condition; AND
Patient must have previously been issued with an authority prescription for this drug for this condition; AND
Patient must have stable or responding disease.
Compliance with Authority Required procedures - Streamlined Authority Code 10705
  1. Schedule 4, Part 1, entry for Venetoclax

omit entry for Circumstances Code “C8579” and substitute: 

C8579 Chronic lymphocytic leukaemia (CLL)
Grandfathered treatment
Patient must have received non-PBS subsidised treatment with this drug for this condition prior to 1 March 2019; AND
Patient must have been considered unsuitable for treatment or retreatment with a purine analogue prior to initiating non-PBS-subsidised treatment with this drug for this condition; AND
The condition must have relapsed or be refractory to at least one prior therapy; AND
Patient must have had a WHO performance status of 0 or 1 prior to initiation of non-PBS-subsidised treatment with this drug for this condition; AND
The treatment must be in combination with rituximab for up to a maximum of 6 cycles, followed by monotherapy; AND
The treatment must be ceased on disease progression or on completion of 24 months of PBS-subsidised treatment with this drug for this condition, whichever comes first.
A Grandfathered patient may qualify for PBS-subsidised treatment under this restriction once only. For continuing PBS-subsidised treatment, a Grandfathered patient must qualify under the continuing treatment criteria.
Compliance with Authority Required procedures
  1. Schedule 5, after entry for Imatinib in the form Tablet 400 mg (as mesilate) [GRP-21080] 

insert:

Imipramine GRP-24222 Tablet containing imipramine hydrochloride 25 mg Oral Tofranil 25
Tablet containing imipramine hydrochloride 25 mg USP Oral Imipramine (Leading)
  1. Schedule 5, entry for Meloxicam in the form Tablet 15 mg [GRP-15468]

(a)omit from the column headed “Brand”: Chem mart Meloxicam 15 mg

(b)omit from the column headed “Brand”: Terry White Chemists Meloxicam 15 mg

  1. Schedule 5, entry for  Meloxicam in the form Tablet 7.5 mg [GRP-15658] 

(a)omit from the column headed “Brand”: Chem mart Meloxicam 7.5 mg

(b)omit from the column headed “Brand”: Terry White Chemists Meloxicam 7.5 mg

  1. Schedule 5, entry for  Metformin in the form Tablet (extended release) containing metformin hydrochloride 500 mg [GRP-24200]

omit from the column headed “Brand”: Diabex XR                    substitute: Diabex XR 500

  1. Schedule 5, entry for Morphine in the form Injection containing morphine sulfate pentahydrate 10 mg in 1 mL [GRP-20890]

omit from the column headed “Brand”: Hospira Pty Limited                   substitute: DBL Morphine Pentahydrate

  1. Schedule 5, entry for Perindopril in the form Tablet containing perindopril erbumine 4 mg [GRP-15442] 

(a)omit from the column headed “Brand”: Chem mart Perindopril

(b)omit from the column headed “Brand”: Terry White Chemists Perindopril

  1. Schedule 5, entry for Perindopril in the form Tablet containing perindopril erbumine 8 mg [GRP-15525]  

(a)omit from the column headed “Brand”: Chem mart Perindopril

(b)omit from the column headed “Brand”: Terry White Chemists Perindopril

  1. Schedule 5, entry for Perindoprilin the form Tablet containing perindopril erbumine 2 mg [GRP-15965]

(a)omit from the column headed “Brand”: Chem mart Perindopril

(b)omit from the column headed “Brand”: Terry White Chemists Perindopril

  1. Schedule 5, entry for Salbutamol in the form Pressurised inhalation 100 micrograms (as sulfate) per dose with dose counter, 200 doses (CFC-free formulation) [GRP-24211]

(a)omit from the column headed “Brand”: Ventolin         substitute: Ventolin CFC-Free with dose counter

(b)omit from the column headed “Brand”: Zempreon      substitute: Zempreon CFC-Free with dose counter

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