National Health Act 1953 - Determinations under sections 85, 85A and 88 - Pharmaceutical benefits (No. PB 15 of 2010)

Administered by Department of Health, Disability and Ageing

Legislation au F2010L00666 Not in force Legislative Instrument

Legislation content

Determination  Pharmaceutical benefits
(PB 15 of 2010)

as amended

made under sections 85, 85A and 88 of the

National Health Act 1953

This compilation was prepared on 1 July 2010
taking into account amendments up to PB 55 of 2010

Prepared by the Office of Legislative Drafting and Publishing,
AttorneyGeneral’s Department, Canberra

Determinations pharmaceutical benefits (PB 15 of 2010)

Commencement [see Note 1]

1. This instrument commences on 1 April 2010.

Repeal

2. Instrument number PB 114 of 2008 is repealed.

Definitions

3. In this instrument:

“Act” means the National Health Act 1953;

“base-priced drug” means —

(a) in relation to ranitidine (tablet, effervescent, 150 mg (as hydrochloride) or syrup 150 mg (as hydrochloride) per 10 mL, 300 mL): cimetidine or famotidine or nizatidine or ranitidine (tablet 150 mg (as hydrochloride) or tablet 300 mg (as hydrochloride)); or

(b) in relation to lercanidipine or nifedipine (tablet 20 mg (controlled release)): amlodipine, felodipine or nifedipine (tablet 10 mg or tablet 20 mg or tablet 30 mg (controlled release) or tablet 60 mg (controlled release)); or

(c) in relation to eprosartan (tablet 400 mg (as mesylate)): candesartan, eprosartan (tablet 600 mg (as mesylate)), irbesartan, olmesartan, telmisartan or valsartan;

“CFC” means chlorofluorocarbon;

“CFU” means colony forming unit;

“electronic communication” has the meaning given by subsection 5(1) of the Electronic Transactions Act 1999;

“g” means gram;

“GP Management Plan” means a comprehensive written plan for the treatment of a patient, prepared by a medical practitioner, that includes a description of the patient's health care needs, management goals, actions to be taken by the patient and  treatment and services the patient is likely to need;

“I.M.” means intramuscular;

“I.U.” means international unit;

“I.V.” means intravenous;

“kg” means kilogram;

“L” means litre;

“m” means metre;

“Medicare Australia CEO” means the Chief Executive Officer of Medicare Australia;

“mg” means milligram;

“mL” means millilitre;

“mm” means millimetre;

“mmol” means millimole;

“palliative care patient”, in relation to a purpose specified in Part 2 of Schedule 2, means a patient with an active, progressive, far-advanced disease, and for whom the prognosis is limited and the focus of care is the quality of life;

“PBS” means Pharmaceutical Benefits Scheme;

“Regulations” means the National Health (Pharmaceutical Benefits) Regulations 1960 made under the Act;

“Team Care Arrangements” means a document prepared by a medical practitioner, following consultation with collaborating providers, that includes a description of the treatment and service goals for the patient, the treatment and services that all collaborating providers will provide and the actions to be taken by the patient.

Form

4. For the purposes of subsection 85(3)    of the Act, where the strength, type of unit, size of unit or other particulars of form are mentioned in Schedule 1 or, if not mentioned in Schedule 1, in Schedule 2 in relation to a listed drug, these particulars are the form or forms of that listed drug.

4A. For the purposes of subsection 85(3)    of the Act, a form mentioned in Schedule 4 is a form of a medicinal preparation composed of one or more drugs or medicinal preparations, including a medicinal preparation containing an additive.

Manner of administration

5. For the purposes of subsection 85(5) of the Act, the manner of administration mentioned under the column headed “Manner of administration” in Schedule 1 or, if not mentioned in Schedule 1, in Schedule 2 for a form of a listed drug is the manner of administration for that form of the listed drug.

Brand

5A. For the purposes of subsection 85(6)    of the Act, a brand mentioned in Schedule 1 or, if not mentioned in Schedule 1, in Schedule 2 for a listed drug in a pharmaceutical item, in a form and with a manner of administration mentioned for the listed drug, is the brand of that pharmaceutical item.

Participating dental practitioners

5B. For the purposes of subsection 88(1A)    of the Act, the pharmaceutical benefits mentioned in Schedule 3 are the pharmaceutical benefits for the supply of which a participating dental practitioner is authorised to write a prescription.

Prescription

6. For the purposes of subsection 85A(2)    of the Act, the quantities and numbers of repeats specified in Part 2 of Schedule 1 or of Schedule 2 for a pharmaceutical item or pharmaceutical benefit are the maximum quantities and number of repeats that a medical practitioner may prescribe or direct on one occasion for the purposes mentioned for the pharmaceutical item or pharmaceutical benefit and no other purposes.

7. For the purposes of subsection 85A(2)    of the Act, the quantities and numbers of repeats specified in Part 2 of Schedule 3 for a pharmaceutical benefit or pharmaceutical item are the maximum quantities and number of repeats that a participating dental practitioner may prescribe or direct on one occasion but only for the purposes mentioned for the pharmaceutical item or pharmaceutical benefit and no other purposes.

8. For the purposes of subsection 85A(2)    of the Act, the manner of administration, if any, mentioned for a pharmaceutical benefit in

(a) Schedule 1 or, if not mentioned in Schedule1, in Schedule 2, is the only manner in which a medical practitioner may, in a prescription, direct the pharmaceutical benefit to be administered; or

(b) Schedule 3, is the only manner in which a participating dental practitioner may, in a prescription, direct the pharmaceutical benefit to be administered.

9. For the purposes of subsection 85A(2)    of the Act, the maximum quantity or number of units of a pharmaceutical item or pharmaceutical benefit that may, in one prescription, be directed to be supplied on any one occasion is:

(a) where a pharmaceutical item or pharmaceutical benefit is mentioned —

(i) in Part 1 of Schedule 1 — the quantity or number, if any, specified in that Part in the column headed “Maximum quantity” in relation to the pharmaceutical item or pharmaceutical benefit; or

(ii) in Part 2 of Schedule 1 and the pharmaceutical item or pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, specified in that Part in the column headed “Maximum quantity” in relation to the pharmaceutical item or pharmaceutical benefit; or

(iii) in Part 1 of Schedule 2 — the quantity or number, if any, specified in that Part in the column headed “Maximum quantity” in relation to the pharmaceutical item or pharmaceutical benefit; or

(iv) in Part 2 of Schedule 2 and the pharmaceutical item or pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical item or pharmaceutical benefit; or

(v) in Part 1 of Schedule 3 — the quantity or number, if any, specified in that Part in the column headed “Maximum quantity” in relation to the pharmaceutical item or pharmaceutical benefit; or

(vi) in Part 2 Schedule 3 and the pharmaceutical item or pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical item or pharmaceutical benefit; or

(b) in any other case — the quantity or number, if any, specified in the column headed “Maximum quantity” in Schedule 4 for the form of the pharmaceutical benefit.

10. For the purposes of subsection 85A(2)    of the Act, the maximum number of occasions, if any, on which the supply of a pharmaceutical benefit may, in one prescription, be directed by a medical practitioner to be repeated is:

(a) where the pharmaceutical benefit is mentioned —

(i) in Part 1 of Schedule 1 — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or

(ii) in Part 2 of Schedule 1 and the pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or

(iii) in Part 1 of Schedule 2 — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or

(iv) in Part 2 of Schedule 2 and the pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or

(b) in any other case — the number, if any, specified in the column headed “Maximum number of repeats” in Schedule 4 for the form of the pharmaceutical benefit.

11. Subject to paragraph 14, the following purposes are specified in relation to each pharmaceutical benefit mentioned in Part 2 of Schedule 1 or 2:

(a) where a class of persons is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for the treatment of a person included in that class of persons;

(b) where a disease or condition is specified in the column headed “Purposes”

(i) if subsubparagraph (ii) does not apply — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in relation to any person; or

(ii) if the disease or condition is specified in relation to a specified class of persons — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in a person included in that class of persons;

(c) where a purpose is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for that purpose;

(d) where it is specified in the column headed “Purposes” that compliance with authority procedures set out in subparagraph 11(d) is required — that a medical practitioner has submitted to the Medicare Australia CEO a prescription for the supply of the pharmaceutical benefit:

(i) by delivering or posting to the Medicare Australia CEO the prescription prepared and signed by the medical practitioner:

(A) in a form approved by the Secretary and completed by the medical practitioner in ink in his or her own handwriting; or

(B) in a form, prepared by means of a computer, that is in accordance with the form approved by the Secretary under subsubsubparagraph (A); or

(C) in a form, prepared by means of a computer, approved in writing for the purpose by the Secretary and in the format approved in writing by the Secretary; or

(D) by a method approved in writing by the Secretary; or

(ii) by submitting the prescription by giving the Medicare Australia CEO by telephone, details of the prescription which has been prepared and signed by the medical practitioner in accordance with subsubparagraph (i); or

(iii) where the medical practitioner has attempted to obtain an authorisation by submitting details of the prescription to the Medicare Australia CEO in accordance with subsubparagraph (ii) but has been unable to do so because of a failure or other form of unavailability in the telephone system established by the Medicare Australia CEO for the provision of such authorisations, by submitting the prescription in accordance with the instructions stipulated in an emergency telephone message provided to the medical practitioner by the Medicare Australia CEO; or

(iv) by submitting the prescription by giving the Medicare Australia CEO, by means of an electronic communication of a kind approved in writing by the Medicare Australia CEO, details of the prescription which has been prepared and signed by the medical practitioner in accordance with subsubparagraph (i).

11A. For the purposes of subparagraph 11(d)(i), a prescription that has been prepared and signed by the medical practitioner in accordance with that subparagraph is taken to have been submitted by him or her if it is submitted by one of his or her employees.

12. Subject to paragraph 12B, the authorisation of a prescription submitted under subparagraph 11(d) may be made:

(a) if the prescription was submitted in accordance with subsubparagraph 11(d)(i) — by the Medicare Australia CEO signing his or her authorisation of the prescription on it and:

(i) if the Medicare Australia CEO requires the medical practitioner to alter the prescription — by returning it to the medical practitioner for alteration before the medical practitioner gives it to the person in respect of whom it was prepared; or

(ii) in any other case:

(A) by returning it to the medical practitioner; or

(B) by sending it to the person in respect of whom it was prepared; or

(b) if the prescription was submitted in accordance with subsubparagraph 11(d)(ii) — orally, at the time the Medicare Australia CEO is given details of the prescription; or

(c) if the prescription was submitted in accordance with subsubparagraph 11(d)(iv) — by the Medicare Australia CEO sending his or her authorisation, by electronic communication, to the medical practitioner.

12A. If the Medicare Australia CEO authorises a prescription in accordance with subparagraph 12(b) or (c):

(a) the Medicare Australia CEO must tell the medical practitioner, orally or by electronic communication, the number that has been allotted to the authorised prescription; and

(b) the medical practitioner must:

(i) mark that number on the prescription; and

(ii) retain a copy of the prescription for 1 year from the date on which the prescription was authorised.

12B. Notwithstanding paragraph 12, if the prescription was submitted in accordance with subsubparagraph 11(d)(iii), authorisation shall be deemed to have been granted upon completion by the medical practitioner of the prescription in accordance with the instructions stipulated in the emergency telephone message provided to the medical practitioner by the Medicare Australia CEO.

12BA. If a medical practitioner has written on a prescription, that has been prepared and signed in accordance with subsubparagraph 11(d)(i), the streamlined authority code mentioned in Part 2 of Schedule 1 for a pharmaceutical benefit and purpose:

(a) subparagraph 11(d) is taken to have been complied with; and

(b) the Medicare Australia CEO is taken to have authorised the prescription.

12BB. Paragraph 12BA applies to a prescription only if there is a streamlined authority code for the pharmaceutical benefit and purpose in Part 2 of Schedule 1.

12C. Where a prescription is authorised, or deemed to be authorised, in accordance with paragraph 12, and an authorisation is also granted in accordance with subregulation 13(5) of the Regulations increasing the maximum quantity or number of units of the pharmaceutical benefit that may, in the prescription, be directed to be supplied on any one occasion, or the maximum number of occasions on which the supply of the pharmaceutical benefit may, in the prescription, be directed to be repeated, the authorisation in accordance with paragraph 12 is taken to be for the prescription of the increased quantity, number, or occasions, as the case may be.

13. The following purposes are specified in relation to a pharmaceutical benefit mentioned in Part 2 of Schedule 3:

(a) where a class of persons is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for the treatment of a person included in that class of persons;

(b) where a disease or condition is specified in the column headed “Purposes” —

(i) if subsubparagraph (ii) does not apply — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in relation to any person; or

(ii) if the disease or condition is specified in relation to a specified class of persons — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in a person included in that class of persons;

(c) where a purpose is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for that purpose.

14. Where the purposes “For use in accordance with paragraph 14” are specified in the column headed “Purposes” in Part 2 of Schedule 1, the purposes specified for the purpose of subparagraph 11(c) are:

(a) that the pharmaceutical benefit is to be supplied for the treatment, in conjunction with dietary therapy, of a patient identified as being in one of the following very high risk categories:

(i) coronary heart disease which has become symptomatic;

(ii) cerebrovascular disease which has become symptomatic;

(iii) peripheral vascular disease which has become symptomatic;

(iv) diabetes mellitus with microalbuminuria (defined as urinary albumin excretion rate of greater than 20 micrograms per minute, or urinary albumin to creatinine ratio of greater than 2.5 for males or greater than 3.5 for females);

(v) diabetes mellitus in Aboriginal or Torres Strait Islander patients;

(vi) diabetes mellitus in patients aged 60 years or more;

(vii) family history of coronary heart disease which has become symptomatic before the age of 55 years in two or more first degree relatives;

(viii) family history of coronary heart disease which has become symptomatic before the age of 45 years in one or more first degree relatives; or

(b) if subparagraph 14(a) does not apply — that the pharmaceutical benefit is to be supplied for the treatment, in conjunction with dietary therapy, of a patient who, after at least 6 weeks of dietary therapy, qualifies for the supply of the benefit in accordance with the following table:

 

Category of patient

Fasting lipid level

Patients with diabetes mellitus not otherwise
included

total cholesterol greater than 5.5 mmol per L

Aboriginal or Torres Strait Islander patients;
Patients with hypertension

total cholesterol greater than 6.5 mmol per L;

or

total cholesterol greater than 5.5 mmol per L and high density lipoprotein cholesterol less than 1 mmol per L

Patients with high density lipoprotein cholesterol less than 1 mmol per L

total cholesterol greater than 6.5 mmol per L

Patients with familial hypercholesterolaemia identified by:

(1) DNA mutation; or

(2) tendon xanthomas in the patient or their first or second degree relative

Patients with:

(1) family history of coronary heart disease which has become symptomatic before the age of 60 years in one or more first degree relatives; or

(2) family history of coronary heart disease which has become symptomatic before the age of 50 years in one or more second degree relatives

If aged 18 years or less at treatment initiation:

low density lipoprotein cholesterol greater than 4 mmol per L


If aged more than 18 years at treatment initiation:

low density lipoprotein cholesterol greater than 5 mmol per L;

or

total cholesterol greater than 6.5 mmol per L;

or

total cholesterol greater than 5.5 mmol per L and high density lipoprotein cholesterol less than 1 mmol per L

Patients not eligible under the above:

(1) men over 34 but less than 76 years of age; or

(2) post-menopausal women less than 76 years of age

total cholesterol greater than 7.5 mmol per L;

or

triglyceride greater than 4 mmol per L

Patients not otherwise included

total cholesterol greater than 9 mmol per L;

or

triglyceride greater than 8 mmol per L

SCHEDULE 1 - PART 1

Listed Drug

Form

(strength, type, size, etc.)

Manner of adminis-
tration

Maximum quantity

Maximum number of repeats

Brand

Abciximab

I.V. injection 10 mg in 5 mL vial

Injection

3

..

ReoPro

Acamprosate

Tablet (enteric coated) containing acamprosate calcium 333 mg

Oral

180

1

Campral

Acarbose

Tablet 50 mg

Oral

90

5

Glucobay 50

 

Tablet 100 mg

Oral

90

5

Glucobay 100

Acetazolamide

Tablet 250 mg

Oral

100

3

Diamox

Aciclovir

Tablet 200 mg

Oral

50

..

Acihexal

 

 

 

 

 

Acyclo-V 200

 

 

 

 

 

GenRx Aciclovir

 

 

 

 

 

Lovir

 

 

 

 

 

Zovirax 200 mg

 

Tablet 800 mg

Oral

35

..

Aciclovir 800

 

 

 

 

 

Acihexal

 

 

 

 

 

Acyclo-V 800

 

 

 

 

 

GenRx Aciclovir

 

 

 

 

 

Lovir

 

 

 

 

 

Zovirax 800 mg

 

Eye ointment 30 mg per g, 4.5 g

Application to the eye

1

..

Zovirax

Acitretin

Capsule 10 mg

Oral

100

2

Neotigason

 

Capsule 25 mg

Oral

100

2

Neotigason

Adalimumab

Injection 40 mg in 0.8 mL pre-filled syringe, 6

Injection

1

..

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen, 6

Injection

1

..

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

Injection

2

2

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

Injection

2

2

Humira

Adrenaline

Injection 1 mg (as acid tartrate) in 1 mL (1 in 1,000)

Injection

5

1

AstraZeneca Pty Ltd

 

I.M. injection 150 micrograms in 0.3 mL single dose syringe auto-injector (EpiPen Jr.)

Injection

1

..

EpiPen Jr.

 

I.M. injection 150 micrograms in 0.3 mL single dose syringe auto-injector (Anapen Junior)

Injection

1

..

Anapen Junior

 

I.M. injection 300 micrograms in 0.3 mL single dose syringe auto-injector (EpiPen)

Injection

1

..

EpiPen

 

I.M. injection 300 micrograms in 0.3 mL single dose syringe auto-injector (Anapen)

Injection

1

..

Anapen

Albendazole

Tablet 200 mg

Oral

6

..

Zentel

 

Tablet 400 mg

Oral

60

2

Eskazole

Alendronic Acid

Tablet 70 mg (as alendronate sodium)

Oral

4

5

Adronat

 

 

 

 

 

Alendrobell 70mg

 

 

 

 

 

Alendronate-GA

 

 

 

 

 

Alendronate Sandoz

 

 

 

 

 

Alendro Once Weekly

 

 

 

 

 

APO-Alendronate

 

 

 

 

 

Chem mart Alendronate 70mg

 

 

 

 

 

Fosamax Once Weekly

 

 

 

 

 

Ossmax 70mg

 

 

 

 

 

Terry White Chemists Alendronate 70mg

 

Tablet 40 mg (as alendronate sodium)

Oral

30

5

Fosamax 40 mg

Alendronic acid with colecalciferol

Tablet 70 mg (as alendronate sodium) with 70 micrograms colecalciferol

Oral

4

5

Fosamax Plus

 

Tablet 70 mg (as alendronate sodium) with 140 micrograms colecalciferol

Oral

4

5

Dronalen Plus

Fosamax Plus 70 mg/140 mcg

Alendronic acid with colecalciferol and calcium

Pack containing 4 tablets containing alendronic acid 70 mg (as alendronate sodium) with 140 micrograms colecalciferol and 48 tablets calcium 500 mg (as carbonate)

Oral

1

5

Fosamax Plus D-Cal

Alginic acid with calcium carbonate and sodium bicarbonate

Oral liquid containing alginic acid as sodium alginate 1 g, calcium carbonate 320 mg and sodium bicarbonate 534 mg in 20 mL, 500 mL

Oral

2

5

Gaviscon P

Allopurinol

Tablet 100 mg

Oral

200

2

Allopurinol Sandoz

 

 

 

 

 

Allosig

 

 

 

 

 

Chem mart Allopurinol

 

 

 

 

 

GenRx Allopurinol

 

 

 

 

 

Progout 100

 

 

 

 

 

Terry White Chemists Allopurinol

 

 

 

 

 

Zyloprim

 

Tablet 300 mg

Oral

60

2

Allopurinol Sandoz

 

 

 

 

 

Allosig

 

 

 

 

 

Chem mart Allopurinol

 

 

 

 

 

GenRx Allopurinol

 

 

 

 

 

Progout 300

 

 

 

 

 

Terry White Chemists Allopurinol

 

 

 

 

 

Zyloprim

Alprazolam

Tablet 250 micrograms

Oral

50

..

Alprax 0.25

 

 

 

 

 

Alprazolam Sandoz

 

 

 

 

 

Kalma 0.25

 

 

 

 

 

Xanax

 

Tablet 500 micrograms

Oral

50

..

Alprax 0.5

 

 

 

 

 

Alprazolam Sandoz

 

 

 

 

 

Kalma 0.5

 

 

 

 

 

Xanax

 

Tablet 1 mg

Oral

50

2

Alprax 1

 

 

 

 

 

Alprazolam-GA

 

 

 

 

 

Alprazolam Sandoz

 

 

 

 

 

Chem mart Alprazolam

 

 

 

 

 

GenRx Alprazolam

 

 

 

 

 

Kalma 1

 

 

 

 

 

Terry White Chemists Alprazolam

 

 

 

 

 

Xanax

 

Tablet 2 mg

Oral

50

2

Alprax 2

 

 

 

 

 

Alprazolam-GA

 

 

 

 

 

Alprazolam Sandoz

 

 

 

 

 

Chem mart Alprazolam

 

 

 

 

 

GenRx Alprazolam

 

 

 

 

 

Kalma 2

 

 

 

 

 

Terry White Chemists Alprazolam

 

 

 

 

 

Xanax Tri-Score

Aluminium Hydroxide with Magnesium Hydroxide

Oral suspension 200 mg-200 mg per 5 mL, 500 mL

Oral

2

5

Mylanta P

Aluminium Hydroxide with Magnesium Trisilicate and Magnesium Hydroxide

Oral suspension 250 mg-120 mg-120 mg per 5 mL, 500 mL

Oral

2

5

Gastrogel

Amantadine

Capsule containing amantadine hydrochloride 100 mg

Oral

100

5

Symmetrel 100

Amiloride

Tablet containing amiloride hydrochloride 5 mg

Oral

100

1

Kaluril

Amino acid formula with fat, carbohydrate, vitamins, minerals and trace elements without phenylalanine and tyrosine, and supplemented with docosahexanoic acid

Oral liquid 125 mL, 36 (TYR Anamix junior LQ)

Oral

4

5

TYR Anamix junior LQ

Amino acid formula without phenylalanine

Capsules 500 mg, 200 (Phlexy-10)

Oral

16

5

Phlexy-10

 

Tablets 1 g, 75 (Phlexy-10)

Oral

24

5

Phlexy-10

 

Sachets containing oral powder 20 g, 30 (Phlexy-10 Drink Mix)

Oral

7

5

Phlexy-10 Drink Mix

Amino acid formula with vitamins, minerals and long chain polyunsaturated fatty acids without phenylalanine

Oral powder 400 g (PKU Anamix infant)

Oral

8

5

PKU Anamix infant

Amino acid formula with vitamins and minerals without lysine and low in tryptophan

Sachets containing oral powder 20 g, 30 (GA gel)

Oral

4

5

GA gel

 

Oral powder 400 g (GA1 Anamix infant)

Oral

8

5

GA1 Anamix infant

 

Oral powder 500 g (XLYS, LOW TRY Maxamaid)

Oral

8

5

XLYS, LOW TRY Maxamaid

Amino acid formula with vitamins and minerals without methionine

Oral powder 400 g (HCU Anamix infant)

Oral

8

5

HCU Anamix infant

 

Sachets containing oral powder 20 g, 30 (HCU gel)

Oral

4

5

HCU gel

 

Sachets containing oral powder 25 g, 30 (HCU express)

Oral

4

5

HCU express

 

Oral powder 500 g (XMET Maxamaid)

Oral

8

5

XMET Maxamaid

 

Oral powder 500 g (XMET Maxamum)

Oral

8

5

XMET Maxamum

 

Oral liquid 130 mL, 30 (HCU Cooler)

Oral

4

5

HCU Cooler

Amino acid formula with vitamins and minerals without methionine, threonine and valine and low in isoleucine

Oral powder 400 g (MMA/PA Anamix infant)

Oral

8

5

MMA/PA Anamix infant

 

Oral powder 500 g (XMTVI Maxamaid)

Oral

8

5

XMTVI Maxamaid

 

Oral powder 500 g (XMTVI Maxamum)

Oral

8

5

XMTVI Maxamum

Amino acid formula with vitamins and minerals without phenylalanine

Sachets containing oral powder 18.2 g, 60 (add-ins)

Oral

3

5

add-ins

 

Sachets containing oral powder 20 g, 30 (PKU-gel)

Oral

4

5

PKU-gel

 

Sachets containing oral powder 25 g, 30 (PKU-Express)

Oral

4

5

PKU-Express

 

Sachets containing oral powder 27.8 g, 30 (Lophlex)

Oral

3

5

Lophlex

 

Sachets containing oral powder 29 g, 30 (PKU Anamix Junior)

Oral

4

5

PKU Anamix Junior

 

Sachets containing oral powder 50 g, 30 (XP Maxamum)

Oral

3

5

XP Maxamum

 

Oral powder 325 g (Phenex-2)

Oral

10

5

Phenex-2

 

Oral powder 500 g (XP Maxamaid)

Oral

8

5

XP Maxamaid

 

Oral powder 500 g (XP Maxamum)

Oral

8

5

XP Maxamum

 

Oral liquid 250 mL (Easiphen)

Oral

90

5

Easiphen

 

Oral liquid 62.5 mL, 60 (PKU Lophlex LQ 10)

Oral

2

5

PKU Lophlex LQ 10

 

Oral liquid 87 mL, 30 (PKU Cooler 10)

Oral

4

5

PKU Cooler 10

 

Oral liquid 125 mL, 30 (PKU Lophlex LQ 20)

Oral

3

5

PKU Lophlex LQ 20

 

Oral liquid 125 mL, 36 (PKU Anamix Junior LQ)

Oral

4

5

PKU Anamix Junior LQ

 

Oral liquid 130 mL, 30 (PKU Cooler 15)

Oral

4

5

PKU Cooler 15

 

Oral liquid 174 mL, 30 (PKU Cooler 20)

Oral

4

5

PKU Cooler 20

Amino acid formula with vitamins and minerals without phenylalanine and tyrosine

Sachets containing oral powder 20 g, 30 (TYR gel)

Oral

4

5

TYR gel

 

Sachets containing oral powder 25 g, 30 (TYR Express)

Oral

4

5

TYR Express

 

Sachets containing oral powder 29 g, 30 (TYR Anamix Junior)

Oral

4

5

TYR Anamix Junior

 

Oral powder 400 g (TYR Anamix infant)

Oral

8

5

TYR Anamix infant

 

Oral powder 500 g (XPhen, Tyr Maxamaid)

Oral

8

5

XPhen, Tyr Maxamaid

 

Oral powder 500 g (XPhen, Tyr Maxamum)

Oral

8

5

XPhen, Tyr Maxamum

 

Oral liquid 130 mL, 30 (TYR Cooler)

Oral

4

5

TYR Cooler

Amino acid formula with vitamins and minerals without valine, leucine and isoleucine

Sachets containing oral powder 20 g, 30 (MSUD-gel)

Oral

4

5

MSUD-gel

 

Sachets containing oral powder 25 g, 30 (MSUD Express)

Oral

4

5

MSUD Express

 

Sachets containing oral powder 29 g, 30 (MSUD Anamix Junior)

Oral

4

5

MSUD Anamix Junior

 

Oral powder 400 g (MSUD Anamix infant)

Oral

8

5

MSUD Anamix infant

 

Oral powder 500 g (MSUD AID III)

Oral

4

5

MSUD AID III

 

Oral powder 500 g (MSUD Maxamaid)

Oral

8

5

MSUD Maxamaid

 

Oral powder 500 g (MSUD Maxamum)

Oral

8

5

MSUD Maxamum

 

Oral liquid 130 mL, 30 (MSUD Cooler)

Oral

4

5

MSUD Cooler

Amino acid formula with vitamins and minerals without valine, leucine and isoleucine with fat, carbohydrate and trace elements and supplemented with docosahexanoic acid

Oral liquid 125 mL, 36 (MSUD Anamix Junior LQ)

Oral

4

5

MSUD Anamix Junior LQ

Amino acids — synthetic, formula

Oral powder 400 g (EleCare)

Oral

8

5

EleCare

 

Oral powder 400 g (Neocate)

Oral

8

5

Neocate

 

Oral powder 400 g (Neocate Advance)

Oral

8

5

Neocate Advance

 

Oral powder 400 g (Neocate Advance Tropical Flavour)

Oral

8

5

Neocate Advance Tropical Flavour

Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids

Oral powder 400 g (Neocate LCP)

Oral

8

5

Neocate LCP

 

Oral powder 400 g (EleCare LCP)

Oral

8

5

EleCare LCP

Amiodarone

Tablet containing amiodarone hydrochloride 100 mg

Oral

30

5

Aratac 100

 

 

 

 

 

Cardinorm

 

 

 

 

 

Cordarone X 100

 

 

 

 

 

Rithmik 100

 

Tablet containing amiodarone hydrochloride 200 mg

Oral

30

5

Aratac 200

 

 

 

 

 

Cardinorm

 

 

 

 

 

Chem mart Amiodarone

 

 

 

 

 

Cordarone X 200

 

 

 

 

 

GenRx Amiodarone

 

 

 

 

 

Rithmik 200

 

 

 

 

 

Terry White Chemists Amiodarone

Amisulpride

Tablet 100 mg

Oral

30

5

Amisulpride 100 Winthrop

 

 

 

 

 

Amisulpride Sandoz

 

 

 

 

 

Solian 100

 

 

 

 

 

Sulprix

 

Tablet 200 mg

Oral

60

5

Amisulpride 200 Winthrop

 

 

 

 

 

Amisulpride Sandoz

 

 

 

 

 

Solian 200

 

 

 

 

 

Sulprix

 

Tablet 400 mg

Oral

60

5

Amipride 400

 

 

 

 

 

Amisulpride 400 Winthrop

 

 

 

 

 

Amisulpride Sandoz

 

 

 

 

 

Solian 400

 

 

 

 

 

Sulprix

 

Oral solution 100 mg per mL, 60 mL

Oral

2

5

Solian Solution

Amitriptyline

Tablet containing amitriptyline hydrochloride 10 mg

Oral

50

2

Endep 10

 

Tablet containing amitriptyline hydrochloride 25 mg

Oral

50

2

Endep 25

 

Tablet containing amitriptyline hydrochloride 50 mg

Oral

50

2

Endep 50

Amlodipine

Tablet 5 mg (as besylate)

Oral

30

5

Amlodipine-DRLA

 

 

 

 

 

Amlodipine-GA

 

 

 

 

 

Amlodipine generichealth

 

 

 

 

 

Amlodipine Sandoz

 

 

 

 

 

APO-Amlodipine

 

 

 

 

 

Chem mart Amlodipine

 

 

 

 

 

Nordip

 

 

 

 

 

Norvapine

 

 

 

 

 

Norvasc

 

 

 

 

 

Ozlodip

 

 

 

 

 

Perivasc

 

 

 

 

 

Pharmacor Amlodipine 5

 

 

 

 

 

Terry White Chemists Amlodipine

 

Tablet 5 mg (as maleate)

Oral

30

5

Amlo 5

 

Tablet 10 mg (as besylate)

Oral

30

5

Amlodipine-DRLA

 

 

 

 

 

Amlodipine-GA

 

 

 

 

 

Amlodipine generichealth

 

 

 

 

 

Amlodipine Sandoz

 

 

 

 

 

APO-Amlodipine

 

 

 

 

 

Chem mart Amlodipine

 

 

 

 

 

Nordip

 

 

 

 

 

Norvapine

 

 

 

 

 

Norvasc

 

 

 

 

 

Ozlodip

 

 

 

 

 

Perivasc

 

 

 

 

 

Pharmacor Amlodipine 10

 

 

 

 

 

Terry White Chemists Amlodipine

 

Tablet 10 mg (as maleate)

Oral

30

5

Amlo 10

Amlodipine with Atorvastatin

Tablet 5 mg amlodipine (as besylate) with 10 mg atorvastatin (as calcium)

Oral

30

5

Caduet 5/10

 

Tablet 5 mg amlodipine (as besylate) with 20 mg atorvastatin (as calcium)

Oral

30

5

Caduet 5/20

 

Tablet 5 mg amlodipine (as besylate) with 40 mg atorvastatin (as calcium)

Oral

30

5

Caduet 5/40

 

Tablet 5 mg amlodipine (as besylate) with 80 mg atorvastatin (as calcium)

Oral

30

5

Caduet 5/80

 

Tablet 10 mg amlodipine (as besylate) with 10 mg atorvastatin (as calcium)

Oral

30

5

Caduet 10/10

 

Tablet 10 mg amlodipine (as besylate) with 20 mg atorvastatin (as calcium)

Oral

30

5

Caduet 10/20

 

Tablet 10 mg amlodipine (as besylate) with 40 mg atorvastatin (as calcium)

Oral

30

5

Caduet 10/40

 

Tablet 10 mg amlodipine (as besylate) with 80 mg atorvastatin (as calcium)

Oral

30

5

Caduet 10/80

Amlodipine with valsartan

Tablet 5 mg (as besylate)-80 mg

Oral

28

5

Exforge 5/80

 

Tablet 5 mg (as besylate)-160 mg

Oral

28

5

Exforge 5/160

 

Tablet 10 mg (as besylate)-160 mg

Oral

28

5

Exforge 10/160

Amoxycillin

Tablet 1 g (as trihydrate)

Oral

14

1

Amoxycillin Sandoz

 

 

 

 

 

Maxamox

 

Capsule 250 mg (as trihydrate)

Oral

20

1

Alphamox 250

 

 

 

 

 

Amoxil

 

 

 

 

 

Amoxycillin-GA

 

 

 

 

 

Amoxycillin Ranbaxy

 

 

 

 

 

Amoxycillin Sandoz

 

 

 

 

 

APO-Amoxycillin

 

 

 

 

 

Chem mart Amoxycillin

 

 

 

 

 

Cilamox

 

 

 

 

 

GenRx Amoxycillin

 

 

 

 

 

Terry White Chemists Amoxycillin

 

Capsule 500 mg (as trihydrate)

Oral

20

1

Alphamox 500

 

 

 

 

 

Amoxil

 

 

 

 

 

Amoxycillin-DP

 

 

 

 

 

Amoxycillin-GA

 

 

 

 

 

Amoxycillin Ranbaxy

 

 

 

 

 

Amoxycillin Sandoz

 

 

 

 

 

APO-Amoxycillin

 

 

 

 

 

Chem mart Amoxycillin

 

 

 

 

 

Cilamox

 

 

 

 

 

GenRx Amoxycillin

 

 

 

 

 

Terry White Chemists Amoxycillin

 

Sachet containing oral powder 3 g (as trihydrate)

Oral

1

..

Amoxil

 

Powder for paediatric oral drops 100 mg (as trihydrate) per mL, 20 mL

Oral

1

1

Amoxil

 

Powder for oral suspension 125 mg (as trihydrate) per 5 mL, 100 mL

Oral

1

1

Alphamox 125

Amoxil

Amoxycillin Sandoz

Bgramin

Chem mart Amoxycillin

GenRx Amoxycillin

Ranmoxy

Terry White Chemists Amoxycillin

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Powder for oral suspension 250 mg (as trihydrate) per 5 mL, 100 mL

Oral

1

1

Alphamox 250

Amoxil Forte

Amoxycillin Sandoz

Bgramin

Chem mart Amoxycillin

Cilamox

GenRx Amoxycillin

Ranmoxy

Terry White Chemists Amoxycillin

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Powder for oral suspension 500 mg (as trihydrate) per 5 mL, 100 mL

Oral

1

1

Maxamox

Amoxycillin with Clavulanic Acid

Tablet containing 500 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate)

Oral

10

1

APO-Amoxycillin/ Clavulanic Acid 500/125

 

 

 

 

 

Augmentin Duo

 

 

 

 

 

Clamoxyl Duo

 

 

 

 

 

Curam Duo 500/125

 

 

 

 

 

GA-Amclav 500/125

 

 

 

 

 

Moxiclav Duo 500/125

 

Tablet containing 875 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate)

Oral

10

1

Augmentin Duo forte

Chem mart Amoxycillin and Clavulanic Acid

Clamoxyl Duo forte

Clavycillin 875/125

Curam Duo Forte 875/125

GA-Amclav Forte 875/125

GenRx Amoxycillin and Clavulanic Acid

Moxiclav Duo Forte 875/125

Terry White Chemists Amoxycillin and Clavulanic Acid

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Powder for oral suspension containing 125 mg amoxycillin (as trihydrate) with 31.25 mg clavulanic acid (as potassium clavulanate) per 5 mL, 75 mL

Oral

1

1

Augmentin

Clamoxyl

Curam

 

 

 

 

 

 

Powder for oral suspension containing 400 mg amoxycillin (as trihydrate) with 57 mg clavulanic acid (as potassium clavulanate) per 5 mL, 60 mL

Oral

1

1

Augmentin Duo 400

Clamoxyl Duo 400

Curam Duo

 

 

 

 

 

Amphotericin

Lozenge 10 mg

Oral

20

1

Fungilin

 

Powder for injection 50 mg

Injection

1

..

Fungizone

Ampicillin

Powder for injection 500 mg (as sodium)

Injection

5

1

Austrapen

 

 

 

 

 

Ibimicyn

 

Powder for injection 1 g (as sodium)

Injection

5

1

Aspen Ampicyn

 

 

 

 

 

Austrapen

 

 

 

 

 

Ibimicyn

Amylopectin, modified long chain

Sachets containing oral powder 60 g, 30 (Glycosade)

Oral

4

5

Glycosade

Anakinra

Injection 100 mg in 0.67 mL single use pre-filled syringe

Injection

28

3

Kineret

Anastrozole

Tablet 1 mg

Oral

30

5

Arimidex

Apraclonidine

Eye drops 5 mg (as hydrochloride) per mL, 10 mL

Application to the eye

1

2

Iopidine 0.5%

Aprepitant

Pack containing 1 capsule 125 mg and 2 capsules 80 mg

Oral

1

..

Emend

Arginine with carbohydrate

Sachets of oral powder 4 g containing 500 mg arginine, 30 (Arginine Amino Acid Supplement)

Oral

4

5

Arginine Amino Acid Supplement

Aripiprazole

Tablet 10 mg

Oral

30

5

Abilify

 

Tablet 15 mg

Oral

30

5

Abilify

 

Tablet 20 mg

Oral

30

5

Abilify

 

Tablet 30 mg

Oral

30

5

Abilify

Arsenic

Injection concentrate containing arsenic trioxide 10 mg in 10 mL

Injection

60

2

Phenasen

Artemether with lumefantrine

Tablet 20 mg-120 mg

Oral

24

..

Riamet

Aspirin

Tablet 100 mg

Oral

112

1

Astrix

 

 

 

 

 

DBL Aspirin 100 mg

 

Tablet, dispersible, 300 mg

Oral

96

1

Solprin

Atenolol

Tablet 50 mg

Oral

30

5

APO-Atenolol

 

 

 

 

 

Atenolol-GA

 

 

 

 

 

Atenolol Sandoz

 

 

 

 

 

Chem mart Atenolol

 

 

 

 

 

Noten

 

 

 

 

 

Tenormin

 

 

 

 

 

Tensig

 

 

 

 

 

Terry White Chemists Atenolol

Atomoxetine

Capsule 10 mg (as hydrochloride)

Oral

56

5

Strattera

 

Capsule 18 mg (as hydrochloride)

Oral

56

5

Strattera

 

Capsule 25 mg (as hydrochloride)

Oral

56

5

Strattera

 

Capsule 40 mg (as hydrochloride)

Oral

56

5

Strattera

 

Capsule 60 mg (as hydrochloride)

Oral

56

5

Strattera

 

Capsule 80 mg (as hydrochloride)

Oral

28

5

Strattera

 

Capsule 100 mg (as hydrochloride)

Oral

28

5

Strattera

Atorvastatin

Tablet 10 mg (as calcium)

Oral

30

5

Lipitor

 

Tablet 20 mg (as calcium)

Oral

30

5

Lipitor

 

Tablet 40 mg (as calcium)

Oral

30

5

Lipitor

 

Tablet 80 mg (as calcium)

Oral

30

5

Lipitor

Atovaquone

Oral suspension 750 mg per 5 mL, 210 mL

Oral

1

..

Wellvone

Atovaquone with proguanil

Tablet containing atovaquone 250 mg with proguanil hydrochloride 100 mg

Oral

12

..

Malarone

Atropine

Injection containing atropine sulfate 600 micrograms in 1 mL

Injection

10

1

AstraZeneca Pty Ltd

 

Eye drops containing atropine sulfate 10 mg per mL, 15 mL

Application to the eye

1

2

Atropt

Auranofin

Tablet 3 mg

Oral

60

5

Ridaura

Aurothiomalate

Injection containing sodium aurothiomalate 10 mg

Injection

10

..

Myocrisin

 

Injection containing sodium aurothiomalate 20 mg

Injection

10

1

Myocrisin

 

Injection containing sodium aurothiomalate 50 mg

Injection

10

1

Myocrisin

Azathioprine

Tablet 25 mg

Oral

100

2

Azahexal

 

 

 

 

 

Imuran

 

Tablet 50 mg

Oral

100

2

Azamun

 

 

 

 

 

Azapin

 

 

 

 

 

Azathioprine Sandoz

 

 

 

 

 

GenRx Azathioprine

 

 

 

 

 

Imuran

 

 

 

 

 

Thioprine

Azithromycin

Tablet 500 mg (as dihydrate)

Oral

2

..

Azithromycin Sandoz

 

 

 

 

 

Zithromax

 

Powder for oral suspension 200 mg (as dihydrate) per 5 mL, 15 mL

Oral

1

..

Zithromax

Baclofen

Tablet 10 mg

Oral

100

5

Chem mart Baclofen

 

 

 

 

 

Clofen 10

 

 

 

 

 

GenRx Baclofen

 

 

 

 

 

Lioresal 10

 

 

 

 

 

Stelax 10

 

 

 

 

 

Terry White Chemists Baclofen

 

Tablet 25 mg

Oral

100

5

Chem mart Baclofen

 

 

 

 

 

Clofen 25

 

 

 

 

 

GenRx Baclofen

 

 

 

 

 

Lioresal 25

 

 

 

 

 

Stelax 25

 

 

 

 

 

Terry White Chemists Baclofen

Balsalazide

Capsule containing balsalazide sodium 750 mg

Oral

180

5

Colazide

"BCG Immunotherapeutic" (Bacillus Calmette-Guérin/ Connaught strain)

Single dose set comprising 1 vial powder for intravesical administration containing 6.6 to 19.2 x 108 CFU and 1 vial diluent 3 mL

Intravesical

3

1

ImmuCyst

"BCG-Tice" (Bacillus Calmette-Guérin/ Tice strain)

Vial containing powder for intravesical administration approximately 5 x 108 CFU

Intravesical

3

1

OncoTICE

Beclomethasone

Pressurised inhalation containing beclomethasone dipropionate 50 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

Qvar 50

 

Pressurised inhalation containing beclomethasone dipropionate 100 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

Qvar 100

 

Pressurised inhalation in breath actuated device containing beclomethasone dipropionate 50 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

Qvar 50 Autohaler

 

Pressurised inhalation in breath actuated device containing beclomethasone dipropionate 100 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

Qvar 100 Autohaler

Benzathine benzylpenicillin

Injection 900 mg in 2.3 mL single use pre-filled syringe

Injection

10

..

Bicillin L-A

Benzhexol

Tablet containing benzhexol hydrochloride 2 mg

Oral

200

2

Artane

 

Tablet containing benzhexol hydrochloride 5 mg

Oral

200

1

Artane

Benztropine

Tablet containing benztropine mesylate 2 mg

Oral

60

2

Benztrop

 

Injection containing benztropine mesylate 2 mg in 2 mL

Injection

5

..

Cogentin

Benzydamine

Mouth and throat rinse containing benzydamine hydrochloride 22.5 mg per 15 mL, 500 mL

Oral application

1

1

Difflam

Benzylpenicillin

Powder for injection 600 mg (as sodium)

Injection

10

1

BenPen

 

Powder for injection 3 g (as sodium)

Injection

10

..

BenPen

 

 

 

 

 

 

Betamethasone

Injection containing betamethasone acetate 3 mg with betamethasone sodium phosphate 3.9 mg in 1 mL

Injection

5

..

Celestone Chronodose

 

Cream 500 micrograms (as dipropionate) per g, 15 g

Application

1

1

Diprosone

 

 

 

 

 

Eleuphrat

 

Cream 200 micrograms (as valerate) per g, 100 g

Application

2

..

Antroquoril

 

 

 

 

 

Betnovate 1/5

 

 

 

 

 

Celestone-M

 

 

 

 

 

Cortival 1/5

 

Ointment 500 micrograms (as dipropionate) per g, 15 g

Application

1

1

Diprosone

 

 

 

 

 

Eleuphrat

 

Cream 500 micrograms (as valerate) per g, 15 g

Application

1

1

Betnovate 1/2

 

 

 

 

 

Cortival 1/2

 

Ointment 200 micrograms (as valerate) per g, 100 g

Application

2

..

Antroquoril

 

 

 

 

 

Celestone-M

 

Ointment 500 micrograms (as valerate) per g, 15 g

Application

1

1

Betnovate 1/2

 

 

 

 

 

Cortival 1/2

Betaxolol

Eye drops, suspension, 2.5 mg (as hydrochloride) per mL, 5 mL

Application to the eye

1

5

Betoptic S

 

Eye drops, solution, 5 mg (as hydrochloride) per mL, 5 mL

Application to the eye

1

5

Betoptic

 

 

 

 

 

BetoQuin

Bethanechol

Tablet containing bethanechol hydrochloride 10 mg

Oral

100

2

Uro-Carb

Bevacizumab

Solution for I.V. infusion 100 mg in 4 mL

Injection

1

..

Avastin

 

Solution for I.V. infusion 400 mg in 16 mL

Injection

1

..

Avastin

Bicalutamide

Tablet 50 mg

Oral

28

5

APO-Bicalutamide

 

 

 

 

 

Bicalutamide-GA

 

 

 

 

 

Bicalutamide Ranbaxy

 

 

 

 

 

Calutex

 

 

 

 

 

Cosamide

 

 

 

 

 

Cosudex

Bimatoprost

Eye drops 300 micrograms per mL, 3 mL

Application to the eye

1

5

Lumigan

Bimatoprost with timolol

Eye drops 300 micrograms bimatoprost with timolol 5 mg (as maleate) per mL, 3 mL

Application to the eye

1

5

Ganfort 0.3/5

Biperiden

Tablet containing biperiden hydrochloride 2 mg

Oral

200

2

Akineton

Bisacodyl

Tablet 5 mg

Oral

200

2

Bisalax

 

 

 

 

 

Lax-Tab

 

Suppositories 10 mg, 10

Rectal

3

5

Dulcolax

 

 

 

 

 

Petrus Bisacodyl Suppositories

 

Suppositories 10 mg, 12

Rectal

3

4

Petrus Bisacodyl Suppositories

 

Enemas 10 mg in 5 mL, 25

Rectal

1

2

Bisalax

Bisoprolol

Tablet containing bisoprolol fumarate 2.5 mg

Oral

28

5

Bicor

 

 

 

 

 

Bisoprolol Sandoz

 

 

 

 

 

Bispro 2.5

 

Tablet containing bisoprolol fumarate 5 mg

Oral

28

5

Bicor

 

 

 

 

 

Bisoprolol Sandoz

 

 

 

 

 

Bispro 5

 

Tablet containing bisoprolol fumarate 10 mg

Oral

28

5

Bicor

 

 

 

 

 

Bisoprolol Sandoz

 

 

 

 

 

Bispro 10

Bivalirudin

Powder for I.V. injection 250 mg (as trifluoroacetate)

Injection

1

..

Angiomax

Bleomycin

Powder for injection containing bleomycin sulfate 15,000 I.U. (with any determined brand of sodium chloride injection as the required solvent)

Injection

10

..

Blenamax

Blenoxane

Hospira Pty Limited

Bortezomib

Powder for injection 3.5 mg (with any determined brand of sodium chloride injection as the required solvent)

Injection

4

2

Velcade

Brimonidine

Eye drops containing brimonidine tartrate 2 mg per mL, 5 mL

Application to the eye

1

5

Alphagan

 

 

 

 

 

Enidin

Brimonidine with Timolol

Eye drops containing brimonidine tartrate 2 mg with timolol 5 mg (as maleate) per mL, 5 mL

Application to the eye

1

5

Combigan

Brinzolamide

Eye drops 10 mg per mL, 5 mL

Application to the eye

1

5

Azopt

 

 

 

 

 

BrinzoQuin

Bromocriptine

Tablet 2.5 mg (as mesylate)

Oral

30

..

Kripton 2.5

 

 

 

 

 

Parlodel

 

Capsule 5 mg (as mesylate)

Oral

60

5

Kripton 5

 

 

 

 

 

Parlodel

 

Capsule 10 mg (as mesylate)

Oral

100

5

Kripton 10

 

 

 

 

 

Parlodel

Budesonide

Nebuliser suspension 500 micrograms in 2 mL single dose units, 30

Inhalation

1

5

Pulmicort Respules

 

Nebuliser suspension 1 mg in 2 mL single dose units, 30

Inhalation

1

5

Pulmicort Respules

 

Powder for oral inhalation in breath actuated device 100 micrograms per dose, 200 doses

Inhalation by mouth

1

5

Pulmicort Turbuhaler

 

Powder for oral inhalation in breath actuated device 200 micrograms per dose, 200 doses

Inhalation by mouth

1

5

Pulmicort Turbuhaler

 

Powder for oral inhalation in breath actuated device 400 micrograms per dose, 200 doses

Inhalation by mouth

1

5

Pulmicort Turbuhaler

Budesonide with Eformoterol

Powder for oral inhalation in breath actuated device containing budesonide 100 micrograms with eformoterol fumarate dihydrate 6 micrograms per dose, 120 doses

Inhalation by mouth

1

5

Symbicort Turbuhaler 100/6

 

Powder for oral inhalation in breath actuated device containing budesonide 200 micrograms with eformoterol fumarate dihydrate 6 micrograms per dose, 120 doses

Inhalation by mouth

1

5

Symbicort Turbuhaler 200/6

 

Powder for oral inhalation in breath actuated device containing budesonide 400 micrograms with eformoterol fumarate dihydrate 12 micrograms per dose, 60 doses, 2

Inhalation by mouth

1

5

Symbicort Turbuhaler 400/12

Buprenorphine

Transdermal patch 5 mg

Transdermal

2

..

Norspan

 

Transdermal patch 10 mg

Transdermal

2

..

Norspan

 

Transdermal patch 20 mg

Transdermal

2

..

Norspan

Bupropion

Tablet containing bupropion hydrochloride 150 mg (sustained release)

Oral

30

..

Clorprax

 

 

 

 

 

Prexaton

 

 

 

 

 

Zyban

Busulfan

Tablet 2 mg

Oral

100

..

Myleran

Cabergoline

Tablet 500 micrograms

Oral

2

..

Dostinex

 

Tablet 1 mg

Oral

30

5

Bergoline 1

 

 

 

 

 

Cabaser

 

Tablet 2 mg

Oral

30

5

Bergoline 2

 

 

 

 

 

Cabaser

Calcipotriol

Cream 50 micrograms (as monohydrate) per g, 30 g

Application

1

1

Daivonex

 

Scalp solution 50 micrograms (as monohydrate) per mL, 30 mL

Application

1

1

Daivonex

Calcipotriol with betamethasone

Ointment containing calcipotriol 50 micrograms with betamethasone 500 micrograms (as dipropionate) per g, 30 g

Application

1

1

Daivobet

Calcitriol

Capsule 0.25 microgram

Oral

100

3

Calcitriol-DP

 

 

 

 

 

Calcitriol-GA

 

 

 

 

 

Citrihexal

 

 

 

 

 

GenRx Calcitriol

 

 

 

 

 

Kosteo

 

 

 

 

 

Rocaltrol

 

 

 

 

 

Sical

Calcium

Tablet, chewable, 500 mg (as carbonate)

Oral

240

1

Cal-Sup

 

Tablet 600 mg (as carbonate)

Oral

240

1

Calci-Tab 600

Candesartan

Tablet containing candesartan cilexetil 4 mg

Oral

30

5

Atacand

 

Tablet containing candesartan cilexetil 8 mg

Oral

30

5

Atacand

 

Tablet containing candesartan cilexetil 16 mg

Oral

30

5

Atacand

 

Tablet containing candesartan cilexetil 32 mg

Oral

30

5

Atacand

Candesartan with Hydrochlorothiazide

Tablet containing candesartan cilexetil 16 mg with hydrochlorothiazide 12.5 mg

Oral

30

5

Atacand Plus 16/12.5

 

Tablet containing candesartan cilexetil 32 mg with hydrochlorothiazide 12.5 mg

Oral

30

5

Atacand Plus 32/12.5

 

Tablet containing candesartan cilexetil 32 mg with hydrochlorothiazide 25 mg

Oral

30

5

Atacand Plus 32/25

Capecitabine

Tablet 150 mg

Oral

60

2

Xeloda

 

Tablet 500 mg

Oral

120

2

Xeloda

Captopril

Tablet 12.5 mg

Oral

90

5

Captopril Sandoz

 

 

 

 

 

GenRx Captopril

 

 

 

 

 

Zedace

 

Tablet 25 mg

Oral

90

5

Ascent Pharma Pty Ltd

 

 

 

 

 

Capoten

 

 

 

 

 

Captopril Sandoz

 

 

 

 

 

GenRx Captopril

 

 

 

 

 

Zedace

 

Tablet 50 mg

Oral

90

5

Ascent Pharma Pty Ltd

 

 

 

 

 

Capoten

 

 

 

 

 

Captopril Sandoz

 

 

 

 

 

GenRx Captopril

 

 

 

 

 

Zedace

 

Oral solution 5 mg per mL, 95 mL

Oral

1

5

Capoten

Carbamazepine

Tablet 100 mg

Oral

200

2

Carbamazepine Sandoz

 

 

 

 

 

Tegretol 100

 

Tablet 200 mg

Oral

200

2

Carbamazepine Sandoz

 

 

 

 

 

Tegretol 200

 

 

 

 

 

Teril

 

Tablet 200 mg (controlled release)

Oral

200

2

Tegretol CR 200

 

Tablet 400 mg (controlled release)

Oral

200

2

Tegretol CR 400

 

Oral suspension 100 mg per 5 mL, 300 mL

Oral

1

5

Tegretol Liquid

Carbimazole

Tablet 5 mg

Oral

200

2

Neo-Mercazole

Carbohydrate, fat, vitamins, minerals and trace elements

Oral powder 400 g (Energivit)

Oral

8

5

Energivit

Carbomer

Eye gel 2 mg per g, 10 g

Application to the eye

1

5

GelTears

 

 

 

 

 

PAA

 

 

 

 

 

Viscotears

 

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

Application to the eye

3

5

Viscotears

Carbomer 974

Ocular lubricating gel 3 mg per g, single dose units 0.5 g, 30

Application to the eye

3

5

Poly Gel

Carboplatin

Solution for I.V. injection 50 mg in 5 mL

Injection

2

..

Carboplatin Ebewe

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

 

Solution for I.V. injection 150 mg in 15 mL

Injection

6

..

Carboplatin Ebewe

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

 

Solution for I.V. injection 450 mg in 45 mL

Injection

2

..

Carboplatin Ebewe

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

Carmellose

Eye drops containing carmellose sodium 5 mg per mL, 15 mL

Application to the eye

1

5

Refresh Tears Plus

 

Eye drops containing carmellose sodium 10 mg per mL, 15 mL

Application to the eye

1

5

Refresh Liquigel

 

Eye drops containing carmellose sodium 2.5 mg per mL, single dose units 0.6 mL, 24

Application to the eye

4

5

TheraTears

 

Eye drops containing carmellose sodium 5 mg per mL, single dose units 0.4 mL, 30

Application to the eye

3

5

Cellufresh

 

Eye drops containing carmellose sodium 10 mg per mL, single dose units 0.4 mL, 30

Application to the eye

3

5

Celluvisc

 

Ocular lubricating gel containing carmellose sodium 10 mg per mL, single dose units 0.6 mL, 28

Application to the eye

3

5

TheraTears

Carmellose with glycerin

Eye drops containing carmellose sodium 5 mg with glycerin 9 mg per mL, 15 mL

Application to the eye

1

3

Optive

 

Eye drops containing carmellose sodium 5 mg with glycerin 9 mg per mL, single dose units 0.4 mL, 30

Application to the eye

3

5

Optive

Carmustine

Implants 7.7 mg, 8

Implantation

1

..

Gliadel

Carvedilol

Tablet 3.125 mg

Oral

30

..

Chem mart Carvedilol 3.125 mg

 

 

 

 

 

Dilasig 3.125

 

 

 

 

 

Dilatrend 3.125

 

 

 

 

 

GenRx Carvedilol

 

 

 

 

 

GN-Carvedilol

 

 

 

 

 

Kredex

 

 

 

 

 

Terry White Chemists Carvedilol 3.125 mg

 

 

 

 

 

Vedilol 3.125

 

Tablet 6.25 mg

Oral

60

5

Carvedilol generichealth

 

 

 

 

 

Carvedilol Sandoz

 

 

 

 

 

Chem mart Carvedilol 6.25 mg

 

 

 

 

 

Dicarz

 

 

 

 

 

Dilasig 6.25

 

 

 

 

 

Dilatrend 6.25

 

 

 

 

 

GenRx Carvedilol

 

 

 

 

 

GN-Carvedilol

 

 

 

 

 

Kredex

 

 

 

 

 

Terry White Chemists Carvedilol 6.25 mg

 

 

 

 

 

Vedilol 6.25

 

Tablet 12.5 mg

Oral

60

5

Carvedilol generichealth

 

 

 

 

 

Carvedilol Sandoz

 

 

 

 

 

Chem mart Carvedilol 12.5 mg

 

 

 

 

 

Dicarz

 

 

 

 

 

Dilasig 12.5

 

 

 

 

 

Dilatrend 12.5

 

 

 

 

 

GenRx Carvedilol

 

 

 

 

 

GN-Carvedilol

 

 

 

 

 

Kredex

 

 

 

 

 

Terry White Chemists Carvedilol 12.5 mg

 

 

 

 

 

Vedilol 12.5

 

Tablet 25 mg

Oral

60

5

Carvedilol generichealth

 

 

 

 

 

Carvedilol Sandoz

 

 

 

 

 

Chem mart Carvedilol 25 mg

 

 

 

 

 

Dicarz

 

 

 

 

 

Dilasig 25

 

 

 

 

 

Dilatrend 25

 

 

 

 

 

GenRx Carvedilol

 

 

 

 

 

GN-Carvedilol

 

 

 

 

 

Kredex

 

 

 

 

 

Terry White Chemists Carvedilol 25 mg

 

 

 

 

 

Vedilol 25

Cefaclor

Tablet (sustained release) 375 mg (as monohydrate)

Oral

10

1

Ceclor CD

 

 

 

 

 

Cefaclor-GA

 

 

 

 

 

Chem mart Cefaclor CD

 

 

 

 

 

Douglas Cefaclor-CD

 

 

 

 

 

GenRx Cefaclor CD

 

 

 

 

 

Karlor CD

 

 

 

 

 

Keflor CD

 

 

 

 

 

Ozcef

 

 

 

 

 

Terry White Chemists Cefaclor CD

 

Powder for oral suspension 125 mg (as monohydrate) per 5 mL, 100 mL

Oral

1

1

Aclor 125

Ceclor

 

 

 

 

 

Cefaclor Sandoz

 

 

 

 

 

Chem mart Cefaclor

 

 

 

 

 

GenRx Cefaclor

 

 

 

 

 

Keflor

 

 

 

 

 

Ozcef

 

 

 

 

 

Terry White Chemists Cefaclor

 

Powder for oral suspension 250 mg (as monohydrate) per 5 mL, 75 mL

Oral

1

1

Aclor 250

Ceclor

 

 

 

 

 

Cefaclor Sandoz

 

 

 

 

 

Chem mart Cefaclor

 

 

 

 

 

GenRx Cefaclor

 

 

 

 

 

Keflor

 

 

 

 

 

Ozcef

 

 

 

 

 

Terry White Chemists Cefaclor

Cefalotin

Powder for injection 1 g (as sodium)

Injection

10

1

Cefalotin Sandoz

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Keflin Neutral

Cefepime

Powder for injection 1 g (as hydrochloride) (with any determined brand of sodium chloride injection as the required solvent)

Injection

10

..

Maxipime

 

Powder for injection 2 g (as hydrochloride) (with any determined brand of sodium chloride injection as the required solvent)

Injection

10

..

Maxipime

Cefotaxime

Powder for injection 1 g (as sodium)

Injection

10

..

Cefotaxime Sandoz

 

 

 

 

 

Hospira Pty Limited

 

Powder for injection 2 g (as sodium)

Injection

10

..

Cefotaxime Sandoz

 

 

 

 

 

Hospira Pty Limited

Ceftriaxone

Powder for injection 500 mg (as sodium)

Injection

1

..

Ceftriaxone ICP

 

Powder for injection 1 g (as sodium)

Injection

5

..

Ceftriaxone ICP

 

 

 

 

 

Ceftriaxone Sandoz

 

 

 

 

 

DBL Ceftriaxone

 

 

 

 

 

Max Pharma Pty Ltd

 

 

 

 

 

Rocephin

 

Powder for injection 2 g (as sodium)

Injection

5

..

Ceftriaxone ICP

 

 

 

 

 

Ceftriaxone Sandoz

 

 

 

 

 

DBL Ceftriaxone

 

 

 

 

 

Rocephin

Cefuroxime

Tablet 250 mg (as axetil)

Oral

14

1

Zinnat

Celecoxib

Capsule 100 mg

Oral

60

3

Celebrex

 

Capsule 200 mg

Oral

30

3

Celebrex

Cephalexin

Capsule 250 mg (anhydrous)

Oral

20

1

Cefalexin Sandoz

 

 

 

 

 

Cephabell

 

 

 

 

 

Cephalexin generichealth

 

 

 

 

 

Cephatrust 250

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 250

 

 

 

 

 

Keflex

 

 

 

 

 

Rancef

 

 

 

 

 

Terry White Chemists Cephalexin

 

Capsule 500 mg (anhydrous)

Oral

20

1

Cefalexin Sandoz

 

 

 

 

 

Cephabell

 

 

 

 

 

Cephalexin generichealth

 

 

 

 

 

Cephatrust 500

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 500

 

 

 

 

 

Keflex

 

 

 

 

 

Rancef

 

 

 

 

 

Terry White Chemists Cephalexin

 

Granules for oral suspension 125 mg per 5 mL, 100 mL

Oral

1

1

APO-Cephalexin

 

 

 

 

 

Cefalexin Sandoz

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 125

 

 

 

 

 

Keflex

 

 

 

 

 

Terry White Chemists Cephalexin

 

Granules for oral suspension 250 mg per 5 mL, 100 mL

Oral

1

1

APO-Cephalexin

 

 

 

 

 

Cefalexin Sandoz

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 250

 

 

 

 

 

Keflex

 

 

 

 

 

Terry White Chemists Cephalexin

Cephazolin

Powder for injection 500 mg (as sodium)

Injection

10

..

Hospira Pty Limited

 

Powder for injection 1 g (as sodium)

Injection

10

..

Cefazolin Sandoz

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Kefzol

 

Powder for injection 2 g (as sodium)

Injection

10

..

Cefazolin Sandoz

Cetuximab

Solution for I.V. infusion 100 mg in 20 mL

Injection

1

..

Erbitux

 

Solution for I.V. infusion 500 mg in 100 mL

Injection

1

..

Erbitux

Chlorambucil

Tablet 2 mg

Oral

100

2

Leukeran

Chloramphenicol

Ear drops (aqueous) 5 mg per mL, 5 mL

Application to the ear

1

2

Chloromycetin

 

Eye drops 5 mg per mL, 10 mL

Application to the eye

1

2

Chloromycetin

 

 

 

 

 

Chlorsig

 

Eye ointment 10 mg per g, 4 g

Application to the eye

1

..

Chloromycetin

 

 

 

 

 

Chlorsig

Chlorpromazine

Tablet containing chlorpromazine hydrochloride 10 mg

Oral

100

5

Largactil

 

Tablet containing chlorpromazine hydrochloride 25 mg

Oral

100

5

Largactil

 

Tablet containing chlorpromazine hydrochloride 100 mg

Oral

100

5

Largactil

 

Oral solution containing chlorpromazine hydrochloride 25 mg per 5 mL, 100 mL

Oral

1

5

Largactil

 

Injection containing chlorpromazine hydrochloride 50 mg in 2 mL

Injection

10

..

Largactil

Chlorthalidone

Tablet 25 mg

Oral

100

1

Hygroton 25

Cholestyramine

Sachets containing 4.7 g oral powder (equivalent to 4 g cholestyramine), 50

Oral

2

5

Questran Lite

Chorionic Gonadotrophin

Injection set containing 3 ampoules powder for injection 1,500 units and 3 ampoules solvent 1 mL

Injection

1

5

Pregnyl

Ciclesonide

Pressurised inhalation 80 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

Alvesco 80

 

Pressurised inhalation 160 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

Alvesco 160

Cimetidine

Tablet 200 mg

Oral

120

5

Magicul 200

 

Tablet 400 mg

Oral

60

5

GenRx Cimetidine

 

 

 

 

 

Magicul 400

 

Tablet 800 mg

Oral

30

5

GenRx Cimetidine

 

 

 

 

 

Magicul 800

Cinacalcet

Tablet 30 mg (as hydrochloride)

Oral

28

5

Sensipar

 

Tablet 60 mg (as hydrochloride)

Oral

28

5

Sensipar

 

Tablet 90 mg (as hydrochloride)

Oral

28

5

Sensipar

Ciprofloxacin

Tablet 250 mg (as hydrochloride)

Oral

14

..

C-Flox 250

 

 

 

 

 

Cifran

 

 

 

 

 

Ciprofloxacin-DRLA

 

 

 

 

 

Ciprol 250

 

 

 

 

 

Ciproxin 250

 

 

 

 

 

GenRx Ciprofloxacin

 

 

 

 

 

Profloxin

 

Tablet 500 mg (as hydrochloride)

Oral

14

..

Ascent Pharmaceuticals Limited

 

 

 

 

 

C-Flox 500

 

 

 

 

 

Cifran

 

 

 

 

 

Ciprofloxacin 500

 

 

 

 

 

Ciprofloxacin-BW

 

 

 

 

 

Ciprofloxacin-DRLA

 

 

 

 

 

Ciprofloxacin-GA

 

 

 

 

 

Ciprol 500

 

 

 

 

 

Ciproxin 500

 

 

 

 

 

GenRx Ciprofloxacin

 

 

 

 

 

Profloxin

 

Tablet 750 mg (as hydrochloride)

Oral

14

..

Ascent Pharmaceuticals Limited

 

 

 

 

 

C-Flox 750

 

 

 

 

 

Cifran

 

 

 

 

 

Ciprofloxacin 750

 

 

 

 

 

Ciprofloxacin-BW

 

 

 

 

 

Ciprofloxacin-DRLA

 

 

 

 

 

Ciprofloxacin Sandoz

 

 

 

 

 

Ciprol 750

 

 

 

 

 

Ciproxin 750

 

 

 

 

 

GenRx Ciprofloxacin

 

Ear drops 3 mg (as hydrochloride) per mL, 5 mL

Application to the ear

1

1

Ciloxan

 

Eye drops 3 mg (as hydrochloride) per mL, 5 mL

Application to the eye

2

..

CiloQuin

 

 

 

 

 

Ciloxan

Cisplatin

I.V. injection 10 mg in 10 mL

Injection

1

..

Pfizer Australia Pty Ltd

 

I.V. injection 50 mg in 50 mL

Injection

1

..

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

 

I.V. injection 100 mg in 100 mL

Injection

1

..

Cisplatin Ebewe

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

Citalopram

Tablet 10 mg (as hydrobromide)

Oral

28

5

Celapram

 

Tablet 20 mg (as hydrobromide)

Oral

28

5

APO-Citalopram

 

 

 

 

 

Celapram

 

 

 

 

 

Celica

 

 

 

 

 

Chem mart Citalopram

 

 

 

 

 

Ciazil

 

 

 

 

 

Cipramil

 

 

 

 

 

Citalobell

 

 

 

 

 

Citalopram 20

 

 

 

 

 

Citalopram generichealth

 

 

 

 

 

Citalopram Sandoz

 

 

 

 

 

GenRx Citalopram

 

 

 

 

 

Talam

 

 

 

 

 

Terry White Chemists Citalopram

 

Tablet 40 mg (as hydrobromide)

Oral

28

5

APO-Citalopram

 

 

 

 

 

Celapram

 

 

 

 

 

Citalopram Sandoz

 

 

 

 

 

GenRx Citalopram

Cladribine

Injection 10 mg in 5 mL

Injection

7

..

Litak

 

Solution for I.V. infusion 10 mg in 10 mL single use vial

Injection

7

..

Leustatin

Clarithromycin

Tablet 250 mg

Oral

14

1

APO-Clarithromycin

 

 

 

 

 

Chem mart Clarithromycin

 

 

 

 

 

Clarac

 

 

 

 

 

Clarihexal

 

 

 

 

 

Clarithro 250

 

 

 

 

 

GenRx Clarithromycin

 

 

 

 

 

Kalixocin

 

 

 

 

 

Klacid

 

 

 

 

 

Terry White Chemists Clarithromycin

 

Powder for oral liquid 250 mg per 5 mL, 50 mL

Oral

1

..

Klacid

Clindamycin

Capsule 150 mg (as hydrochloride)

Oral

24

..

Cleocin

 

 

 

 

 

Dalacin C

Clodronic Acid

Capsule containing 400 mg sodium clodronate (as tetrahydrate)

Oral

100

2

Bonefos

 

Capsule containing 800 mg sodium clodronate (as tetrahydrate)

Oral

60

2

Bonefos 800 mg

Clomiphene

Tablet containing clomiphene citrate 50 mg

Oral

10

5

Clomid

 

 

 

 

 

Serophene

Clomipramine

Tablet containing clomipramine hydrochloride 25 mg

Oral

50

2

Anafranil 25

 

 

 

 

 

Chem mart Clomipramine

 

 

 

 

 

GenRx Clomipramine

 

 

 

 

 

Placil

 

 

 

 

 

Terry White Chemists Clomipramine

Clonazepam

Tablet 500 micrograms

Oral

200

2

Paxam 0.5

 

 

 

 

 

Rivotril

 

Tablet 2 mg

Oral

200

2

Paxam 2

 

 

 

 

 

Rivotril

 

Oral liquid 2.5 mg per mL, 10 mL

Oral

2

..

Rivotril

 

Injection 1 mg in 2 mL (set containing solution 1 mg in 1 mL and 1 mL diluent)

Injection

5

..

Rivotril

Clonidine

Tablet containing clonidine hydrochloride 100 micrograms

Oral

100

5

Catapres 100

 

Tablet containing clonidine hydrochloride 150 micrograms

Oral

100

5

Catapres

Clopidogrel

Tablet 75 mg (as hydrogen sulfate)

Oral

28

5

APO-Clopidogrel

 

 

 

 

 

Chem mart Clopidogrel

 

 

 

 

 

Clopidogrel Sandoz

 

 

 

 

 

Iscover

 

 

 

 

 

Plavix

 

 

 

 

 

Terry White Chemists Clopidogrel

 

Tablet 75 mg (as besilate)

Oral

28

5

Clovix 75

Clopidogrel with aspirin

Tablet 75 mg (as hydrogen sulfate)-100 mg

Oral

30

5

CoPlavix

 

 

 

 

 

DuoCover

Clotrimazole

Cream 10 mg per g, 20 g

Application

2

3

Clonea

Coal Tar - Prepared

Gel 10 mg per g, 100 mL

Application

1

2

Exorex

Codeine

Tablet containing codeine phosphate 30 mg

Oral

20

..

Fawns and McAllan Proprietary Limited

Codeine with Paracetamol

Tablet containing codeine phosphate 30 mg with paracetamol 500 mg

Oral

20

..

APO- Paracetamol/Codeine 500/30

 

 

 

 

 

Codalgin Forte

 

 

 

 

 

Codapane Forte

 

 

 

 

 

Comfarol Forte

 

 

 

 

 

Dolaforte

 

 

 

 

 

Panadeine Forte

 

 

 

 

 

Prodeine Forte

Colchicine

Tablet 500 micrograms

Oral

100

2

Colgout

 

 

 

 

 

Lengout

Colestipol

Oral powder, sachets containing colestipol hydrochloride 5 g, 120

Oral

1

5

Colestid

Copper Sulfate

Tablets, diagnostic compound, 36

For external use

2

3

Clinitest

Cortisone

Tablet containing cortisone acetate 5 mg

Oral

50

4

Cortate

 

Tablet containing cortisone acetate 25 mg

Oral

60

4

Cortate

Cromoglycic Acid

Capsule containing powder for oral inhalation containing sodium cromoglycate 20 mg (for use in Intal Spinhaler or Intal Halermatic)

Inhalation by mouth

100

5

Intal Spincaps

 

Pressurised inhalation containing sodium cromoglycate 1 mg per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

Intal CFC-Free

 

Pressurised inhalation containing sodium cromoglycate 5 mg per dose, 112 doses (CFC-free formulation)

Inhalation by mouth

1

5

Intal Forte CFC-Free

 

Eye drops containing sodium cromoglycate 20 mg per mL, 10 mL

Application to the eye

1

5

Cromolux

 

 

 

 

 

Opticrom

Cyclophosphamide

Tablet 50 mg

Oral

50

2

Cycloblastin

 

Powder for injection 500 mg (anhydrous) (with any determined brand of sodium chloride injection as the required solvent)

Injection

2

..

Endoxan

 

Powder for injection 1 g (anhydrous) (with any determined brand of sodium chloride injection as the required solvent)

Injection

1

..

Endoxan

 

Powder for injection 2 g (anhydrous) (with any determined brand of sodium chloride injection as the required solvent)

Injection

1

..

Endoxan

Cyclosporin

Capsule 10 mg

Oral

120

3

Neoral 10

 

Capsule 25 mg

Oral

60

3

Cicloral

 

 

 

 

 

Neoral 25

 

Capsule 50 mg

Oral

60

3

Cicloral

 

 

 

 

 

Neoral 50

 

Capsule 100 mg

Oral

60

3

Cicloral

 

 

 

 

 

Neoral 100

 

Oral liquid 100 mg per mL, 50 mL

Oral

2

3

Neoral

Cyproheptadine

Tablet containing cyproheptadine hydrochloride 4 mg (anhydrous)

Oral

100

2

Periactin

Cyproterone

Tablet containing cyproterone acetate 50 mg

Oral

20

5

Androcur

 

 

 

 

 

Cyprohexal

 

 

 

 

 

Cyprone

 

 

 

 

 

Cyprostat

 

 

 

 

 

GenRx Cyproterone Acetate

 

 

 

 

 

Procur

 

Tablet containing cyproterone acetate 100 mg

Oral

50

5

Androcur-100

 

 

 

 

 

Cyprohexal

 

 

 

 

 

Cyprostat-100

 

 

 

 

 

GenRx Cyproterone Acetate

 

 

 

 

 

Procur 100

Cystine with carbohydrate

Sachets of oral powder 4 g containing 500 mg cystine, 30 (Cystine Amino Acid Supplement)

Oral

4

5

Cystine Amino Acid Supplement

Cytarabine

Injection 100 mg in 5 mL vial

Injection

10

1

Pfizer Australia Pty Ltd

Dabigatran etexilate

Capsules 75 mg (as mesilate), 60

Oral

1

..

Pradaxa

 

Capsules 110 mg (as mesilate), 60

Oral

1

..

Pradaxa

 

Capsule 75 mg (as mesilate)

Oral

20

..

Pradaxa

 

Capsule 110 mg (as mesilate)

Oral

20

..

Pradaxa

Dalteparin

Injection containing dalteparin sodium 2,500 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

Injection

10

1

Fragmin

 

Injection containing dalteparin sodium 5,000 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

Injection

10

1

Fragmin

 

Injection containing dalteparin sodium 7,500 I.U. (anti-Xa) in 0.75 mL single dose pre-filled syringe

Injection

10

1

Fragmin

 

Injection containing dalteparin sodium 10,000 I.U. (anti-Xa) in 1 mL single dose pre-filled syringe

Injection

10

1

Fragmin

Danazol

Capsule 100 mg

Oral

100

5

Azol 100

 

Capsule 200 mg

Oral

100

5

Azol 200

Dantrolene

Capsule containing dantrolene sodium 25 mg

Oral

100

2

Dantrium

 

Capsule containing dantrolene sodium 50 mg

Oral

100

2

Dantrium

Dapsone

Tablet 25 mg

Oral

100

1

Link Medical Products Pty Ltd

 

Tablet 100 mg

Oral

100

1

Link Medical Products Pty Ltd

Dasatinib

Tablet 20 mg

Oral

60

2

Sprycel

 

Tablet 50 mg

Oral

60

2

Sprycel

 

Tablet 70 mg

Oral

60

2

Sprycel

 

Tablet 100 mg

Oral

30

2

Sprycel

Desmopressin

Intranasal solution containing desmopressin acetate 100 micrograms per mL, 2.5 mL dropper bottle

Nasal

5

5

Minirin

 

Tablet containing desmopressin acetate 200 micrograms

Oral

30

5

Minirin

 

Wafer 120 micrograms (as acetate)

Sublingual

30

5

Minirin Melt

 

Nasal spray (pump pack) containing desmopressin acetate 10 micrograms per actuation, 60 actuations, 6 mL

Nasal

1

5

Minirin Nasal Spray

Desvenlafaxine

Tablet (extended release) 50 mg (as succinate)

Oral

28

5

Pristiq

 

Tablet (extended release) 100 mg (as succinate)

Oral

28

5

Pristiq

Dexamethasone

Tablet 500 micrograms

Oral

30

4

Dexmethsone

 

Tablet 4 mg

Oral

30

4

Dexmethsone

 

Injection containing dexamethasone sodium phosphate equivalent to 4 mg dexamethasone phosphate in 1 mL

Injection

5

..

Hospira Pty Limited

 

Injection containing dexamethasone sodium phosphate equivalent to 8 mg dexamethasone phosphate in 2 mL

Injection

5

1

Hospira Pty Limited

 

Eye drops 1 mg per mL, 5 mL

Application to the eye

1

2

Maxidex

Dexamethasone with Framycetin and Gramicidin

Ear drops containing dexamethasone 500 micrograms (as sodium metasulfobenzoate), framycetin sulfate 5 mg and gramicidin 50 micrograms per mL, 8 mL

Application to the ear

1

2

Otodex

 

 

 

 

 

Sofradex

Dexamphetamine

Tablet containing dexamphetamine sulfate 5 mg

Oral

100

5

Sigma Pharmaceuticals (Australia) Pty Ltd

Diazepam

Tablet 2 mg

Oral

50

..

Antenex 2

 

 

 

 

 

Valium

 

 

 

 

 

Valpam 2

 

Tablet 5 mg

Oral

50

..

Antenex 5

 

 

 

 

 

Diazepam-GA

 

 

 

 

 

Ranzepam

 

 

 

 

 

Valium

 

 

 

 

 

Valpam 5

 

Injection 10 mg in 2 mL

Injection

5

..

Hospira Pty Limited

Diclofenac

Tablet (enteric coated) containing diclofenac sodium 25 mg

Oral

100

3

APO-Diclofenac

 

 

 

 

 

Chem mart Diclofenac

 

 

 

 

 

Clonac 25

 

 

 

 

 

Diclofenac-GA

 

 

 

 

 

Diclofenac Sandoz

 

 

 

 

 

Fenac 25

 

 

 

 

 

Terry White Chemists Diclofenac

 

 

 

 

 

Voltaren 25

 

Tablet (enteric coated) containing diclofenac sodium 50 mg

Oral

50

3

APO-Diclofenac

 

 

 

 

 

Chem mart Diclofenac

 

 

 

 

 

Clonac 50

 

 

 

 

 

Diclofenac-GA

 

 

 

 

 

Diclofenac Sandoz

 

 

 

 

 

Fenac

 

 

 

 

 

Terry White Chemists Diclofenac

 

 

 

 

 

Voltaren 50

 

Suppository containing diclofenac sodium 100 mg

Rectal

40

3

Voltaren 100

Dicloxacillin

Capsule 250 mg (as sodium)

Oral

24

..

Dicloxsig

 

 

 

 

 

Distaph 250

 

Capsule 500 mg (as sodium)

Oral

24

..

Diclocil

 

 

 

 

 

Dicloxsig

 

 

 

 

 

Distaph 500

Digoxin

Tablet 62.5 micrograms

Oral

200

1

Lanoxin-PG

 

 

 

 

 

Sigmaxin-PG

 

Tablet 250 micrograms

Oral

100

1

Lanoxin

 

 

 

 

 

Sigmaxin

 

Paediatric oral solution 50 micrograms per mL, 60 mL

Oral

2

3

Lanoxin

Dihydroergotamine

Injection containing dihydroergotamine mesylate 1 mg in 1 mL

Injection

5

..

Dihydergot

Diltiazem

Tablet containing diltiazem hydrochloride 60 mg

Oral

90

5

Cardizem

 

 

 

 

 

Chem mart Diltiazem

 

 

 

 

 

Coras

 

 

 

 

 

Diltiazem Sandoz

 

 

 

 

 

Dilzem 60 mg

 

 

 

 

 

GenRx Diltiazem

 

 

 

 

 

Terry White Chemists Diltiazem

 

 

 

 

 

Vasocardol

 

Capsule (controlled delivery) containing diltiazem hydrochloride 180 mg

Oral

30

5

Cardizem CD

Chem mart Diltiazem CD

Diltahexal CD

Dilzem CD

GenRx Diltiazem CD

Terry White Chemists Diltiazem CD

Vasocardol CD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Capsule (controlled delivery) containing diltiazem hydrochloride 240 mg

Oral

30

5

Cardizem CD

Chem mart Diltiazem CD

Diltahexal CD

Dilzem CD

GenRx Diltiazem CD

Terry White Chemists Diltiazem CD

Vasocardol CD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Capsule (controlled delivery) containing diltiazem hydrochloride 360 mg

Oral

30

5

Cardizem CD

Diltahexal CD

Vasocardol CD

Diphenoxylate with Atropine

Tablet containing diphenoxylate hydrochloride 2.5 mg with atropine sulfate 25 micrograms

Oral

20

..

Lofenoxal

 

 

 

 

 

Lomotil

Diphtheria and tetanus vaccine, adsorbed, diluted for adult use

Injection 0.5 mL in pre-filled syringe

Injection

5

..

ADT Booster

Dipyridamole

Capsule 200 mg (sustained release)

Oral

60

5

Persantin SR

Dipyridamole with Aspirin

Capsule 200 mg (sustained release)-25 mg

Oral

60

5

Asasantin SR

Disopyramide

Capsule 100 mg

Oral

100

5

Rythmodan

 

Capsule 150 mg

Oral

100

5

Rythmodan

Docetaxel

Injection set containing 1 single use vial concentrate for I.V. infusion 20 mg (anhydrous) in 0.5 mL with solvent

Injection

1

..

Taxotere

 

Injection set containing 1 single use vial concentrate for I.V. infusion 80 mg (anhydrous) in 2 mL with solvent

Injection

1

..

Taxotere

Dolasetron

Tablet containing dolasetron mesylate 200 mg

Oral

2

..

Anzemet

 

I.V. injection containing dolasetron mesylate 100 mg in 5 mL

Injection

1

..

Anzemet

Domperidone

Tablet 10 mg

Oral

25

..

Motilium

Donepezil

Tablet containing donepezil hydrochloride 5 mg

Oral

28

5

Aricept

 

Tablet containing donepezil hydrochloride 10 mg

Oral

28

5

Aricept

Dorzolamide

Eye drops 20 mg (as hydrochloride) per mL, 5 mL

Application to the eye

1

5

Trusopt

Dorzolamide with Timolol

Eye drops containing dorzolamide 20 mg (as hydrochloride) with timolol 5 mg (as maleate) per mL, 5 mL

Application to the eye

1

5

Cosopt

Dothiepin

Capsule containing dothiepin hydrochloride 25 mg

Oral

50

2

Dothep 25

 

 

 

 

 

Prothiaden

 

Tablet containing dothiepin hydrochloride 75 mg

Oral

30

2

Dothep 75

 

 

 

 

 

Prothiaden

Doxepin

Tablet 50 mg (as hydrochloride)

Oral

50

2

Deptran 50

 

Capsule 10 mg (as hydrochloride)

Oral

50

2

Deptran 10

 

 

 

 

 

Sinequan

 

Capsule 25 mg (as hydrochloride)

Oral

50

2

Deptran 25

 

 

 

 

 

Sinequan

Doxorubicin

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 10 mg in 5 mL single dose vial

Injection/intravesical

4

..

Adriamycin Solution

Doxorubicin Ebewe

Hospira Pty Limited

 

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 20 mg in 10 mL single dose vial

Injection/intravesical

4

..

Adriamycin Solution

 

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 50 mg in 25 mL single dose vial

Injection/intravesical

3

..

Adriamycin Solution

 

 

 

 

 

Doxorubicin Ebewe

 

 

 

 

 

Hospira Pty Limited

 

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 100 mg in 50 mL single dose vial

Injection/intravesical

1

..

Doxorubicin Ebewe

 

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 200 mg in 100 mL single dose vial

Injection/intravesical

1

..

Adriamycin

 

 

 

 

 

Doxorubicin Ebewe

Doxorubicin - Pegylated Liposomal

Suspension for I.V. infusion containing pegylated liposomal doxorubicin hydrochloride 20 mg in 10 mL

Injection

1

..

Caelyx

 

Suspension for I.V. infusion containing pegylated liposomal doxorubicin hydrochloride 50 mg in 25 mL

Injection

1

..

Caelyx

Doxycycline

Tablet 100 mg (as monohydrate)

Oral

7

1

Chem mart Doxycycline

 

 

 

 

 

Doxyhexal

 

 

 

 

 

GenRx Doxycycline

 

 

 

 

 

Terry White Chemists Doxycycline

 

Tablet 100 mg (as hydrochloride)

Oral

7

1

Doxsig

 

 

 

 

 

Doxy-100

 

 

 

 

 

Doxylin 100

 

 

 

 

 

Vibramycin

 

Capsule 100 mg (as hydrochloride) (containing enteric coated pellets)

Oral

7

1

DBL Doxycycline

Doryx

 

Tablet 50 mg (as monohydrate)

Oral

25

5

Chem mart Doxycycline

 

 

 

 

 

Doxyhexal

 

 

 

 

 

Frakas

 

 

 

 

 

GenRx Doxycycline

 

 

 

 

 

Terry White Chemists Doxycycline

 

Tablet 50 mg (as hydrochloride)

Oral

25

5

Doxy-50

 

 

 

 

 

Doxylin 50

 

 

 

 

 

Vibra-Tabs

 

Capsule 50 mg (as hydrochloride) (containing enteric coated pellets)

Oral

25

5

DBL Doxycycline

Doryx

Drotrecogin Alfa (activated)

Powder for I.V. infusion 5 mg

Injection

1

..

Xigris

Duloxetine

Capsule 30 mg (as hydrochloride)

Oral

28

..

Cymbalta

 

Capsule 60 mg (as hydrochloride)

Oral

28

5

Cymbalta

Dydrogesterone

Tablet 10 mg

Oral

28

2

Duphaston

Eformoterol

Capsule containing powder for oral inhalation containing eformoterol fumarate dihydrate 12 micrograms (for use in Foradile Aerolizer)

Inhalation by mouth

60

5

Foradile

 

Powder for oral inhalation in breath actuated device containing eformoterol fumarate dihydrate 6 micrograms per dose, 60 doses

Inhalation by mouth

1

5

Oxis Turbuhaler

 

Powder for oral inhalation in breath actuated device containing eformoterol fumarate dihydrate 12 micrograms per dose, 60 doses

Inhalation by mouth

1

5

Oxis Turbuhaler

Electrolyte Replacement, Oral

Oral rehydration salts containing glucose 3.56 g, sodium chloride 470 mg, potassium chloride 300 mg and sodium acid citrate 530 mg per sachet, 10

Oral

1

..

O.R.S.

Repalyte New Formulation

restore O.R.S.

 

 

 

 

 

Electrolyte Replacement, Solution

Electrolyte replacement solution containing sodium chloride 5.26 g, sodium acetate 3.68 g, sodium gluconate 5.02 g, potassium chloride 370 mg and magnesium chloride 300 mg per L, 1 L

Injection

2

1

Plasma-Lyte 148

Enalapril

Tablet containing enalapril maleate 5 mg

Oral

30

5

Alphapril

 

 

 

 

 

Auspril

 

 

 

 

 

Chem mart Enalapril

 

 

 

 

 

Enahexal

 

 

 

 

 

Enalabell

 

 

 

 

 

Enalapril-DP 5mg

 

 

 

 

 

Enalapril generichealth

 

 

 

 

 

Enalapril Winthrop

 

 

 

 

 

GenRx Enalapril

 

 

 

 

 

Renitec M

 

 

 

 

 

Terry White Chemists Enalapril

 

Tablet containing enalapril maleate 10 mg

Oral

30

5

Alphapril

 

 

 

 

 

Auspril

 

 

 

 

 

Chem mart Enalapril

 

 

 

 

 

Enahexal

 

 

 

 

 

Enalabell

 

 

 

 

 

Enalapril-DP 10mg

 

 

 

 

 

Enalapril generichealth

 

 

 

 

 

Enalapril Winthrop

 

 

 

 

 

GenRx Enalapril

 

 

 

 

 

Renitec

 

 

 

 

 

Terry White Chemists Enalapril

 

Tablet containing enalapril maleate 20 mg

Oral

30

5

Alphapril

 

 

 

 

 

Auspril

 

 

 

 

 

Chem mart Enalapril

 

 

 

 

 

Enahexal

 

 

 

 

 

Enalabell

 

 

 

 

 

Enalapril-DP 20mg

 

 

 

 

 

Enalapril generichealth

 

 

 

 

 

GenRx Enalapril

 

 

 

 

 

Renitec 20

 

 

 

 

 

Terry White Chemists Enalapril

Enalapril with Hydrochlorothiazide

Tablet containing enalapril maleate 20 mg with hydrochlorothiazide 6 mg

Oral

30

5

Enalapril/HCT Sandoz

 

 

 

 

 

Renitec Plus 20/6

Enoxaparin

Injection containing enoxaparin sodium 20 mg (2,000 I.U. anti-Xa) in 0.2 mL pre-filled syringe

Injection

20

..

Clexane

 

Injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL pre-filled syringe

Injection

20

..

Clexane

 

Solution for injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL

Injection

20

..

Clexane

 

Injection containing enoxaparin sodium 60 mg (6,000 I.U. anti-Xa) in 0.6 mL pre-filled syringe

Injection

10

1

Clexane

 

Injection containing enoxaparin sodium 80 mg (8,000 I.U. anti-Xa) in 0.8 mL pre-filled syringe

Injection

10

1

Clexane

 

Injection containing enoxaparin sodium 100 mg (10,000 I.U. anti-Xa) in 1 mL pre-filled syringe

Injection

10

1

Clexane

Entacapone

Tablet 200 mg

Oral

200

4

Comtan

Epirubicin

Solution for injection containing epirubicin hydrochloride 10 mg in 5 mL

Injection/intravesical

4

..

Epirubicin Ebewe

 

 

 

 

 

Pharmorubicin Solution

 

Solution for injection containing epirubicin hydrochloride 20 mg in 10 mL

Injection/intravesical

4

..

Pharmorubicin Solution

 

Solution for injection containing epirubicin hydrochloride 50 mg in 25 mL

Injection/intravesical

4

..

Epirubicin Ebewe

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Pharmorubicin Solution

 

Solution for injection containing epirubicin hydrochloride 100 mg in 50 mL

Injection/intravesical

2

..

Epirubicin Ebewe

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

 

 

Solution for injection containing epirubicin hydrochloride 200 mg in 100 mL

Injection/intravesical

1

..

Epirubicin Ebewe

Eplerenone

Tablet 25 mg

Oral

30

5

Inspra

 

Tablet 50 mg

Oral

30

5

Inspra

Eprosartan

Tablet 400 mg (as mesylate)

Oral

56

5

Teveten

 

Tablet 600 mg (as mesylate)

Oral

28

5

Teveten

Eprosartan with Hydrochlorothiazide

Tablet 600 mg eprosartan (as mesylate) with 12.5 mg hydrochlorothiazide

Oral

28

5

Teveten Plus 600/12.5

Eptifibatide

Solution for I.V. injection 20 mg (as acetate) in 10 mL

Injection

2

..

Integrilin

 

Solution for I.V. infusion 75 mg (as acetate) in 100 mL

Injection

3

..

Integrilin

Erlotinib

Tablet 25 mg (as hydrochloride)

Oral

30

3

Tarceva

 

Tablet 100 mg (as hydrochloride)

Oral

30

3

Tarceva

 

Tablet 150 mg (as hydrochloride)

Oral

30

3

Tarceva

Erythromycin

Tablet 400 mg (as ethyl succinate)

Oral

25

1

E.E.S. 400 Filmtab

 

 

 

 

 

E-Mycin

 

Capsule 250 mg (containing enteric coated pellets)

Oral

25

1

DBL Erythromycin

 

 

 

 

 

Eryc

 

Powder for oral liquid 200 mg (as ethyl succinate) per 5 mL, 100 mL

Oral

1

1

E.E.S. 200

 

 

 

 

 

E-Mycin 200

 

Powder for oral liquid 400 mg (as ethyl succinate) per 5 mL, 100 mL

Oral

1

1

E.E.S. Granules

 

 

 

 

 

E-Mycin 400

 

Powder for I.V. infusion 1 g (as lactobionate)

Injection

5

..

Erythrocin-I.V.

Escitalopram

Tablet 10 mg (as oxalate)

Oral

28

5

APO-Escitalopram

 

 

 

 

 

Chem mart Escitalopram

 

 

 

 

 

Esipram

 

 

 

 

 

Esitalo

 

 

 

 

 

Lexam 10

 

 

 

 

 

Lexapro

 

 

 

 

 

LoxaLate

 

 

 

 

 

Terry White Chemists Escitalopram

 

Tablet 20 mg (as oxalate)

Oral

28

5

APO-Escitalopram

 

 

 

 

 

Chem mart Escitalopram

 

 

 

 

 

Esipram

 

 

 

 

 

Esitalo

 

 

 

 

 

Lexam 20

 

 

 

 

 

Lexapro

 

 

 

 

 

LoxaLate

 

 

 

 

 

Terry White Chemists Escitalopram

 

Oral solution 10 mg (as oxalate) per mL, 28 mL

Oral

1

5

Lexapro

Esomeprazole

Tablet (enteric coated) 20 mg (as magnesium trihydrate)

Oral

30

1

Nexium

 

Tablet (enteric coated) 40 mg (as magnesium trihydrate)

Oral

30

1

Nexium

Esomeprazole and Clarithromycin and Amoxycillin

Pack containing 14 tablets (enteric coated) containing esomeprazole 20 mg (as magnesium trihydrate), 14 tablets clarithromycin 500 mg and 28 capsules amoxycillin 500 mg (as trihydrate)

Oral

1

..

Nexium Hp7

Essential amino acids formula

Oral powder 200 g, 2 (Essential Amino Acid Mix)

Oral

3

5

Essential Amino Acid Mix

Essential amino acids formula with minerals and vitamin C

Oral powder 400 g (Dialamine)

Oral

5

5

Dialamine

Essential amino acids formula with vitamins and minerals

Sachets containing oral powder 12.5 g, 50 (EAA Supplement)

Oral

4

5

EAA Supplement

Etanercept

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

Injection

2

3

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

Injection

1

3

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

Injection

1

3

Enbrel

Ethacrynic Acid

Tablet 25 mg

Oral

200

1

Edecrin

Ethosuximide

Capsule 250 mg

Oral

200

2

Zarontin

 

Oral solution 250 mg per 5 mL, 200 mL

Oral

1

5

Zarontin

Etidronic Acid

Tablet containing disodium etidronate 200 mg

Oral

60

5

Didronel

Etidronic Acid and Calcium

Pack containing 28 tablets disodium etidronate 200 mg and 76 tablets calcium 500 mg (as carbonate)

Oral

1

1

Didrocal

Etonogestrel

Subcutaneous implant 68 mg

Implantation

1

..

Implanon

Etoposide

Capsule 50 mg

Oral

20

..

Vepesid

 

Capsule 100 mg

Oral

10

..

Vepesid

 

Solution for I.V. infusion 100 mg in 5 mL vial

Injection

5

..

Etoposide Ebewe

 

 

 

 

 

Hospira Pty Limited

 

Powder for I.V. infusion 100 mg (as phosphate)

Injection

5

..

Etopophos

 

Powder for I.V. infusion 1 g (as phosphate)

Injection

1

..

Etopophos

Everolimus

Tablet 0.25 mg

Oral

60

3

Certican

 

Tablet 0.5 mg

Oral

60

3

Certican

 

Tablet 0.75 mg

Oral

120

3

Certican

 

Tablet 1 mg

Oral

120

3

Certican

Exemestane

Tablet 25 mg

Oral

30

5

Aromasin

Ezetimibe

Tablet 10 mg

Oral

30

5

Ezetrol

Ezetimibe with Simvastatin

Tablet 10 mg-10 mg

Oral

30

5

Vytorin

 

Tablet 10 mg-20 mg

Oral

30

5

Vytorin

 

Tablet 10 mg-40 mg

Oral

30

5

Vytorin

 

Tablet 10 mg-80 mg

Oral

30

5

Vytorin

Famciclovir

Tablet 125 mg

Oral

40

1

Ezovir

 

 

 

 

 

Famvir

 

 

 

 

 

Favic 125

 

Tablet 250 mg

Oral

20

1

Ezovir

 

 

 

 

 

Famciclovir Sandoz

 

 

 

 

 

Famvir

 

 

 

 

 

Favic 250

 

Tablet 500 mg

Oral

30

..

Famvir

 

 

 

 

 

Favic 500

Famotidine

Tablet 20 mg

Oral

60

5

Ausfam 20

 

 

 

 

 

Chem mart Famotidine

 

 

 

 

 

Famohexal

 

 

 

 

 

GenRx Famotidine

 

 

 

 

 

Pamacid 20

 

 

 

 

 

Pepcidine M

 

 

 

 

 

Pepzan

 

 

 

 

 

Terry White Chemists Famotidine

 

Tablet 40 mg

Oral

30

5

Ausfam 40

 

 

 

 

 

Chem mart Famotidine

 

 

 

 

 

Famotidine Sandoz

 

 

 

 

 

GenRx Famotidine

 

 

 

 

 

Pamacid 40

 

 

 

 

 

Pepcidine

 

 

 

 

 

Pepzan

 

 

 

 

 

Terry White Chemists Famotidine

Felodipine

Tablet 2.5 mg (extended release)

Oral

30

5

Felodur ER 2.5 mg

 

 

 

 

 

Plendil ER

 

Tablet 5 mg (extended release)

Oral

30

5

Felodil XR 5

 

 

 

 

 

Felodur ER 5 mg

 

 

 

 

 

Plendil ER

 

Tablet 10 mg (extended release)

Oral

30

5

Felodil XR 10

 

 

 

 

 

Felodur ER 10 mg

 

 

 

 

 

Plendil ER

Fenofibrate

Tablet 48 mg

Oral

60

5

Lipidil

 

Tablet 145 mg

Oral

30

5

Lipidil

Fentanyl

Transdermal patch 2.1 mg

Transdermal

5

..

Durogesic 12

 

Transdermal patch 4.2 mg

Transdermal

5

..

Durogesic 25

 

Transdermal patch 8.4 mg

Transdermal

5

..

Durogesic 50

 

Transdermal patch 12.6 mg

Transdermal

5

..

Durogesic 75

 

Transdermal patch 16.8 mg

Transdermal

5

..

Durogesic 100

Ferrous Fumarate with Folic Acid

Tablet 310 mg (equivalent to 100 mg iron)-350 micrograms

Oral

60

1

Ferro-f-tab

Ferrous Sulfate

Oral liquid 30 mg per mL, 250 mL

Oral

1

2

Ferro-Liquid

Flecainide

Tablet containing flecainide acetate 50 mg

Oral

60

5

Tambocor

 

Tablet containing flecainide acetate 100 mg

Oral

60

5

Flecatab

 

 

 

 

 

Tambocor

Flucloxacillin

Capsule 250 mg (as sodium)

Oral

24

..

Flopen

 

 

 

 

 

Staphylex 250

 

Capsule 500 mg (as sodium)

Oral

24

..

Flopen

 

 

 

 

 

Staphylex 500

 

Powder for oral liquid 125 mg (as sodium) per 5 mL, 100 mL

Oral

1

..

Aspen Pharmacare Australia Pty Limited

 

Powder for oral liquid 250 mg (as sodium) per 5 mL, 100 mL

Oral

1

..

Aspen Pharmacare Australia Pty Limited

 

Powder for injection 500 mg (as sodium)

Injection

5

..

Flubiclox

 

 

 

 

 

Flucil

 

Powder for injection 1 g (as sodium)

Injection

5

1

Flubiclox

 

 

 

 

 

Flucil

 

 

 

 

 

Hospira Pty Limited

Fluconazole

Capsule 50 mg

Oral

28

5

DBL Fluconazole

 

 

 

 

 

Diflucan

 

 

 

 

 

Dizole 50

 

 

 

 

 

Fluconazole Sandoz

 

 

 

 

 

Fluzole 50

 

 

 

 

 

Ozole

 

Capsule 100 mg

Oral

28

5

DBL Fluconazole

 

 

 

 

 

Diflucan

 

 

 

 

 

Dizole 100

 

 

 

 

 

Fluconazole Sandoz

 

 

 

 

 

Fluconazole Winthrop

 

 

 

 

 

Ozole

 

Capsule 200 mg

Oral

28

5

APO-Fluconazole

 

 

 

 

 

DBL Fluconazole

 

 

 

 

 

Diflucan

 

 

 

 

 

Dizole 200

 

 

 

 

 

Fluconazole Sandoz

 

 

 

 

 

Fluconazole Winthrop

 

 

 

 

 

Fluzole 200

 

 

 

 

 

Ozole

 

Solution for I.V. infusion 100 mg in 50 mL

Injection

7

..

Diflucan

 

 

 

 

 

Fluconazole Hexal

 

Solution for I.V. infusion 200 mg in 100 mL

Injection

7

..

Baxter Healthcare Pty Ltd

 

 

 

 

 

Diflucan

 

 

 

 

 

Fluconazole Hexal

 

Solution for I.V. infusion 400 mg in 200 mL

Injection

1

..

Baxter Healthcare Pty Ltd

Fludarabine

Tablet containing fludarabine phosphate 10 mg

Oral

20

5

Fludara

 

Powder for I.V. injection containing fludarabine phosphate 50 mg

Injection

5

3

Farine

 

 

 

 

 

Fludara

 

 

 

 

 

Fludarabine Actavis

 

Solution for I.V. injection 50 mg fludarabine phosphate in 2 mL

Injection

5

3

Fludarabine Ebewe

Fludrocortisone

Tablet containing fludrocortisone acetate 100 micrograms

Oral

200

1

Florinef

Fluorometholone

Eye drops 1 mg per mL, 5 mL

Application to the eye

1

5

Flucon

 

 

 

 

 

FML Liquifilm

 

Eye drops containing fluorometholone acetate 1 mg per mL, 5 mL

Application to the eye

1

2

Flarex

Fluorouracil

Injection 500 mg in 10 mL

Injection

10

..

Fluorouracil Ebewe

 

 

 

 

 

Hospira Pty Limited

 

Injection 1000 mg in 20 mL

Injection

5

..

Fluorouracil Ebewe

Fluoxetine

Tablet, dispersible, 20 mg (as hydrochloride)

Oral

28

5

Lovan 20 Tab

 

 

 

 

 

Prozac Tab

 

Capsule 20 mg (as hydrochloride)

Oral

28

5

Auscap

 

 

 

 

 

Chem mart Fluoxetine

 

 

 

 

 

Fluohexal

 

 

 

 

 

Fluoxebell

 

 

 

 

 

Fluoxetine 20

 

 

 

 

 

Fluoxetine-GA

 

 

 

 

 

Fluoxetine generichealth

 

 

 

 

 

GenRx Fluoxetine

 

 

 

 

 

Lovan

 

 

 

 

 

Prozac 20

 

 

 

 

 

Terry White Chemists Fluoxetine

 

 

 

 

 

Zactin

Flupenthixol Decanoate

Oily I.M. injection 20 mg in 1 mL ampoule

Injection

5

..

Fluanxol Depot

 

Oily I.M. injection 40 mg in 2 mL ampoule

Injection

5

..

Fluanxol Depot

 

Oily I.M. injection 100 mg in 1 mL ampoule

Injection

5

..

Fluanxol Concentrated Depot

Fluphenazine Decanoate

Injection 12.5 mg in 0.5 mL ampoule

Injection

5

..

Modecate

 

Injection 25 mg in 1 mL ampoule

Injection

5

..

Modecate

 

Injection 50 mg in 2 mL ampoule

Injection

5

..

Modecate

Flurbiprofen

Eye drops containing flurbiprofen sodium 300 micrograms per mL, single dose units 0.4 mL, 5

Application to the eye

1

..

Ocufen

Flutamide

Tablet 250 mg

Oral

100

5

Eulexin

 

 

 

 

 

Flutamin

Fluticasone

Pressurised inhalation containing fluticasone propionate 50 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

Flixotide Junior

 

Pressurised inhalation containing fluticasone propionate 125 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

Flixotide

 

Pressurised inhalation containing fluticasone propionate 250 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

1

Flixotide

 

Powder for oral inhalation in breath actuated device containing fluticasone propionate 100 micrograms per dose, 60 doses

Inhalation by mouth

1

5

Flixotide Junior Accuhaler

 

Powder for oral inhalation in breath actuated device containing fluticasone propionate 250 micrograms per dose, 60 doses

Inhalation by mouth

1

5

Flixotide Accuhaler

 

Powder for oral inhalation in breath actuated device containing fluticasone propionate 500 micrograms per dose, 60 doses

Inhalation by mouth

1

1

Flixotide Accuhaler

Fluticasone with Salmeterol

Pressurised inhalation containing fluticasone propionate 50 micrograms with salmeterol 25 micrograms (as xinafoate) per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

Seretide MDI 50/25

 

Pressurised inhalation containing fluticasone propionate 125 micrograms with salmeterol 25 micrograms (as xinafoate) per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

Seretide MDI 125/25

 

Powder for oral inhalation in breath actuated device containing fluticasone propionate 100 micrograms with salmeterol 50 micrograms (as xinafoate) per dose, 60 doses

Inhalation by mouth

1

5

Seretide Accuhaler 100/50

 

Powder for oral inhalation in breath actuated device containing fluticasone propionate 250 micrograms with salmeterol 50 micrograms (as xinafoate) per dose, 60 doses

Inhalation by mouth

1

5

Seretide Accuhaler 250/50

 

Pressurised inhalation containing fluticasone propionate 250 micrograms with salmeterol 25 micrograms (as xinafoate) per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

Seretide MDI 250/25

 

Powder for oral inhalation in breath actuated device containing fluticasone propionate 500 micrograms with salmeterol 50 micrograms (as xinafoate) per dose, 60 doses

Inhalation by mouth

1

5

Seretide Accuhaler 500/50

Fluvastatin

Capsule 20 mg (as sodium)

Oral

28

5

Lescol

 

 

 

 

 

Vastin

 

Capsule 40 mg (as sodium)

Oral

28

5

Lescol

 

 

 

 

 

Vastin

 

Tablet (prolonged release) 80 mg (as sodium)

Oral

28

5

Lescol XL

Fluvoxamine

Tablet containing fluvoxamine maleate 50 mg

Oral

30

5

APO-Fluvoxamine

 

 

 

 

 

Faverin 50

 

 

 

 

 

Luvox

 

 

 

 

 

Movox 50

 

 

 

 

 

Voxam

 

Tablet containing fluvoxamine maleate 100 mg

Oral

30

5

APO-Fluvoxamine

 

 

 

 

 

Faverin 100

 

 

 

 

 

Luvox

 

 

 

 

 

Movox 100

 

 

 

 

 

Voxam

Folic Acid

Tablet 500 micrograms

Oral

200

..

Megafol 0.5

 

Tablet 5 mg

Oral

200

1

Megafol 5

Folinic acid

Tablet containing calcium folinate equivalent to 15 mg folinic acid

Oral

10

..

Leucovorin Calcium (Hospira Pty Limited)

 

Injection containing calcium folinate equivalent to 50 mg folinic acid in 5 mL

Injection

5

5

Calcium Folinate Ebewe

 

 

 

 

 

Leucovorin Calcium (Hospira Pty Limited)

 

 

 

 

 

Leucovorin Calcium (Pfizer Australia Pty Ltd)

 

Injection containing calcium folinate equivalent to 100 mg folinic acid in 10 mL

Injection

10

1

Calcium Folinate Ebewe

 

 

 

 

 

Leucovorin Calcium (Pfizer Australia Pty Ltd)

 

Injection containing calcium folinate equivalent to 300 mg folinic acid in 30 mL

Injection

4

1

Leucovorin Calcium (Hospira Pty Limited)

Follitropin Alfa

Injection 300 I.U. in 0.5 mL multi-dose cartridge

Injection

3

5

Gonal-f Pen

 

Injection 450 I.U. in 0.75 mL multi-dose cartridge

Injection

3

5

Gonal-f Pen

 

Injection 900 I.U. in 1.5 mL multi-dose cartridge

Injection

2

5

Gonal-f Pen

Follitropin Beta

Solution for injection 300 I.U. in 0.36 mL multi-dose cartridge

Injection

3

5

Puregon 300 IU/0.36 mL

 

Solution for injection 600 I.U. in 0.72 mL multi-dose cartridge

Injection

2

5

Puregon 600 IU/0.72 mL

 

Solution for injection 900 I.U. in 1.08 mL multi-dose cartridge

Injection

2

5

Puregon 900 IU/1.08 mL

Fondaparinux

Injection containing fondaparinux sodium 2.5 mg in 0.5 mL single dose pre-filled syringe

Injection

7

..

Arixtra

Fosinopril

Tablet containing fosinopril sodium 10 mg

Oral

30

5

Fosinopril Sandoz

 

 

 

 

 

Fosipril 10

 

 

 

 

 

GenRx Fosinopril

 

 

 

 

 

Monace 10

 

 

 

 

 

Monopril

 

Tablet containing fosinopril sodium 20 mg

Oral

30

5

Fosinopril Sandoz

 

 

 

 

 

Fosipril 20

 

 

 

 

 

GenRx Fosinopril

 

 

 

 

 

Monace 20

 

 

 

 

 

Monopril

Fosinopril with Hydrochlorothiazide

Tablet containing fosinopril sodium 10 mg with hydrochlorothiazide 12.5 mg

Oral

30

5

APO-Fosinopril HCTZ 10/12.5

 

 

 

 

 

Fosinopril/HCT Sandoz 10mg/12.5mg

 

 

 

 

 

Hyforil

 

 

 

 

 

Monoplus 10/12.5

 

Tablet containing fosinopril sodium 20 mg with hydrochlorothiazide 12.5 mg

Oral

30

5

APO-Fosinopril HCTZ 20/12.5

 

 

 

 

 

Fosetic 20/12.5

 

 

 

 

 

Fosinopril/HCT Sandoz 20mg/12.5mg

 

 

 

 

 

Hyforil

 

 

 

 

 

Monoplus 20/12.5

Fotemustine

Powder for injection 208 mg with solvent

Injection

1

4

Muphoran

Framycetin

Eye or ear drops containing framycetin sulfate 5 mg per mL, 8 mL

Application to the eye/ear

1

2

Soframycin

Frusemide

Tablet 20 mg

Oral

100

1

Chem mart Frusemide

 

 

 

 

 

Frusid

 

 

 

 

 

GenRx Frusemide

 

 

 

 

 

Lasix-M

 

 

 

 

 

Terry White Chemists Frusemide

 

 

 

 

 

Urex-M

 

Tablet 40 mg

Oral

100

1

Chem mart Frusemide

 

 

 

 

 

Frusehexal 40 mg

 

 

 

 

 

Frusid

 

 

 

 

 

GenRx Frusemide

 

 

 

 

 

Lasix

 

 

 

 

 

Terry White Chemists Frusemide

 

 

 

 

 

Uremide

 

 

 

 

 

Urex

 

Tablet 500 mg

Oral

50

3

Urex-Forte

 

Oral solution 10 mg per mL, 30 mL

Oral

1

3

Lasix

 

Injection 20 mg in 2 mL

Injection

5

..

Frusehexal

 

 

 

 

 

Frusemide-Claris

 

 

 

 

 

Lasix

Fusidic Acid

Tablet containing sodium fusidate 250 mg

Oral

36

1

Fucidin

Gabapentin

Capsule 100 mg

Oral

100

5

APO-Gabapentin

 

 

 

 

 

DBL Gabapentin

 

 

 

 

 

Gabatine 100

 

 

 

 

 

Gantin

 

 

 

 

 

Neurontin

 

 

 

 

 

Nupentin 100

 

Capsule 300 mg

Oral

100

5

DBL Gabapentin

 

 

 

 

 

Gabapentin 300

 

 

 

 

 

Gabapentin-GA

 

 

 

 

 

Gabapentin Sandoz

 

 

 

 

 

Gabatine 300

 

 

 

 

 

Gantin

 

 

 

 

 

GenRx Gabapentin

 

 

 

 

 

Neurontin

 

 

 

 

 

Nupentin 300

 

Capsule 400 mg

Oral

100

5

DBL Gabapentin

 

 

 

 

 

Douglas Gabapentin 400mg

 

 

 

 

 

Gabapentin 400

 

 

 

 

 

Gabapentin Sandoz

 

 

 

 

 

Gabatine 400

 

 

 

 

 

Gantin

 

 

 

 

 

GenRx Gabapentin

 

 

 

 

 

Neurontin

 

 

 

 

 

Nupentin 400

 

Tablet 600 mg

Oral

100

5

Gabahexal 600mg

 

 

 

 

 

Gabaran

 

 

 

 

 

Gabatine 600

 

 

 

 

 

GenRx Gabapentin

 

 

 

 

 

Neurontin

 

Tablet 800 mg

Oral

100

5

Gabaran

 

 

 

 

 

Gabatine 800

 

 

 

 

 

Gantin

 

 

 

 

 

GenRx Gabapentin

 

 

 

 

 

Neurontin

 

 

 

 

 

Pendine 800

Galantamine

Capsule (prolonged release) 8 mg (as hydrobromide)

Oral

28

5

Reminyl

 

Capsule (prolonged release) 16 mg (as hydrobromide)

Oral

28

5

Reminyl

 

Capsule (prolonged release) 24 mg (as hydrobromide)

Oral

28

5

Reminyl

Gefitinib

Tablet 250 mg

Oral

30

1

Iressa

Gelatin - Succinylated

I.V. infusion 20 g per 500 mL, 500 mL

Injection

3

..

Gelofusine

Gemcitabine

Powder for I.V. infusion 200 mg (as hydrochloride)

Injection

4

2

DBL Gemcitabine for Injection

 

 

 

 

 

Gemcitabine Actavis

 

 

 

 

 

Gemcitabine Ebewe

 

 

 

 

 

Gemcite

 

 

 

 

 

Gemzar

 

Solution concentrate for I.V. infusion 200 mg (as hydrochloride) in 20 mL

Injection

4

2

Gemcitabine Ebewe

 

Solution concentrate for I.V. infusion 500 mg (as hydrochloride) in 50 mL

Injection

4

2

Gemcitabine Ebewe

 

Powder for I.V. infusion 1 g (as hydrochloride)

Injection

2

2

DBL Gemcitabine for Injection

 

 

 

 

 

Gemcitabine Actavis

 

 

 

 

 

Gemcitabine Ebewe

 

 

 

 

 

Gemcite

 

 

 

 

 

Gemzar

 

Solution concentrate for I.V. infusion 1000 mg (as hydrochloride) in 100 mL

Injection

2

2

Gemcitabine Ebewe

 

Powder for I.V. infusion 2 g (as hydrochloride)

Injection

1

2

DBL Gemcitabine for Injection

Gemfibrozil

Tablet 600 mg

Oral

60

5

Ausgem

 

 

 

 

 

Chem mart Gemfibrozil

 

 

 

 

 

Gemhexal

 

 

 

 

 

GenRx Gemfibrozil

 

 

 

 

 

Jezil

 

 

 

 

 

Lipazil 600 mg

 

 

 

 

 

Lipigem

 

 

 

 

 

Lopid

 

 

 

 

 

Pharmacor Gemfibrozil 600

 

 

 

 

 

Terry White Chemists Gemfibrozil

Gentamicin

Injection 80 mg (as sulfate) in 2 mL

Injection

10

1

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

 

Eye drops 3 mg (as sulfate) per mL, 5 mL

Application to the eye

1

2

Genoptic

Gestrinone

Capsule 2.5 mg

Oral

8

5

Dimetriose

Glatiramer

Injection containing glatiramer acetate 20 mg in 1 mL single dose pre-filled syringe

Injection

28

5

Copaxone

Glibenclamide

Tablet 5 mg

Oral

100

5

Daonil

 

 

 

 

 

Glimel

Gliclazide

Tablet 30 mg (modified release)

Oral

100

5

APO-Gliclazide MR

 

 

 

 

 

Chem mart Gliclazide MR

 

 

 

 

 

Glyade MR

 

 

 

 

 

Oziclide MR

 

 

 

 

 

Terry White Chemists Gliclazide MR

 

Tablet 60 mg (modified release)

Oral

60

5

Diamicron 60mg MR

 

Tablet 80 mg

Oral

100

5

Chem mart Gliclazide

 

 

 

 

 

GenRx Gliclazide

 

 

 

 

 

Glyade

 

 

 

 

 

Mellihexal

 

 

 

 

 

Nidem

 

 

 

 

 

Terry White Chemists Gliclazide

Glimepiride

Tablet 1 mg

Oral

30

5

Amaryl

 

 

 

 

 

APO-Glimepiride

 

 

 

 

 

Aylide 1

 

 

 

 

 

Diapride 1

 

 

 

 

 

Dimirel

 

 

 

 

 

Glimepiride Sandoz

 

Tablet 2 mg

Oral

30

5

Amaryl

 

 

 

 

 

APO-Glimepiride

 

 

 

 

 

Aylide 2

 

 

 

 

 

Diapride 2

 

 

 

 

 

Dimirel

 

 

 

 

 

Glimepiride Sandoz

 

Tablet 3 mg

Oral

30

5

Amaryl

 

 

 

 

 

APO-Glimepiride

 

 

 

 

 

Aylide 3

 

 

 

 

 

Diapride 3

 

 

 

 

 

Dimirel

 

 

 

 

 

Glimepiride Sandoz

 

Tablet 4 mg

Oral

30

5

Amaryl

 

 

 

 

 

APO-Glimepiride

 

 

 

 

 

Aylide 4

 

 

 

 

 

Diapride 4

 

 

 

 

 

Dimirel

 

 

 

 

 

Glimepiride Sandoz

Glipizide

Tablet 5 mg

Oral

100

5

Melizide

 

 

 

 

 

Minidiab

Glucagon

Injection set containing glucagon hydrochloride 1 mg (1 I.U.) and 1 mL solvent in disposable syringe

Injection

1

1

GlucaGen Hypokit

Glucose

I.V. infusion 69.5 mmol (anhydrous) per 250 mL, 250 mL

Injection

5

1

B. Braun Australia Pty Ltd

 

 

 

 

 

Glucose 5% Freeflex

 

I.V. infusion 139 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

1

B. Braun Australia Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

 

I.V. infusion 278 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

1

Fresenius Kabi Australia Pty Limited

 

I.V. infusion 278 mmol (anhydrous) per L, 1 L

Injection

5

1

B. Braun Australia Pty Ltd

 

 

 

 

 

Baxter Healthcare Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

Glucose and Ketone Indicator—Urine

Test strips, 50 (Keto-Diabur-Test 5000)

For external use

2

2

Keto-Diabur- Test 5000

 

Test strips, 50 (Keto-Diastix)

For external use

2

2

Keto-Diastix

Glucose Indicator—Blood

Test strips, 25 (On-Call Plus)

For external use

4

5

On-Call Plus

 

Test strips, 50 (Accu-Chek Go)

For external use

2

5

Accu-Chek Go

 

Test strips, 51 (Accu-Chek Integra)

For external use

2

5

Accu-Chek Integra

 

Test strips, 50 (Advantage II)

For external use

2

5

Advantage II

 

Test strips, 50 (Betachek)

For external use

2

5

Betachek

 

Test strips, 50 (Betachek G5)

For external use

2

5

Betachek G5

 

Test strips, 50 (Bionime Rightest)

For external use

2

5

Bionime Rightest

 

Test strips, 50 (CareSens)

For external use

2

5

CareSens

 

Test strips, 50 (CareSens N)

For external use

2

5

CareSens N

 

Test strips, 50 (FreeStyle)

For external use

2

5

FreeStyle

 

Test strips, 50 (Freestyle Papillon)

For external use

2

5

Freestyle Papillon

 

Test strips, 50 (Glucocard 01 Sensor)

For external use

2

5

Glucocard 01 Sensor

 

Test strips, 50 (Glucoflex-R)

For external use

2

5

Glucoflex-R

 

Test strips, 50 (GlucoOz)

For external use

2

5

GlucoOz

 

Test strips, 50 (Glucostix)

For external use

2

5

Glucostix

 

Test strips, 50 (Lifeline Attest)

For external use

2

5

Lifeline Attest

 

Test strips, 50 (MWD Pen Sensor Strips)

For external use

2

5

MWD Pen Sensor Strips

 

Test strips, 50 (MyGlucoHealth)

For external use

2

5

MyGlucoHealth

 

Test strips, 50 (Omnitest EZ)

For external use

2

5

Omnitest EZ

 

Test strips, 50 (Omnitest Plus)

For external use

2

5

Omnitest Plus

 

Test strips, 50 (Optium Omega)

For external use

2

5

Optium Omega

 

Test strips, 50 (SensoCard)

For external use

2

5

SensoCard

 

Test strips, 50 (TrueTrack)

For external use

2

5

TrueTrack

 

Test strips, 50 (WaveSense Jazz)

For external use

2

5

WaveSense Jazz

 

Test strips, 100 (Accu-Chek Active)

For external use

1

5

Accu-Chek Active

 

Test strips, 100 (Accu-Chek Mobile)

For external use

1

5

Accu-Chek Mobile

 

Test strips, 100 (Accu-Chek Performa)

For external use

1

5

Accu-Chek Performa

 

Test strips, 100 (FreeStyle Lite)

For external use

1

5

FreeStyle Lite

 

Test strips, 100 (Optium glucose)

For external use

1

5

Optium glucose

Glucose Indicator—Urine

Test strips, 50 (Clinistix)

For external use

2

2

Clinistix

 

Test strips, 50 (Diastix)

For external use

2

2

Diastix

Glycerol

Suppositories 700 mg, 12

Rectal

3

5

Petrus Pharmaceuticals Pty Ltd

 

Suppositories 1.4 g, 12

Rectal

3

5

Petrus Pharmaceuticals Pty Ltd

 

Suppositories 2.8 g, 12

Rectal

3

5

Petrus Pharmaceuticals Pty Ltd

Glyceryl Trinitrate

Tablets 600 micrograms, 100

Buccal/sublingual

1

5

Anginine Stabilised

 

 

 

 

 

Lycinate

 

Sublingual spray (pump pack) 400 micrograms per dose, 200 doses

Sublingual

1

5

Nitrolingual Pumpspray

 

Transdermal patch 18 mg

Transdermal

30

5

Minitran 5

 

Transdermal patch 25 mg

Transdermal

30

5

Transiderm-Nitro 25

 

Transdermal patch 40 mg

Transdermal

30

5

Nitro-Dur 5

 

Transdermal patch 36 mg

Transdermal

30

5

Minitran 10

 

Transdermal patch 50 mg

Transdermal

30

5

Transiderm-Nitro 50

 

Transdermal patch 80 mg

Transdermal

30

5

Nitro-Dur 10

 

Transdermal patch 54 mg

Transdermal

30

5

Minitran 15

 

Transdermal patch 120 mg

Transdermal

30

5

Nitro-Dur 15

Goserelin

Subcutaneous implant 3.6 mg (as acetate) in pre-filled injection syringe

Implantation

1

5

Zoladex Implant

 

Subcutaneous implant (long acting) 10.8 mg (as acetate) in pre-filled injection syringe

Implantation

1

1

Zoladex 10.8 Implant

Goserelin and Bicalutamide

Pack containing 1 subcutaneous implant containing goserelin 3.6 mg (as acetate) in pre-filled injection syringe and 28 tablets bicalutamide 50 mg

Implantation/oral

1

5

ZolaCos CP 3.6/50

 

Pack containing 1 subcutaneous implant containing goserelin 10.8 mg (as acetate) in pre-filled injection syringe and 28 tablets bicalutamide 50 mg

Implantation/oral

1

..

ZolaCos CP 10.8/50(28)

 

Pack containing 1 subcutaneous implant containing goserelin 10.8 mg (as acetate) in pre-filled injection syringe and 84 tablets bicalutamide 50 mg

Implantation/oral

1

1

ZolaCos CP 10.8/50(84)

Granisetron

Tablet 2 mg (as hydrochloride)

Oral

2

..

Kytril

 

Concentrated injection 3 mg (as hydrochloride) in 3 mL

Injection

1

..

Kytril

Griseofulvin

Tablet 125 mg

Oral

100

2

Grisovin

 

Tablet 500 mg

Oral

28

2

Grisovin 500

Haloperidol

Tablet 500 micrograms

Oral

100

5

Serenace

 

Tablet 1.5 mg

Oral

100

5

Serenace

 

Tablet 5 mg

Oral

50

5

Serenace

 

Oral solution 2 mg per mL, 100 mL

Oral

1

5

Serenace

 

Injection 5 mg in 1 mL

Injection

10

..

Serenace

Haloperidol Decanoate

I.M. injection equivalent to 50 mg haloperidol in 1 mL ampoule

Injection

5

..

Haldol decanoate

 

I.M. injection equivalent to 150 mg haloperidol in 3 mL ampoule

Injection

5

..

Haldol decanoate

Heparin

Injection 5,000 units (as sodium) in 0.2 mL

Injection

5

5

Hospira Pty Limited

 

Injection (preservative-free) 5,000 I.U. (as sodium) in 5 mL

Injection

50

5

Pfizer Australia Pty Ltd

 

Injection 35,000 units (as sodium) in 35 mL

Injection

12

5

Hospira Pty Limited

Hexamine

Tablet containing hexamine hippurate 1 g

Oral

100

5

Hiprex

High fat formula with vitamins, minerals and trace elements and low in protein and carbohydrate

Oral powder 300 g (KetoCal)

Oral

24

5

KetoCal

Homatropine

Eye drops containing homatropine hydrobromide 20 mg per mL, 15 mL

Application to the eye

1

2

Isopto Homatropine

Hydralazine

Tablet containing hydralazine hydrochloride 25 mg

Oral

200

2

Alphapress 25

 

Tablet containing hydralazine hydrochloride 50 mg

Oral

200

2

Alphapress 50

Hydrochlorothiazide

Tablet 25 mg

Oral

100

1

Dithiazide

Hydrochlorothiazide with Amiloride

Tablet containing hydrochlorothiazide 50 mg with amiloride hydrochloride 5 mg

Oral

100

1

Moduretic

Hydrochlorothiazide with Triamterene

Tablet 25 mg-50 mg

Oral

100

1

Hydrene 25/50

Hydrocortisone

Tablet 4 mg

Oral

50

4

Hysone 4

 

Tablet 20 mg

Oral

60

4

Hysone 20

 

Injection 100 mg (as sodium succinate) with 2 mL solvent

Injection

2

..

Solu-Cortef

 

Injection 250 mg (as sodium succinate) with 2 mL solvent

Injection

1

..

Solu-Cortef

 

Eye ointment containing hydrocortisone acetate 5 mg per g, 5 g

Application to the eye

1

..

Hycor

 

Eye ointment containing hydrocortisone acetate 10 mg per g, 5 g

Application to the eye

1

..

Hycor

 

Cream containing hydrocortisone acetate 10 mg per g, 30 g

Application

1

1

Cortic-DS 1%

 

 

 

 

 

Sigmacort

 

Cream containing hydrocortisone acetate 10 mg per g, 50 g

Application

1

1

Cortef

 

 

 

 

 

Cortic-DS 1%

 

 

 

 

 

Sigmacort

 

Ointment containing hydrocortisone acetate 10 mg per g, 30 g

Application

1

1

Cortic-DS 1%

 

 

 

 

 

Sigmacort

 

Ointment containing hydrocortisone acetate 10 mg per g, 50 g

Application

1

1

Cortic-DS 1%

 

 

 

 

 

Sigmacort

 

Rectal foam containing hydrocortisone acetate 90 mg per applicatorful, 14 applications, aerosol 21.1 g

Rectal

2

3

Colifoam

Hydromorphone

Tablet containing hydromorphone hydrochloride 2 mg

Oral

20

..

Dilaudid

 

Tablet containing hydromorphone hydrochloride 4 mg

Oral

20

..

Dilaudid

 

Tablet containing hydromorphone hydrochloride 8 mg

Oral

20

..

Dilaudid

 

 

 

 

 

 

 

Tablet (modified release) containing hydromorphone hydrochloride 4 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 8 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 16 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 32 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 64 mg

Oral

10

..

Jurnista

 

Oral liquid containing hydromorphone hydrochloride 1 mg per mL, 473 mL

Oral

1

..

Dilaudid

 

Injection containing hydromorphone hydrochloride 2 mg in 1 mL

Injection

5

..

Dilaudid

 

Injection containing hydromorphone hydrochloride 10 mg in 1 mL

Injection

5

..

Dilaudid-HP

 

Injection containing hydromorphone hydrochloride 50 mg in 5 mL

Injection

5

..

Dilaudid-HP

 

Injection containing hydromorphone hydrochloride 500 mg in 50 mL

Injection

1

..

Dilaudid-HP

Hydroxocobalamin

Injection 1 mg in 1 mL

Injection

3

..

Neo-B12

Hydroxychloroquine

Tablet containing hydroxychloroquine sulfate 200 mg

Oral

100

1

Plaquenil

Hydroxyethyl starch 130/0.4

I.V. infusion 30 g per 500 mL, 500 mL

Injection

3

..

Voluven 6%

Hydroxyurea

Capsule 500 mg

Oral

100

..

Hydrea

Hypromellose

Eye drops 3 mg per mL, 15 mL

Application to the eye

1

5

Genteal

 

 

 

 

 

In a Wink Moisturising

 

Eye drops 5 mg per mL, 15 mL

Application to the eye

1

5

Methopt

Hypromellose with Carbomer 980

Ocular lubricating gel 3 mg-2 mg per g, 10 g

Application to the eye

1

5

Genteal gel

 

 

 

 

 

HPMC PAA

Hypromellose with Dextran

Eye drops containing 3 mg hypromellose 4500 with 1 mg dextran 70 per mL, 15 mL

Application to the eye

1

5

Poly-Tears

 

 

 

 

 

Tears Naturale

 

Eye drops containing 3 mg hypromellose 2900 with 1 mg dextran 70 per mL, single dose units 0.4 mL, 28

Application to the eye

3

5

Bion Tears

Ibandronic acid

Tablet 50 mg (as ibandronate sodium monohydrate)

Oral

28

2

Bondronat

Ibuprofen

Tablet 400 mg

Oral

30

..

Brufen

Idarubicin

Capsule containing idarubicin hydrochloride 5 mg

Oral

3

..

Zavedos

 

Capsule containing idarubicin hydrochloride 10 mg

Oral

3

..

Zavedos

 

Solution for I.V. injection containing idarubicin hydrochloride 5 mg in 5 mL single use vial

Injection

3

..

Zavedos Solution

 

Solution for I.V. injection containing idarubicin hydrochloride 10 mg in 10 mL single use vial

Injection

6

..

Zavedos Solution

Ifosfamide

Powder for I.V. injection 1 g in single dose vial

Injection

5

5

Holoxan

 

Powder for I.V. injection 2 g in single dose vial

Injection

5

5

Holoxan

Imatinib

Tablet 100 mg (as mesylate)

Oral

60

2

Glivec

 

Tablet 400 mg (as mesylate)

Oral

30

2

Glivec

Imipramine

Tablet containing imipramine hydrochloride 10 mg

Oral

50

2

Tofranil 10

 

 

 

 

 

Tolerade 10

 

Tablet containing imipramine hydrochloride 25 mg

Oral

50

2

Tofranil 25

 

 

 

 

 

Tolerade 25

Imiquimod

Cream 50 mg per g, 250 mg single use sachets, 12

Application

1

1

Aldara

Indapamide

Tablet containing indapamide hemihydrate 1.5 mg (sustained release)

Oral

90

1

Natrilix SR

 

Tablet containing indapamide hemihydrate 2.5 mg

Oral

90

1

Chem mart Indapamide

 

 

 

 

 

Dapa-Tabs

 

 

 

 

 

GenRx Indapamide

 

 

 

 

 

Indahexal

 

 

 

 

 

Indapamide-GA

 

 

 

 

 

Insig

 

 

 

 

 

Natrilix

 

 

 

 

 

Terry White Chemists Indapamide

Indomethacin

Capsule 25 mg

Oral

100

3

Arthrexin

 

 

 

 

 

Indocid

 

Suppository 100 mg

Rectal

40

3

Indocid

Insect Allergen Extract—Honey Bee Venom

Injection set containing 550 micrograms

Injection

1

..

Albey Bee Venom

Insect Allergen Extract—Paper Wasp Venom

Injection set containing 550 micrograms

Injection

1

..

Albey Paper Wasp Venom

Insect Allergen Extract—Yellow Jacket Venom

Injection set containing 550 micrograms

Injection

1

..

Albey Yellow Jacket Venom

Insulin Aspart

Injection (human analogue) 100 units per mL, 10 mL vial

Injection

5

2

NovoRapid

 

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

NovoRapid FlexPen

NovoRapid Penfill 3 mL

Insulin Aspart with Insulin Aspart Protamine Suspension

Injections (human analogue), cartridges, 30 units-70 units per mL, 3 mL, 5

Injection

5

1

NovoMix 30 FlexPen

NovoMix 30 Penfill 3 mL

Insulin Detemir

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

Levemir FlexPen

 

 

 

 

 

Levemir Penfill

Insulin Glargine

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

Lantus

 

 

 

 

 

Lantus SoloStar

Insulin Glulisine

Injection (human analogue) 100 units per mL, 10 mL

Injection

5

2

Apidra

 

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

Apidra SoloStar

Insulin Isophane

Injection (bovine) 100 units per mL, 10 mL

Injection

5

2

Hypurin Isophane

 

Injection (human) 100 units per mL, 10 mL

Injection

5

2

Humulin NPH

 

 

 

 

 

Protaphane

 

Injections (human), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

Humulin NPH

 

 

 

 

 

Protaphane InnoLet

 

 

 

 

 

Protaphane NovoLet 3 mL

 

 

 

 

 

Protaphane Penfill 3 mL

Insulin Lispro

Injection (human analogue) 100 units per mL, 10 mL vial

Injection

5

2

Humalog

 

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

Humalog

 

 

 

 

 

Humalog KwikPen

Insulin Lispro with Insulin Lispro Protamine Suspension

Injections (human analogue), cartridges, 25 units-75 units per mL, 3 mL, 5

Injection

5

1

Humalog Mix25

 

 

 

 

 

Humalog Mix25 KwikPen

 

Injections (human analogue), cartridges, 50 units-50 units per mL, 3 mL, 5

Injection

5

1

Humalog Mix50

 

 

 

 

 

Humalog Mix50 KwikPen

Insulin Neutral

Injection (bovine) 100 units per mL, 10 mL

Injection

5

2

Hypurin Neutral

 

Injection (human) 100 units per mL, 10 mL

Injection

5

2

Actrapid

 

 

 

 

 

Humulin R

 

Injections (human), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

Actrapid Penfill 3 mL

 

 

 

 

 

Humulin R

Insulin Neutral with Insulin Isophane

Injection (human) 30 units-70 units per mL, 10 mL

Injection

5

2

Humulin 30/70

 

Injections (human), cartridges, 30 units-70 units per mL, 3 mL, 5

Injection

5

1

Humulin 30/70

 

 

 

 

 

Mixtard 30/70 InnoLet

 

 

 

 

 

Mixtard 30/70 Penfill 3 mL

 

Injections (human), cartridges, 50 units-50 units per mL, 3 mL, 5

Injection

5

1

Mixtard 50/50 Penfill 3 mL

Interferon Alfa-2a

Injection 3,000,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

15

4

Roferon-A

 

Injection 4,500,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

5

4

Roferon-A

 

Injection 6,000,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

5

4

Roferon-A

 

Injection 9,000,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

5

4

Roferon-A

Interferon Alfa-2b

Solution for injection 18,000,000 I.U. in 1.2 mL multi-dose injection pen

Injection

3

4

Intron A Redipen

 

Solution for injection 30,000,000 I.U. in 1.2 mL multi-dose injection pen

Injection

3

5

Intron A Redipen

Interferon Beta-1a

Injection set comprising 1 vial powder for injection 30 micrograms (6,000,000 I.U.) with diluent

Injection

4

5

Avonex

 

Injection 30 micrograms (6,000,000 I.U.) in 0.5 mL single dose pre-filled syringe

Injection

4

5

Avonex

 

Injection 44 micrograms (12,000,000 I.U.) in 0.5 mL single dose pre-filled syringe

Injection

12

5

Rebif 44

 

Solution for injection 132 micrograms in 1.5 mL multidose cartridge

Injection

4

5

Rebif 44

Interferon Beta-1b

Injection set including 1 vial powder for injection 8,000,000 I.U. (250 micrograms) and solvent

Injection

15

5

Betaferon

Ipratropium

Pressurised inhalation containing ipratropium bromide 21 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

2

5

Atrovent

 

Nebuliser solution containing ipratropium bromide 250 micrograms (anhydrous) in 1 mL single dose units, 30

Inhalation

2

5

Aeron 250

 

 

 

 

 

APO-Ipratropium

 

 

 

 

 

Atrovent

 

 

 

 

 

Ipratrin

 

 

 

 

 

Ipravent

 

Nebuliser solution containing ipratropium bromide 500 micrograms (anhydrous) in 1 mL single dose units, 30

Inhalation

2

5

Aeron 500

 

 

 

 

 

APO-Ipratropium

 

 

 

 

 

Atrovent Adult

 

 

 

 

 

Ipratrin Adult

 

 

 

 

 

Ipravent

Irbesartan

Tablet 75 mg

Oral

30

5

Avapro

 

 

 

 

 

Karvea

 

Tablet 150 mg

Oral

30

5

Avapro

 

 

 

 

 

Karvea

 

Tablet 300 mg

Oral

30

5

Avapro

 

 

 

 

 

Karvea

Irbesartan with Hydrochlorothiazide

Tablet 150 mg-12.5 mg

Oral

30

5

Avapro HCT 150/12.5

 

 

 

 

 

Karvezide 150/12.5

 

Tablet 300 mg-12.5 mg

Oral

30

5

Avapro HCT 300/12.5

 

 

 

 

 

Karvezide 300/12.5

 

Tablet 300 mg-25 mg

Oral

30

5

Avapro HCT 300/25

 

 

 

 

 

Karvezide 300/25

Irinotecan

I.V. injection containing irinotecan hydrochloride trihydrate 40 mg in 2 mL

Injection

1

3

Camptosar

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Irinotecan Actavis

 

 

 

 

 

Irinotecan Alphapharm

 

 

 

 

 

Irinotecan Ebewe

 

 

 

 

 

Irinotecan Sandoz

 

 

 

 

 

Omegapharm Irinotecan

 

 

 

 

 

Tecan

 

I.V. injection containing irinotecan hydrochloride trihydrate 100 mg in 5 mL

Injection

2

3

Camptosar

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Irinotecan Actavis

 

 

 

 

 

Irinotecan Alphapharm

 

 

 

 

 

Irinotecan Ebewe

 

 

 

 

 

Irinotecan Sandoz

 

 

 

 

 

Omegapharm Irinotecan

 

 

 

 

 

Tecan

 

I.V. injection containing irinotecan hydrochloride trihydrate 300 mg in 15 mL

Injection

1

3

Camptosar

 

 

 

 

 

Irinotecan Ebewe

 

I.V. injection containing irinotecan hydrochloride trihydrate 500 mg in 25 mL

Injection

1

3

Hospira Pty Limited

 

 

 

 

 

Irinotecan Ebewe

Iron Polymaltose Complex

Injection 100 mg (iron) in 2 mL ampoule

Injection

5

..

Ferrosig

 

 

 

 

 

Ferrum H

Iron Sucrose

Concentrate for solution for infusion 2.7 g (equivalent to 100 mg iron (III)) in 5 mL ampoule

Injection

5

..

Venofer

Isoleucine with carbohydrate

Sachets of oral powder 4 g containing 50 mg isoleucine, 30 (Isoleucine Amino Acid Supplement)

Oral

4

5

Isoleucine Amino Acid Supplement

 

Sachets of oral powder 4 g containing 1 g isoleucine, 30 (Isoleucine 1000 Amino Acid Supplement)

Oral

4

5

Isoleucine 1000 Amino Acid Supplement

Isoniazid

Tablet 100 mg

Oral

100

2

Fawns and McAllan Proprietary Limited

Isosorbide Dinitrate

Tablet 10 mg

Oral

200

2

Sorbidin

 

Tablet 5 mg (sublingual)

Oral

200

2

Isordil Sublingual

Isosorbide Mononitrate

Tablet 60 mg (sustained release)

Oral

30

5

Chem mart Isosorbide Mononitrate

 

 

 

 

 

Duride

 

 

 

 

 

GenRx Isosorbide Mononitrate

 

 

 

 

 

Imdur Durule

 

 

 

 

 

Imtrate 60 mg

 

 

 

 

 

Isomonit

 

 

 

 

 

Monodur 60 mg

 

 

 

 

 

Terry White Chemists Isosorbide Mononitrate

 

Tablet 120 mg (sustained release)

Oral

30

5

Imdur 120 mg

 

 

 

 

 

Monodur 120 mg

Isotretinoin

Capsule 10 mg

Oral

60

3

Oratane

 

 

 

 

 

Roaccutane

 

Capsule 20 mg

Oral

60

3

GenRx Isotretinoin

 

 

 

 

 

Oratane

 

 

 

 

 

Roaccutane

 

Capsule 40 mg

Oral

30

3

Oratane

Itraconazole

Capsule 100 mg

Oral

60

5

Sporanox

Ivermectin

Tablet 3 mg

Oral

4

..

Stromectol

Ketoconazole

Tablet 200 mg

Oral

10

..

Nizoral

 

Cream 20 mg per g, 30 g

Application

1

2

Nizoral 2% Cream

 

Shampoo 10 mg per g, 100 mL

Application

1

1

Nizoral 1%

 

Shampoo 20 mg per g, 60 mL

Application

1

1

Nizoral 2%

Ketoprofen

Capsule 200 mg (sustained release)

Oral

28

3

Orudis SR 200

 

 

 

 

 

Oruvail SR

 

Suppository 100 mg

Rectal

40

3

Orudis

Labetalol

Tablet containing labetalol hydrochloride 100 mg

Oral

100

5

Presolol 100

 

 

 

 

 

Trandate

 

Tablet containing labetalol hydrochloride 200 mg

Oral

100

5

Presolol 200

 

 

 

 

 

Trandate

Lacosamide

Tablet 50 mg

Oral

14

1

Vimpat

 

Tablets 100 mg, 14

Oral

1

1

Vimpat

 

Tablet 100 mg

Oral

56

5

Vimpat

 

Tablets 150 mg, 14

Oral

1

1

Vimpat

 

Tablet 150 mg

Oral

56

5

Vimpat

 

Tablet 200 mg

Oral

56

5

Vimpat

Lactulose

Solution BP 3.34 g per 5 mL, 500 mL

Oral

1

5

Actilax

 

 

 

 

 

Duphalac

 

 

 

 

 

Genlac

 

 

 

 

 

GenRx Lactulose

 

 

 

 

 

Lac-Dol

 

 

 

 

 

Lactocur

Lamotrigine

Tablet 5 mg

Oral

56

5

Lamictal

 

 

 

 

 

Lamogine

 

 

 

 

 

Seaze 5

 

Tablet 25 mg

Oral

56

5

GenRx Lamotrigine

 

 

 

 

 

Lamictal

 

 

 

 

 

Lamidus

 

 

 

 

 

Lamogine

 

 

 

 

 

Lamotrigine-DP

 

 

 

 

 

Lamotrigine-GA

 

 

 

 

 

Lamotrigine generichealth

 

 

 

 

 

Lamotrigine Sandoz

 

 

 

 

 

Lamotrust 25

 

 

 

 

 

Seaze 25

 

Tablet 50 mg

Oral

56

5

GenRx Lamotrigine

 

 

 

 

 

Lamictal

 

 

 

 

 

Lamidus

 

 

 

 

 

Lamogine

 

 

 

 

 

Lamotrigine-DP

 

 

 

 

 

Lamotrigine-GA

 

 

 

 

 

Lamotrigine generichealth

 

 

 

 

 

Lamotrigine Sandoz

 

 

 

 

 

Lamotrust 50

 

 

 

 

 

Seaze 50

 

Tablet 100 mg

Oral

56

5

GenRx Lamotrigine

 

 

 

 

 

Lamictal

 

 

 

 

 

Lamidus

 

 

 

 

 

Lamogine

 

 

 

 

 

Lamotrigine-DP

 

 

 

 

 

Lamotrigine-GA

 

 

 

 

 

Lamotrigine generichealth

 

 

 

 

 

Lamotrigine Sandoz

 

 

 

 

 

Lamotrust 100

 

 

 

 

 

Seaze 100

 

Tablet 200 mg

Oral

56

5

APO-Lamotrigine

 

 

 

 

 

GenRx Lamotrigine

 

 

 

 

 

Lamictal

 

 

 

 

 

Lamidus

 

 

 

 

 

Lamogine

 

 

 

 

 

Lamotrigine-DP

 

 

 

 

 

Lamotrigine-GA

 

 

 

 

 

Lamotrigine generichealth

 

 

 

 

 

Lamotrigine Sandoz

 

 

 

 

 

Lamotrust 200

 

 

 

 

 

Seaze 200

Lansoprazole

Tablet 30 mg (orally disintegrating)

Oral

28

1

Zoton FasTabs

 

Capsule 30 mg

Oral

28

1

APO-Lansoprazole

 

 

 

 

 

Lanzopran

 

 

 

 

 

Zopral

 

Tablet 15 mg (orally disintegrating)

Oral

28

5

Zoton FasTabs

 

Capsule 15 mg

Oral

30

5

Zopral

Lanthanum

Tablet, chewable, 500 mg (as carbonate hydrate)

Oral

90

5

Fosrenol

 

Tablet, chewable, 750 mg (as carbonate hydrate)

Oral

90

5

Fosrenol

 

Tablet, chewable, 1000 mg (as carbonate hydrate)

Oral

90

5

Fosrenol

Lapatinib

Tablet 250 mg (as ditosylate monohydrate)

Oral

140

2

Tykerb

Latanoprost

Eye drops 50 micrograms per mL, 2.5 mL

Application to the eye

1

5

Xalatan

Latanoprost with Timolol

Eye drops 50 micrograms latanoprost with timolol 5 mg (as maleate) per mL, 2.5 mL

Application to the eye

1

5

Xalacom

Leflunomide

Pack containing 3 tablets leflunomide 100 mg and 30 tablets leflunomide 20 mg

Oral

1

..

Arava

 

Tablet 10 mg

Oral

30

5

Arabloc

 

 

 

 

 

Arava

 

Tablet 20 mg

Oral

30

5

Arabloc

 

 

 

 

 

Arava

Lercanidipine

Tablet containing lercanidipine hydrochloride 10 mg

Oral

28

5

Zanidip

 

Tablet containing lercanidipine hydrochloride 20 mg

Oral

28

5

Zanidip

Lercanidipine with enalapril

Tablet containing lercanidipine hydrochloride 10 mg with enalapril maleate 10 mg

Oral

28

5

Zan-Extra 10/10

 

Tablet containing lercanidipine hydrochloride 10 mg with enalapril maleate 20 mg

Oral

28

5

Zan-Extra 10/20

Letrozole

Tablet 2.5 mg

Oral

30

5

Femara 2.5 mg

Leuprorelin

I.M. injection (modified release), powder for injection containing leuprorelin acetate 7.5 mg with diluent in pre-filled dual-chamber syringe

Injection

1

5

Lucrin Depot 7.5mg PDS

 

Suspension for subcutaneous injection (modified release) containing leuprorelin acetate 7.5 mg, injection set

Injection

1

5

Eligard 1 month

 

I.M. injection (modified release), powder for injection containing leuprorelin acetate 22.5 mg with diluent in pre-filled dual-chamber syringe

Injection

1

1

Lucrin Depot 3 Month PDS

 

Suspension for subcutaneous injection (modified release) containing leuprorelin acetate 22.5 mg, injection set

Injection

1

1

Eligard 3 month

 

I.M. injection (modified release), powder for injection containing leuprorelin acetate 30 mg with diluent in pre-filled dual-chamber syringe

Injection

1

1

Lucrin Depot 4 Month PDS

 

Suspension for subcutaneous injection (modified release) containing leuprorelin acetate 30 mg, injection set

Injection

1

1

Eligard 4 month

 

Suspension for subcutaneous injection (modified release) containing leuprorelin acetate 45 mg, injection set

Injection

1

..

Eligard 6 month

Levetiracetam

Tablet 250 mg

Oral

60

5

APO-Levetiracetam

 

 

 

 

 

Chem mart Levetiracetam

 

 

 

 

 

Kepcet

 

 

 

 

 

Keppra

 

 

 

 

 

Kevtam

 

 

 

 

 

Levitam 250

 

 

 

 

 

Terry White Chemists Levetiracetam

 

Tablet 500 mg

Oral

60

5

APO-Levetiracetam

 

 

 

 

 

Chem mart Levetiracetam

 

 

 

 

 

Kepcet

 

 

 

 

 

Keppra

 

 

 

 

 

Kevtam

 

 

 

 

 

Levitam 500

 

 

 

 

 

Terry White Chemists Levetiracetam

 

Tablet 1 g

Oral

60

5

APO-Levetiracetam

 

 

 

 

 

Chem mart Levetiracetam

 

 

 

 

 

Kepcet

 

 

 

 

 

Keppra

 

 

 

 

 

Kevtam

 

 

 

 

 

Levitam 1000

 

 

 

 

 

Terry White Chemists Levetiracetam

 

Oral solution 100 mg per mL, 300 mL

Oral

1

5

Keppra

Levodopa with Benserazide

Dispersible tablet containing levodopa 50 mg with 12.5 mg benserazide (as hydrochloride)

Oral

100

5

Madopar Rapid 62.5

 

Dispersible tablet containing levodopa 100 mg with 25 mg benserazide (as hydrochloride)

Oral

100

5

Madopar Rapid 125

 

Tablet containing levodopa 100 mg with 25 mg benserazide (as hydrochloride)

Oral

100

5

Madopar 125

 

Tablet containing levodopa 200 mg with 50 mg benserazide (as hydrochloride)

Oral

100

5

Madopar

 

Capsule containing levodopa 50 mg with 12.5 mg benserazide (as hydrochloride)

Oral

100

5

Madopar 62.5

 

Capsule containing levodopa 100 mg with 25 mg benserazide (as hydrochloride)

Oral

100

5

Madopar 125

 

Capsule containing levodopa 100 mg with 25 mg benserazide (as hydrochloride) (sustained release)

Oral

100

5

Madopar HBS

 

Capsule containing levodopa 200 mg with 50 mg benserazide (as hydrochloride)

Oral

100

5

Madopar

Levodopa with Carbidopa

Tablet 200 mg-50 mg (anhydrous) (modified release)

Oral

100

5

Sinemet CR

 

Tablet 100 mg-25 mg (anhydrous)

Oral

100

5

Kinson

 

 

 

 

 

Sinemet 100/25

 

Tablet 250 mg-25 mg (anhydrous)

Oral

100

5

Levohexal

 

 

 

 

 

Sinemet

Levodopa with Carbidopa and Entacapone

Tablet 50 mg-12.5 mg-200 mg

Oral

200

4

Stalevo 50/12.5/200mg

 

Tablet 75 mg-18.75 mg-200 mg

Oral

200

4

Stalevo 75/18.75/200mg

 

Tablet 100 mg-25 mg-200 mg

Oral

200

4

Stalevo 100/25/200mg

 

Tablet 125 mg-31.25 mg-200 mg

Oral

200

4

Stalevo 125/31.25/200mg

 

Tablet 150 mg-37.5 mg-200 mg

Oral

200

4

Stalevo 150/37.5/200mg

 

Tablet 200 mg-50 mg-200 mg

Oral

200

4

Stalevo 200/50/200mg

Levonorgestrel

Tablets 30 micrograms, 28

Oral

4

2

Microlut 28

 

Intrauterine drug delivery system 52 mg

Intrauterine

1

..

Mirena

Levonorgestrel with Ethinyloestradiol

Pack containing 21 tablets 125 micrograms-50 micrograms and 7 inert tablets

Oral

4

2

Microgynon 50 ED

 

Tablets 150 micrograms-30 micrograms, 21

Oral

4

2

Microgynon 30

 

Pack containing 21 tablets 150 micrograms-30 micrograms and 7 inert tablets

Oral

4

2

Levlen ED

 

 

 

 

 

Microgynon 30 ED

 

 

 

 

 

Monofeme 28

 

 

 

 

 

Nordette 28

 

Pack containing 6 tablets 50 micrograms-30 micrograms, 5 tablets 75 micrograms-40 micrograms, 10 tablets 125 micrograms-30 micrograms and 7 inert tablets

Oral

4

2

Logynon ED

Trifeme 28

Triphasil 28

Triquilar ED

Lignocaine

Injection containing lignocaine hydrochloride 100 mg in 5 mL

Injection

5

..

Pfizer Australia Pty Ltd

 

Infusion containing lignocaine hydrochloride 500 mg in 5 mL

Injection

10

..

Xylocard 500

Lincomycin

Injection 600 mg (as hydrochloride) in 2 mL

Injection

5

..

Lincocin

Liothyronine

Tablet containing liothyronine sodium 20 micrograms

Oral

100

2

Tertroxin

Lisinopril

Tablet 5 mg

Oral

30

5

APO-Lisinopril

 

 

 

 

 

Chem mart Lisinopril

 

 

 

 

 

Fibsol 5

 

 

 

 

 

GenRx Lisinopril

 

 

 

 

 

Liprace

 

 

 

 

 

Lisinobell

 

 

 

 

 

Lisinopril 5

 

 

 

 

 

Lisinopril-DRLA

 

 

 

 

 

Lisinopril-GA

 

 

 

 

 

Lisinopril generichealth

 

 

 

 

 

Lisinopril Ranbaxy

 

 

 

 

 

Lisinopril-Sandoz

 

 

 

 

 

Lisinopril Winthrop

 

 

 

 

 

Lisodur

 

 

 

 

 

Prinivil 5

 

 

 

 

 

Terry White Chemists Lisinopril

 

 

 

 

 

Zestril

 

Tablet 10 mg

Oral

30

5

APO-Lisinopril

 

 

 

 

 

Chem mart Lisinopril

 

 

 

 

 

Fibsol 10

 

 

 

 

 

GenRx Lisinopril

 

 

 

 

 

Liprace

 

 

 

 

 

Lisinobell

 

 

 

 

 

Lisinopril 10

 

 

 

 

 

Lisinopril-DRLA

 

 

 

 

 

Lisinopril-GA

 

 

 

 

 

Lisinopril generichealth

 

 

 

 

 

Lisinopril Hexal

 

 

 

 

 

Lisinopril Ranbaxy

 

 

 

 

 

Lisinopril Winthrop

 

 

 

 

 

Lisodur

 

 

 

 

 

Prinivil 10

 

 

 

 

 

Terry White Chemists Lisinopril

 

 

 

 

 

Zestril

 

Tablet 20 mg

Oral

30

5

APO-Lisinopril

 

 

 

 

 

Chem mart Lisinopril

 

 

 

 

 

Fibsol 20

 

 

 

 

 

GenRx Lisinopril

 

 

 

 

 

Liprace

 

 

 

 

 

Lisinobell

 

 

 

 

 

Lisinopril 20

 

 

 

 

 

Lisinopril-DRLA

 

 

 

 

 

Lisinopril-GA

 

 

 

 

 

Lisinopril generichealth

 

 

 

 

 

Lisinopril Ranbaxy

 

 

 

 

 

Lisinopril Sandoz

 

 

 

 

 

Lisinopril Winthrop

 

 

 

 

 

Lisodur

 

 

 

 

 

Prinivil 20

 

 

 

 

 

Terry White Chemists Lisinopril

 

 

 

 

 

Zestril

Lithium

Tablet containing lithium carbonate 250 mg

Oral

200

2

Lithicarb

 

Tablet containing lithium carbonate 450 mg (slow release)

Oral

200

2

Quilonum SR

Loperamide

Capsule containing loperamide hydrochloride 2 mg

Oral

12

..

Gastro-Stop Loperamide

 

 

 

 

 

Imodium

Macrogol 3350

Sachets containing powder for oral solution 6.563 g with electrolytes, 30

Oral

1

5

Movicol-Half

 

Sachets containing powder for oral solution 13.125 g with electrolytes, 30

Oral

1

5

Movicol

Medroxyprogesterone

Tablet containing medroxyprogesterone acetate 500 mg

Oral

30

2

Provera

 

Tablet containing medroxyprogesterone acetate 100 mg

Oral

100

2

Provera

 

Tablet containing medroxyprogesterone acetate 200 mg

Oral

60

2

Provera

 

Tablet containing medroxyprogesterone acetate 250 mg

Oral

60

2

Provera

 

Tablet containing medroxyprogesterone acetate 5 mg

Oral

56

2

Provera

 

 

 

 

 

Ralovera

 

Tablet containing medroxyprogesterone acetate 10 mg

Oral

30

2

Medroxyhexal

 

 

 

 

 

Provera

 

 

 

 

 

Ralovera

 

Injection containing medroxyprogesterone acetate 150 mg in 1 mL

Injection

1

1

Depo-Provera

Depo-Ralovera

Mefenamic Acid

Capsule 250 mg

Oral

50

2

Ponstan

Megestrol

Tablet containing megestrol acetate 160 mg

Oral

30

2

Megace

Meloxicam

Tablet 7.5 mg

Oral

30

3

Chem mart Meloxicam 7.5 mg

 

 

 

 

 

GenRx Meloxicam

 

 

 

 

 

Meloxibell

 

 

 

 

 

Meloxicam-GA

 

 

 

 

 

Meloxicam Ranbaxy

 

 

 

 

 

Meloxicam Sandoz

 

 

 

 

 

Meloxicam Winthrop

 

 

 

 

 

Mobic

 

 

 

 

 

Movalis 7.5

 

 

 

 

 

Moxicam 7.5

 

 

 

 

 

Pharmacor Meloxicam 7.5

 

 

 

 

 

Terry White Chemists Meloxicam 7.5 mg

 

Tablet 15 mg

Oral

30

3

Chem mart Meloxicam 15 mg

 

 

 

 

 

GenRx Meloxicam

 

 

 

 

 

Meloxibell

 

 

 

 

 

Meloxicam-GA

 

 

 

 

 

Meloxicam Ranbaxy

 

 

 

 

 

Meloxicam Sandoz

 

 

 

 

 

Meloxicam Winthrop

 

 

 

 

 

Mobic

 

 

 

 

 

Movalis 15

 

 

 

 

 

Moxicam 15

 

 

 

 

 

Pharmacor Meloxicam 15

 

 

 

 

 

Terry White Chemists Meloxicam 15 mg

 

Capsule 7.5 mg

Oral

30

3

Mobic

 

 

 

 

 

Movalis 7.5

 

Capsule 15 mg

Oral

30

3

Mobic

 

 

 

 

 

Movalis 15

Melphalan

Tablet 2 mg

Oral

25

1

Alkeran

Memantine

Tablet containing memantine hydrochloride 10 mg

Oral

56

5

Ebixa

 

 

 

 

 

Memanxa

 

Tablet containing memantine hydrochloride 20 mg

Oral

28

5

Ebixa

 

Oral drops containing memantine hydrochloride 10 mg per g, 50 g

Oral

1

5

Ebixa

Mercaptopurine

Tablet 50 mg

Oral

100

2

Purinethol

Mesalazine

Tablet 250 mg (enteric coated)

Oral

100

5

Mesasal

 

Tablet 500 mg (enteric coated)

Oral

200

5

Salofalk

 

Tablet 500 mg (prolonged release)

Oral

200

5

Pentasa

 

Tablet 1.2 g (prolonged release)

Oral

60

5

Mezavant

 

Sachet containing prolonged release granules, 1 g per sachet

Oral

100

5

Pentasa

 

Sachet containing prolonged release granules, 2 g per sachet

Oral

60

5

Pentasa

 

Sachet containing granules, 500 mg per sachet

Oral

200

5

Salofalk

 

Sachet containing granules, 1 g per sachet

Oral

100

5

Salofalk

 

Sachet containing granules, 1.5 g per sachet

Oral

60

5

Salofalk

 

Suppository 1 g

Rectal

28

1

Pentasa

 

Enemas 1 g in 100 mL, 7

Rectal

4

1

Pentasa

 

Enemas 2 g in 60 mL, 7

Rectal

4

1

Salofalk

 

Enemas 4 g in 60 mL, 7

Rectal

4

1

Salofalk

 

Rectal foam 1 g per applicatorful, 14 applications, aerosol 80 g

Rectal

4

1

Salofalk

Mesna

Solution for I.V. injection 400 mg in 4 mL ampoule

Injection

15

5

Uromitexan

 

Solution for I.V. injection 1 g in 10 mL ampoule

Injection

15

5

Uromitexan

Metformin

Tablet containing metformin hydrochloride 500 mg

Oral

100

5

Ascent Pharmaceuticals Limited

 

 

 

 

 

Chem mart Metformin

 

 

 

 

 

Diabex

 

 

 

 

 

Diaformin

 

 

 

 

 

Formet 500

 

 

 

 

 

GenRx Metformin

 

 

 

 

 

Glucohexal

 

 

 

 

 

Glucophage

 

 

 

 

 

Metforbell

 

 

 

 

 

Metformin 500

 

 

 

 

 

Metformin-GA

 

 

 

 

 

Metformin generichealth

 

 

 

 

 

Metformin Ranbaxy

 

 

 

 

 

Terry White Chemists Metformin

 

Tablet (extended release) containing metformin hydrochloride 500 mg

Oral

120

5

Diabex XR

 

 

 

 

 

Diaformin XR

 

 

 

 

 

Metex XR

 

Tablet containing metformin hydrochloride 850 mg

Oral

60

5

Ascent Pharmaceuticals Limited

 

 

 

 

 

Chem mart Metformin

 

 

 

 

 

Diabex 850

 

 

 

 

 

Diaformin 850

 

 

 

 

 

Formet 850

 

 

 

 

 

GenRx Metformin

 

 

 

 

 

Glucohexal

 

 

 

 

 

Glucophage

 

 

 

 

 

Metforbell

 

 

 

 

 

Metformin 850

 

 

 

 

 

Metformin-GA

 

 

 

 

 

Metformin generichealth

 

 

 

 

 

Metformin Ranbaxy

 

 

 

 

 

Terry White Chemists Metformin

 

Tablet containing metformin hydrochloride 1 g

Oral

90

5

Diabex 1000

 

 

 

 

 

Diaformin 1000

 

 

 

 

 

Formet 1000

 

 

 

 

 

Glucohexal

 

 

 

 

 

Metformin-GA

Metformin with Glibenclamide

Tablet containing metformin hydrochloride 250 mg with glibenclamide 1.25 mg

Oral

90

5

Glucovance 250mg/1.25mg

 

Tablet containing metformin hydrochloride 500 mg with glibenclamide 2.5 mg

Oral

90

5

Glucovance 500mg/2.5mg

 

Tablet containing metformin hydrochloride 500 mg with glibenclamide 5 mg

Oral

90

5

Glucovance 500mg/5mg

Methadone

Tablet containing methadone hydrochloride 10 mg

Oral

20

..

Physeptone

 

Injection containing methadone hydrochloride 10 mg in 1 mL

Injection

5

..

Physeptone

Methotrexate

Tablet 2.5 mg

Oral

30

5

Hospira Pty Limited

 

 

 

 

 

Methoblastin

 

Tablet 10 mg

Oral

15

1

Methoblastin

 

Injection 5 mg in 2 mL vial

Injection

5

..

Hospira Pty Limited

 

Injection 50 mg in 2 mL vial

Injection

5

..

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

 

Solution concentrate for I.V. infusion 500 mg in 20 mL vial

Injection

1

..

Hospira Pty Limited

 

Solution concentrate for I.V. infusion 1000 mg in 10 mL vial

Injection

1

..

Hospira Pty Limited

 

 

 

 

 

Methotrexate Ebewe

 

Solution concentrate for I.V. infusion 5000 mg in 50 mL vial

Injection

1

..

Methotrexate Ebewe

Methyldopa

Tablet 250 mg

Oral

100

5

Aldomet

 

 

 

 

 

Hydopa

Methylphenidate

Tablet containing methylphenidate hydrochloride 10 mg

Oral

100

5

Ritalin 10

 

Tablet containing methylphenidate hydrochloride 18 mg (extended release)

Oral

30

5

Concerta

 

Tablet containing methylphenidate hydrochloride 27 mg (extended release)

Oral

30

5

Concerta

 

Tablet containing methylphenidate hydrochloride 36 mg (extended release)

Oral

30

5

Concerta

 

Tablet containing methylphenidate hydrochloride 54 mg (extended release)

Oral

30

5

Concerta

 

Capsule containing methylphenidate hydrochloride 20 mg (modified release)

Oral

30

5

Ritalin LA

 

Capsule containing methylphenidate hydrochloride 30 mg (modified release)

Oral

30

5

Ritalin LA

 

Capsule containing methylphenidate hydrochloride 40 mg (modified release)

Oral

30

5

Ritalin LA

Methylprednisolone

Injection containing methylprednisolone acetate 40 mg in 1 mL

Injection

5

..

Depo-Medrol

 

 

 

 

 

Depo-Nisolone

 

Powder for injection 40 mg (as sodium succinate) with diluent

Injection

5

..

Solu-Medrol

 

Powder for injection 1 g (as sodium succinate) with diluent

Injection

1

..

Solu-Medrol

 

Cream containing methylprednisolone aceponate 1 mg per g, 15 g

Application

1

..

Advantan

 

Ointment containing methylprednisolone aceponate 1 mg per g, 15 g

Application

1

..

Advantan

 

Fatty ointment containing methylprednisolone aceponate 1 mg per g, 15 g

Application

1

..

Advantan

 

Lotion containing methylprednisolone aceponate 1 mg per g, 20 g

Application

1

..

Advantan

Methysergide

Tablet 1 mg (as maleate)

Oral

100

2

Deseril

Metoclopramide

Tablet containing metoclopramide hydrochloride 10 mg

Oral

25

..

Maxolon

 

 

 

 

 

Pramin

 

Injection containing metoclopramide hydrochloride 10 mg in 2 mL

Injection

10

..

Maxolon

Metoprolol

Tablet containing metoprolol tartrate 50 mg

Oral

100

5

Betaloc

 

 

 

 

 

Chem mart Metoprolol

 

 

 

 

 

GenRx Metoprolol

 

 

 

 

 

Lopresor 50

 

 

 

 

 

Metohexal

 

 

 

 

 

Metrol 50

 

 

 

 

 

Minax 50

 

 

 

 

 

Terry White Chemists Metoprolol

 

Tablet containing metoprolol tartrate 100 mg

Oral

60

5

Betaloc

 

 

 

 

 

Chem mart Metoprolol

 

 

 

 

 

GenRx Metoprolol

 

 

 

 

 

Lopresor 100

 

 

 

 

 

Metohexal

 

 

 

 

 

Metrol 100

 

 

 

 

 

Minax 100

 

 

 

 

 

Terry White Chemists Metoprolol

Metoprolol succinate

Tablet 23.75 mg (controlled release)

Oral

15

..

Toprol-XL 23.75

 

Tablet 47.5 mg (controlled release)

Oral

30

5

Toprol-XL 47.5

 

Tablet 95 mg (controlled release)

Oral

30

5

Toprol-XL 95

 

Tablet 190 mg (controlled release)

Oral

30

5

Toprol-XL 190

Metronidazole

Tablet 200 mg

Oral

21

1

Flagyl

 

 

 

 

 

Metrogyl 200

 

 

 

 

 

Metronide 200

 

Tablet 400 mg

Oral

5

2

Metrogyl 400

 

Oral suspension containing metronidazole benzoate 320 mg per 5 mL, 100 mL

Oral

1

..

Flagyl S

 

I.V. infusion 500 mg in 100 mL

Injection

5

1

Baxter Healthcare Pty Ltd

 

 

 

 

 

DBL Metronidazole Intravenous Infusion

 

 

 

 

 

Metronidazole Sandoz

 

Suppositories 500 mg, 10

Rectal

1

..

Flagyl

Mexiletine

Capsule containing mexiletine hydrochloride 50 mg

Oral

100

5

Mexitil

 

Capsule containing mexiletine hydrochloride 200 mg

Oral

100

5

Mexitil

Mianserin

Tablet containing mianserin hydrochloride 10 mg

Oral

50

5

Lumin 10

 

 

 

 

 

Tolvon

 

Tablet containing mianserin hydrochloride 20 mg

Oral

50

5

Lumin 20

 

 

 

 

 

Tolvon

Miconazole

Cream containing miconazole nitrate 20 mg per g, 15 g

Application

2

3

Daktarin

 

Cream containing miconazole nitrate 20 mg per g, 30 g

Application

1

2

Daktarin

 

Cream containing miconazole nitrate 20 mg per g, 70 g

Application

1

1

Daktarin

 

Powder containing miconazole nitrate 20 mg per g, 30 g

Application

1

2

Daktarin

 

Tincture 20 mg per mL, 30 mL

Application

1

2

Daktarin

 

Lotion containing miconazole nitrate 20 mg per mL, 30 g

Application

1

2

Daktarin

Milk powder — lactose free formula

Oral powder 900 g (S-26 LF)

Oral

5

..

S-26 LF

 

Oral powder 900 g (Karicare De-Lact)

Oral

5

..

Karicare De-Lact

Milk powder — lactose modified

Oral powder 900 g (Digestelact)

Oral

3

1

Digestelact

Milk powder — synthetic

Low calcium oral powder 400 g (Locasol)

Oral

8

5

Locasol

Milk protein and fat formula with vitamins and minerals — carbohydrate free

Oral powder 225 g (Carbohydrate Free Mixture)

Oral

24

5

Carbohydrate Free Mixture

Minocycline

Tablet 50 mg (as hydrochloride)

Oral

60

5

Akamin 50

 

 

 

 

 

Minomycin-50

 

Capsule 100 mg (as hydrochloride)

Oral

11

..

Akamin 100

Minoxidil

Tablet 10 mg

Oral

100

5

Loniten

Mirtazapine

Tablet 15 mg

Oral

30

5

Axit 15

 

Tablet 15 mg (orally disintegrating)

Oral

30

5

Avanza SolTab

 

Tablet 30 mg

Oral

30

5

Avanza

 

 

 

 

 

Axit 30

 

 

 

 

 

Chem mart Mirtazapine

 

 

 

 

 

GenRx Mirtazapine

 

 

 

 

 

Mirtazapine-DP

 

 

 

 

 

Mirtazapine Sandoz

 

 

 

 

 

Mirtazon

 

 

 

 

 

Terry White Chemists Mirtazapine

 

Tablet 30 mg (orally disintegrating)

Oral

30

5

Avanza SolTab

 

Tablet 45 mg

Oral

30

5

APO-Mirtazapine

 

 

 

 

 

Avanza

 

 

 

 

 

Chem mart Mirtazapine

 

 

 

 

 

Mirtazapine Sandoz

 

 

 

 

 

Mirtazon

 

 

 

 

 

Terry White Chemists Mirtazapine

 

Tablet 45 mg (orally disintegrating)

Oral

30

5

Avanza SolTab

Misoprostol

Tablet 200 micrograms

Oral

120

2

Cytotec

Mitozantrone

Injection 10 mg (as hydrochloride) in 5 mL

Injection

1

..

Pfizer Australia Pty Ltd

 

Injection 20 mg (as hydrochloride) in 10 mL

Injection

1

..

Hospira Pty Limited

 

 

 

 

 

Mitozantrone Ebewe

 

 

 

 

 

Onkotrone

 

 

 

 

 

Pfizer Australia Pty Ltd

 

Injection 25 mg (as hydrochloride) in 12.5 mL

Injection

1

..

Onkotrone

 

 

 

 

 

Pfizer Australia Pty Ltd

Moclobemide

Tablet 150 mg

Oral

60

5

Amira 150

 

 

 

 

 

Aurorix

 

 

 

 

 

Chem mart Moclobemide

 

 

 

 

 

Clobemix

 

 

 

 

 

GenRx Moclobemide

 

 

 

 

 

Mohexal

 

 

 

 

 

Terry White Chemists Moclobemide

 

Tablet 300 mg

Oral

60

5

Amira 300

 

 

 

 

 

Aurorix 300 mg

 

 

 

 

 

Chem mart Moclobemide

 

 

 

 

 

Clobemix

 

 

 

 

 

GenRx Moclobemide

 

 

 

 

 

Maosig

 

 

 

 

 

Moclobemide Sandoz

 

 

 

 

 

Terry White Chemists Moclobemide

Modafinil

Tablet 100 mg

Oral

120

5

Modavigil

Mometasone

Cream containing mometasone furoate 1 mg per g, 15 g

Application

1

..

Elocon

 

 

 

 

 

Novasone

 

Ointment containing mometasone furoate 1 mg per g, 15 g

Application

1

..

Elocon

 

 

 

 

 

Novasone

 

Lotion containing mometasone furoate 1 mg per g, 30 mL

Application

1

..

Elocon

 

 

 

 

 

Novasone

Montelukast

Tablet, chewable, 4 mg (as sodium)

Oral

28

5

Singulair

 

Tablet, chewable, 5 mg (as sodium)

Oral

28

5

Singulair

Morphine

Tablet containing morphine sulfate 10 mg

Oral

20

..

Sevredol

 

Tablet containing morphine sulfate 20 mg

Oral

20

..

Sevredol

 

Tablet containing morphine sulfate 30 mg

Oral

20

..

Anamorph

 

Tablet containing morphine sulfate 5 mg (controlled release)

Oral

20

..

MS Contin

 

Tablet containing morphine sulfate 10 mg (controlled release)

Oral

20

..

Momex SR 10

 

 

 

 

 

MS Contin

 

Tablet containing morphine sulfate 15 mg (controlled release)

Oral

20

..

MS Contin

 

Tablet containing morphine sulfate 30 mg (controlled release)

Oral

20

..

Momex SR 30

 

 

 

 

 

MS Contin

 

Tablet containing morphine sulfate 60 mg (controlled release)

Oral

20

..

Momex SR 60

 

 

 

 

 

MS Contin

 

Tablet containing morphine sulfate 100 mg (controlled release)

Oral

20

..

Momex SR 100

 

 

 

 

 

MS Contin

 

Tablet containing morphine sulfate 200 mg (controlled release)

Oral

20

..

MS Contin

 

Capsule containing morphine sulfate 10 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 20 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 30 mg (controlled release)

Oral

10

..

MS Mono

 

Capsule containing morphine sulfate 50 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 60 mg (controlled release)

Oral

10

..

MS Mono

 

Capsule containing morphine sulfate 90 mg (controlled release)

Oral

10

..

MS Mono

 

Capsule containing morphine sulfate 100 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 120 mg (controlled release)

Oral

10

..

MS Mono

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 20 mg per sachet

Oral

20

..

MS Contin Suspension 20 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 30 mg per sachet

Oral

20

..

MS Contin Suspension 30 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 60 mg per sachet

Oral

20

..

MS Contin Suspension 60 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 100 mg per sachet

Oral

20

..

MS Contin Suspension 100 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 200 mg per sachet

Oral

20

..

MS Contin Suspension 200 mg

 

Oral solution containing morphine hydrochloride 2 mg per mL, 200 mL

Oral

1

..

Ordine 2

 

Oral solution containing morphine hydrochloride 5 mg per mL, 200 mL

Oral

1

..

Ordine 5

 

Oral solution containing morphine hydrochloride 10 mg per mL, 200 mL

Oral

1

..

Ordine 10

 

Injection containing morphine sulfate 10 mg in 1 mL

Injection

5

..

Hospira Pty Limited

 

Injection containing morphine tartrate 120 mg in 1.5 mL

Injection

5

..

Hospira Pty Limited

 

Injection containing morphine sulfate 15 mg in 1 mL

Injection

5

..

Hospira Pty Limited

 

Injection containing morphine sulfate 30 mg in 1 mL

Injection

5

..

Hospira Pty Limited

Moxonidine

Tablet 200 micrograms

Oral

30

5

Physiotens

 

Tablet 400 micrograms

Oral

30

5

Physiotens

Mupirocin

Nasal ointment 20 mg (as calcium) per g, 3 g

Nasal

1

..

Bactroban

Mycophenolic Acid

Tablet (enteric coated) containing mycophenolate sodium equivalent to 180 mg mycophenolic acid

Oral

120

3

Myfortic

 

Tablet (enteric coated) containing mycophenolate sodium equivalent to 360 mg mycophenolic acid

Oral

120

3

Myfortic

 

Capsule containing mycophenolate mofetil 250 mg

Oral

300

3

CellCept

 

Tablet containing mycophenolate mofetil 500 mg

Oral

150

3

CellCept

 

Powder for oral suspension containing mycophenolate mofetil 1 g per 5 mL, 165 mL

Oral

1

3

CellCept

Nafarelin

Nasal spray (pump pack) 200 micrograms (as acetate) per dose, 60 doses

Nasal

1

5

Synarel

Naloxone

Injection containing naloxone hydrochloride 2 mg in 5 mL disposable injection set

Injection

1

..

Naloxone Min-I-Jet

Naltrexone

Tablet containing naltrexone hydrochloride 50 mg

Oral

30

1

Naltrexone generichealth

 

 

 

 

 

Naltrexone QP

 

 

 

 

 

ReVia

Nandrolone Decanoate

Injection 50 mg in 1 mL disposable syringe

Injection

1

7

Deca-Durabolin

Naproxen

Tablet 250 mg

Oral

100

3

Inza 250

 

 

 

 

 

Naprosyn

 

Tablet containing naproxen sodium 550 mg

Oral

50

3

Anaprox 550

 

 

 

 

 

Crysanal

 

Tablet 500 mg

Oral

50

3

Inza 500

 

 

 

 

 

Naprosyn

 

Tablet 750 mg (sustained release)

Oral

28

3

Naprosyn SR750

 

 

 

 

 

Proxen SR 750

 

Tablet 1 g (sustained release)

Oral

28

3

Naprosyn SR1000

 

 

 

 

 

Proxen SR 1000

 

Oral suspension 125 mg per 5 mL, 474 mL

Oral

1

3

Naprosyn

Naratriptan

Tablet 2.5 mg (as hydrochloride)

Oral

4

5

Naramig

Nebivolol

Tablet 1.25 mg (as hydrochloride), 28

Oral

1

5

Nebilet

 

Tablet 1.25 mg (as hydrochloride)

Oral

56

5

Nebilet

 

Tablet 5 mg (as hydrochloride)

Oral

28

5

Nebilet

 

Tablet 10 mg (as hydrochloride)

Oral

28

5

Nebilet

Nedocromil

Pressurised inhalation containing nedocromil sodium 2 mg per dose, 112 doses (CFC-free formulation)

Inhalation by mouth

1

5

Tilade CFC-Free

Neomycin

Tablet containing neomycin sulfate 500 mg

Oral

25

1

Neosulf

Neomycin with Bacitracin

Ear ointment 3.5 mg neomycin (as undecenoate) with bacitracin zinc 400 units per g, 10 g

Application to the ear

1

..

Nemdyn

Nicorandil

Tablets 10 mg, 60

Oral

1

5

Ikorel

 

Tablets 20 mg, 60

Oral

1

5

Ikorel

Nicotine

Transdermal patch 24.9 mg

Transdermal

28

2

Nicorette Patch

Nifedipine

Tablet 10 mg

Oral

60

5

Adalat 10

 

 

 

 

 

Adefin 10

 

Tablet 20 mg

Oral

60

5

Adalat 20

 

 

 

 

 

Adefin 20

 

 

 

 

 

GenRx Nifedipine

 

 

 

 

 

Nifehexal

 

Tablet 20 mg (controlled release)

Oral

30

5

Adalat Oros 20mg

 

Tablet 30 mg (controlled release)

Oral

30

5

Adalat Oros 30

 

 

 

 

 

Addos XR 30

 

 

 

 

 

Adefin XL 30

 

 

 

 

 

APO-Nifedipine XR

 

Tablet 60 mg (controlled release)

Oral

30

5

Adalat Oros 60

 

 

 

 

 

Addos XR 60

 

 

 

 

 

Adefin XL 60

 

 

 

 

 

APO-Nifedipine XR

Nilotinib

Capsule 200 mg (as hydrochloride monohydrate)

Oral

112

2

Tasigna

Nilutamide

Tablet 150 mg

Oral

30

5

Anandron

Nitrazepam

Tablet 5 mg

Oral

25

..

Alodorm

 

 

 

 

 

Mogadon

Nitrofurantoin

Capsule 50 mg

Oral

30

1

Macrodantin

 

Capsule 100 mg

Oral

30

1

Macrodantin

Nizatidine

Capsule 150 mg

Oral

60

5

Nizac

 

 

 

 

 

Tacidine

 

 

 

 

 

Tazac

 

Capsule 300 mg

Oral

30

5

Nizac

 

 

 

 

 

Tacidine

 

 

 

 

 

Tazac

Norethisterone

Tablets 350 micrograms, 28

Oral

4

2

Locilan 28 Day

 

 

 

 

 

Micronor

 

 

 

 

 

Noriday 28 Day

 

Tablet 5 mg

Oral

30

2

Primolut N

Norethisterone with Ethinyloestradiol

Tablets 500 micrograms-35 micrograms, 21

Oral

4

2

Brevinor

 

Pack containing 21 tablets 500 micrograms-35 micrograms and 7 inert tablets

Oral

4

2

Brevinor

 

 

 

 

 

Norimin 28 Day

 

Tablets 1 mg-35 micrograms, 21

Oral

4

2

Brevinor-1

 

Pack containing 21 tablets 1 mg-35 micrograms and 7 inert tablets

Oral

4

2

Brevinor-1

Norimin-1 28 Day

 

 

 

 

 

 

Pack containing 12 tablets 500 micrograms-35 micrograms, 9 tablets 1 mg-35 micrograms and 7 inert tablets

Oral

4

2

Improvil 28 Day

Synphasic

 

 

 

 

 

Norethisterone with Mestranol

Tablets 1 mg-50 micrograms, 21

Oral

4

2

Norinyl-1

 

Pack containing 21 tablets 1 mg-50 micrograms and 7 inert tablets

Oral

4

2

Norinyl-1/28

Norfloxacin

Tablet 400 mg

Oral

14

1

Ascent Pharmaceuticals Limited

 

 

 

 

 

Chem mart Norfloxacin

 

 

 

 

 

GenRx Norfloxacin

 

 

 

 

 

Norflohexal

 

 

 

 

 

Noroxin

 

 

 

 

 

Nufloxib

 

 

 

 

 

Roxin

 

 

 

 

 

Terry White Chemists Norfloxacin

Nortriptyline

Tablet 10 mg (as hydrochloride)

Oral

50

2

Allegron

 

Tablet 25 mg (as hydrochloride)

Oral

50

2

Allegron

Nystatin

Tablet 500,000 units

Oral

50

..

Nilstat

 

Capsule 500,000 units

Oral

50

..

Nilstat

 

Oral suspension 100,000 units per mL, 24 mL

Oral

1

1

Mycostatin

 

 

 

 

 

Nilstat

 

Cream 100,000 units per g, 15 g

Application

2

3

Mycostatin

Oestradiol

Tablet 2 mg

Oral

56

2

Zumenon

 

Tablet containing oestradiol valerate 1 mg

Oral

56

2

Progynova

 

Tablet containing oestradiol valerate 2 mg

Oral

56

2

Progynova

 

Transdermal gel 1 mg (as hemihydrate) in 1 g sachet, 28

Transdermal

1

5

Sandrena

 

Transdermal patches 390 micrograms, 8

Transdermal

1

5

Estradot 25

 

Transdermal patches 750 micrograms (as hemihydrate), 8

Transdermal

1

5

Estraderm MX 25

 

Transdermal patches 2 mg, 4

Transdermal

1

5

Climara 25

 

Transdermal patches 2 mg, 8

Transdermal

1

5

Estraderm 25

 

Transdermal patches 585 micrograms, 8

Transdermal

1

5

Estradot 37.5

 

Transdermal patches 1.5 mg (as hemihydrate), 8

Transdermal

1

5

Estraderm MX 50

 

Transdermal patches 3.8 mg, 4

Transdermal

1

5

Climara 50

 

Transdermal patches 780 micrograms, 8

Transdermal

1

5

Estradot 50

 

Transdermal patches 5.7 mg, 4

Transdermal

1

5

Climara 75

 

Transdermal patches 1.17 mg, 8

Transdermal

1

5

Estradot 75

 

Transdermal patches 3 mg (as hemihydrate), 8

Transdermal

1

5

Estraderm MX 100

 

Transdermal patches 7.6 mg, 4

Transdermal

1

5

Climara 100

 

Transdermal patches 8 mg, 8

Transdermal

1

5

Estraderm 100

 

Transdermal patches 1.56 mg, 8

Transdermal

1

5

Estradot 100

 

Vaginal tablets 25 micrograms, 15

Vaginal

1

2

Vagifem

Oestradiol and Oestradiol with Dydrogesterone

Pack containing 14 tablets oestradiol 2 mg and 14 tablets oestradiol 2 mg with dydrogesterone 10 mg

Oral

1

5

Femoston 2/10

Oestradiol and Oestradiol with Norethisterone

Pack containing 4 transdermal patches 780 micrograms oestradiol (as hemihydrate) and 4 transdermal patches 620 micrograms oestradiol (as hemihydrate) with 2.7 mg norethisterone acetate

Transdermal

1

5

Estalis sequi 50/140

 

Pack containing 4 transdermal patches 780 micrograms oestradiol (as hemihydrate) and 4 transdermal patches 510 micrograms oestradiol (as hemihydrate) with 4.8 mg norethisterone acetate

Transdermal

1

5

Estalis sequi 50/250

Oestradiol with Norethisterone

Transdermal patches containing 620 micrograms oestradiol (as hemihydrate) with 2.7 mg norethisterone acetate, 8

Transdermal

1

5

Estalis continuous 50/140

 

Transdermal patches containing 510 micrograms oestradiol (as hemihydrate) with 4.8 mg norethisterone acetate, 8

Transdermal

1

5

Estalis continuous 50/250

Oestriol

Pessaries 500 micrograms, 15

Vaginal

1

2

Ovestin Ovula

 

Vaginal cream 1 mg per g, 15 g

Application

1

1

Ovestin

Ofloxacin

Eye drops 3 mg per mL, 5 mL

Application to the eye

2

..

Ocuflox

Olanzapine

Tablet 2.5 mg

Oral

28

5

Zyprexa

 

Tablet 5 mg

Oral

28

5

Zyprexa

 

Tablet 7.5 mg

Oral

28

5

Zyprexa

 

Tablet 10 mg

Oral

28

5

Zyprexa

 

Wafer 5 mg

Oral

28

5

Zyprexa Zydis

 

Wafer 10 mg

Oral

28

5

Zyprexa Zydis

 

Powder for injection 210 mg (as pamoate monohydrate) with diluent

Injection

2

5

Zyprexa Relprevv

 

Powder for injection 300 mg (as pamoate monohydrate) with diluent

Injection

2

5

Zyprexa Relprevv

 

Powder for injection 405 mg (as pamoate monohydrate) with diluent

Injection

1

5

Zyprexa Relprevv

Olmesartan

Tablet containing olmesartan medoxomil 20 mg

Oral

30

5

Olmetec

 

Tablet containing olmesartan medoxomil 40 mg

Oral

30

5

Olmetec

Olmesartan with Hydrochlorothiazide

Tablet containing olmesartan medoxomil 20 mg with hydrochlorothiazide 12.5 mg

Oral

30

5

Olmetec Plus

 

Tablet containing olmesartan medoxomil 40 mg with hydrochlorothiazide 12.5 mg

Oral

30

5

Olmetec Plus

 

Tablet containing olmesartan medoxomil 40 mg with hydrochlorothiazide 25 mg

Oral

30

5

Olmetec Plus

Olsalazine

Capsule containing olsalazine sodium 250 mg

Oral

100

5

Dipentum

 

Tablet containing olsalazine sodium 500 mg

Oral

100

5

Dipentum

Omeprazole

Tablet 20 mg (as magnesium)

Oral

30

1

Acimax Tablets

 

 

 

 

 

Losec Tablets

 

 

 

 

 

Omepral

 

Tablet 20 mg

Oral

30

1

APO-Omeprazole

 

 

 

 

 

Chem mart Omeprazole

 

 

 

 

 

GenRx Omeprazole

 

 

 

 

 

Meprazol

 

 

 

 

 

Omeprazole-GA

 

 

 

 

 

Omeprazole Ranbaxy

 

 

 

 

 

Omeprazole Winthrop

 

 

 

 

 

Ozmep

 

 

 

 

 

Terry White Chemists Omeprazole

 

Capsule 20 mg

Oral

30

1

Probitor

 

Tablet 10 mg (as magnesium)

Oral

30

5

Losec Tablets

Omeprazole and Clarithromycin and Amoxycillin

Pack containing 14 capsules omeprazole 20 mg, 14 tablets clarithromycin 500 mg and 28 capsules amoxycillin 500 mg (as trihydrate)

Oral

1

..

Klacid Hp 7

Ondansetron

Tablet 4 mg (as hydrochloride dihydrate)

Oral

4

..

APO-Ondansetron

 

 

 

 

 

Ondansetron-RL

 

 

 

 

 

Ondaz

 

 

 

 

 

Onsetron 4

 

 

 

 

 

Zofran

 

Tablet 8 mg (as hydrochloride dihydrate)

Oral

4

..

APO-Ondansetron

 

 

 

 

 

Ondansetron-RL

 

 

 

 

 

Ondaz

 

 

 

 

 

Onsetron 8

 

 

 

 

 

Zofran

 

Wafer 4 mg

Oral

4

..

Ondansetron-RL Zydis

 

 

 

 

 

Ondaz Zydis

 

 

 

 

 

Zofran Zydis

 

Wafer 8 mg

Oral

4

..

Ondansetron-RL Zydis

 

 

 

 

 

Ondaz Zydis

 

 

 

 

 

Zofran Zydis

 

Syrup 4 mg (as hydrochloride dihydrate) per 5 mL, 50 mL

Oral

1

..

Zofran syrup 50 mL

 

I.V. injection 4 mg (as hydrochloride dihydrate) in 2 mL

Injection

1

..

Ondansetron-RL

 

 

 

 

 

Ondaz

 

 

 

 

 

Onsetron

 

 

 

 

 

Pfizer Australia Pty Ltd

 

 

 

 

 

Zofran

 

I.V. injection 8 mg (as hydrochloride dihydrate) in 4 mL

Injection

1

..

Ondansetron-RL

 

 

 

 

 

Ondaz

 

 

 

 

 

Onsetron

 

 

 

 

 

Pfizer Australia Pty Ltd

 

 

 

 

 

Zofran

Oxaliplatin

Solution concentrate for I.V. infusion 50 mg in 10 mL

Injection

1

2

Eloxatin

 

Powder for I.V. infusion 50 mg

Injection

1

2

Hospira Pty Limited

 

 

 

 

 

Oxalatin

 

 

 

 

 

Oxaliplatin Actavis

 

 

 

 

 

Oxaliplatin Alphapharm

 

 

 

 

 

Oxaliplatin Ebewe

 

 

 

 

 

Oxaliplatin Link

 

Solution concentrate for I.V. infusion 100 mg in 20 mL

Injection

1

2

Eloxatin

 

Powder for I.V. infusion 100 mg

Injection

1

2

Hospira Pty Limited

 

 

 

 

 

Oxalatin

 

 

 

 

 

Oxaliplatin Actavis

 

 

 

 

 

Oxaliplatin Alphapharm

 

 

 

 

 

Oxaliplatin Ebewe

 

 

 

 

 

Oxaliplatin Link

 

 

 

 

 

Winthrop Oxaliplatin

 

Solution concentrate for I.V. infusion 200 mg in 40 mL

Injection

1

2

Eloxatin

Oxazepam

Tablet 15 mg

Oral

25

..

Alepam 15

 

 

 

 

 

Serepax

 

Tablet 30 mg

Oral

25

..

Alepam 30

 

 

 

 

 

Murelax

 

 

 

 

 

Serepax

Oxcarbazepine

Tablet 150 mg

Oral

100

5

Trileptal

 

Tablet 300 mg

Oral

100

5

Trileptal

 

Tablet 600 mg

Oral

100

5

Trileptal

 

Oral suspension 60 mg per mL, 250 mL

Oral

2

5

Trileptal

Oxprenolol

Tablet containing oxprenolol hydrochloride 20 mg

Oral

100

5

Corbeton 20

 

Tablet containing oxprenolol hydrochloride 40 mg

Oral

100

5

Corbeton 40

Oxybutynin

Tablet containing oxybutynin hydrochloride 5 mg

Oral

100

5

Ditropan

 

 

 

 

 

Oxybutynin Sandoz

 

 

 

 

 

Oxybutynin Winthrop

 

Transdermal patches 36 mg, 8

Transdermal

1

5

Oxytrol

Oxycodone

Tablet containing oxycodone hydrochloride 5 mg

Oral

20

..

Endone

 

Capsule containing oxycodone hydrochloride 5 mg

Oral

20

..

OxyNorm

 

Capsule containing oxycodone hydrochloride 10 mg

Oral

20

..

OxyNorm

 

Capsule containing oxycodone hydrochloride 20 mg

Oral

20

..

OxyNorm

 

Oral solution containing oxycodone hydrochloride 5 mg per 5 mL, 250 mL

Oral

1

..

OxyNorm Liquid 5mg/5mL

 

Tablet containing oxycodone hydrochloride 5 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 10 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 15 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 20 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 30 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 40 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 80 mg (controlled release)

Oral

20

..

OxyContin

 

Suppository 30 mg (as pectinate)

Rectal

12

..

Proladone

Paclitaxel

Solution concentrate for I.V. infusion 30 mg in 5 mL

Injection

5

..

Anzatax

 

 

 

 

 

Paclitaxel Actavis

 

 

 

 

 

Paclitaxel Ebewe

 

 

 

 

 

Plaxel

 

 

 

 

 

Taxol

 

Solution concentrate for I.V. infusion 100 mg in 16.7 mL

Injection

2

..

Anzatax

 

 

 

 

 

Paclitaxel Actavis

 

 

 

 

 

Paclitaxel Ebewe

 

 

 

 

 

Plaxel

 

 

 

 

 

Taxol

 

Solution concentrate for I.V. infusion 150 mg in 25 mL

Injection

2

..

Anzatax

 

 

 

 

 

Paclitaxel Actavis

 

 

 

 

 

Paclitaxel Ebewe

 

 

 

 

 

Plaxel

 

Solution concentrate for I.V. infusion 300 mg in 50 mL

Injection

1

..

Anzatax

 

 

 

 

 

Paclitaxel Actavis

 

 

 

 

 

Paclitaxel Ebewe

 

 

 

 

 

Plaxel

 

 

 

 

 

Taxol

Paclitaxel, nanoparticle albumin-bound

Powder for I.V. injection containing 100 mg paclitaxel

Injection

1

..

Abraxane

Paliperidone

Tablet 3 mg (prolonged release)

Oral

28

5

Invega

 

Tablet 6 mg (prolonged release)

Oral

28

5

Invega

 

Tablet 9 mg (prolonged release)

Oral

28

5

Invega

Pamidronic Acid

Concentrated injection containing disodium pamidronate 15 mg in 5 mL

Injection

4

..

Pamisol

 

Injection set containing 4 vials powder for I.V. infusion containing disodium pamidronate 15 mg and 4 ampoules solvent 5 mL

Injection

1

..

Aredia 15 mg

 

 

 

 

 

 

 

Concentrated injection containing disodium pamidronate 30 mg in 10 mL

Injection

2

..

Pamisol

 

Injection set containing 2 vials powder for I.V. infusion containing disodium pamidronate 30 mg and 2 ampoules solvent 10 mL

Injection

1

..

Aredia 30 mg

 

Concentrated injection containing disodium pamidronate 60 mg in 10 mL

Injection

1

..

Pamisol

Pancreatic Extract

Capsule (containing enteric coated minimicrospheres) providing not less than 5,000 BP units of lipase activity

Oral

500

10

Creon 5000

 

Capsule (containing enteric coated minimicrospheres) providing not less than 10,000 BP units of lipase activity

Oral

500

10

Creon 10,000

 

Capsule (containing enteric coated minimicrospheres) providing not less than 25,000 BP units of lipase activity

Oral

200

10

Creon 25,000

 

 

 

 

 

 

 

Capsule (containing enteric coated minimicrospheres) providing not less than 40,000 BP units of lipase activity

Oral

200

10

Creon 40,000

Pancrelipase

Capsule (containing enteric coated microtablets) providing not less than 25,000 BP units of lipase activity

Oral

200

10

Panzytrat 25000

Pantoprazole

Tablet (enteric coated) 40 mg (as sodium sesquihydrate)

Oral

30

2

APO-Pantoprazole

 

 

 

 

 

Chem mart Pantoprazole

 

 

 

 

 

Ozpan

 

 

 

 

 

Panto

 

 

 

 

 

Pantoloc

 

 

 

 

 

Pantoprazole-GA

 

 

 

 

 

Pantoprazole Sandoz

 

 

 

 

 

Salpraz

 

 

 

 

 

Somac

 

 

 

 

 

Sozol

 

 

 

 

 

Terry White Chemists Pantoprazole

 

Sachet containing granules 40 mg (as sodium sesquihydrate)

Oral

30

2

Somac

 

Tablet (enteric coated) 20 mg (as sodium sesquihydrate)

Oral

30

5

APO-Pantoprazole

 

 

 

 

 

Chem mart Pantoprazole

 

 

 

 

 

Ozpan

 

 

 

 

 

Panto

 

 

 

 

 

Pantoloc

 

 

 

 

 

Pantoprazole-GA

 

 

 

 

 

Pantoprazole Sandoz

 

 

 

 

 

Salpraz

 

 

 

 

 

Somac

 

 

 

 

 

Terry White Chemists Pantoprazole

Paracetamol

Tablet 500 mg

Oral

100

1

APO-Paracetamol

 

 

 

 

 

Chem mart Paracetamol

 

 

 

 

 

Febridol

 

 

 

 

 

Generic Health Pty Ltd

 

 

 

 

 

Panamax

 

 

 

 

 

Paracetamol Sandoz

 

 

 

 

 

Paralgin

 

 

 

 

 

Pharmacy Choice Paracetamol

 

 

 

 

 

Terry White Chemists Paracetamol

 

Tablet 665 mg (modified release)

Oral

192

5

Panadol Osteo

 

Oral liquid 120 mg per 5 mL, 100 mL

Oral

1

2

Panamax

 

Oral liquid 240 mg per 5 mL, 200 mL

Oral

1

2

Panamax 240 Elixir

Paraffin

Eye ointment, compound, containing white soft paraffin with liquid paraffin, 3.5 g

Application to the eye

2

5

Duratears

 

 

 

 

 

Poly Visc

 

Pack containing 2 tubes eye ointment, compound, containing white soft paraffin with liquid paraffin, 3.5 g

Application to the eye

1

5

Ircal

 

 

 

 

 

Lacri-Lube

 

 

 

 

 

Poly Visc

Paroxetine

Tablet 20 mg (as hydrochloride)

Oral

30

5

Aropax

 

 

 

 

 

Chem mart Paroxetine

 

 

 

 

 

Extine 20

 

 

 

 

 

GenRx Paroxetine

 

 

 

 

 

Paroxetine 20

 

 

 

 

 

Paroxetine-DP

 

 

 

 

 

Paroxetine-GA

 

 

 

 

 

Paroxetine Sandoz

 

 

 

 

 

Paxtine

 

 

 

 

 

Terry White Chemists Paroxetine

 

Tablet 20 mg (as mesilate)

Oral

30

5

Paroxetine generichealth

 

 

 

 

 

Pharmacor Paroxo 20

Pemetrexed

Powder for I.V. infusion 100 mg (as disodium heptahydrate)

Injection

1

3

Alimta

 

Powder for I.V. infusion 500 mg (as disodium heptahydrate)

Injection

1

3

Alimta

Penicillamine

Tablet 125 mg

Oral

100

1

D-Penamine

 

Tablet 250 mg

Oral

100

1

D-Penamine

Pergolide

Tablet 50 micrograms (as mesylate)

Oral

100

..

Permax

 

Tablet 250 micrograms (as mesylate)

Oral

100

5

Permax

 

Tablet 1 mg (as mesylate)

Oral

100

5

Permax

Perhexiline

Tablet containing perhexiline maleate 100 mg

Oral

100

5

Pexsig

Pericyazine

Tablet 2.5 mg

Oral

100

5

Neulactil

 

Tablet 10 mg

Oral

100

5

Neulactil

Perindopril

Tablet containing perindopril erbumine 2 mg

Oral

30

5

Chem mart Perindopril

 

 

 

 

 

GenRx Perindopril

 

 

 

 

 

Indopril 2

 

 

 

 

 

Ozapace

 

 

 

 

 

Perindo

 

 

 

 

 

Perindopril 2

 

 

 

 

 

Perindopril-DP

 

 

 

 

 

Perindopril-GA

 

 

 

 

 

Terry White Chemists Perindopril

 

Tablet containing perindopril arginine 2.5 mg

Oral

30

5

Coversyl 2.5mg

 

Tablet containing perindopril erbumine 4 mg

Oral

30

5

Chem mart Perindopril

 

 

 

 

 

GenRx Perindopril

 

 

 

 

 

Indopril 4

 

 

 

 

 

Ozapace

 

 

 

 

 

Perindo

 

 

 

 

 

Perindopril 4

 

 

 

 

 

Perindopril-DP

 

 

 

 

 

Perindopril-GA

 

 

 

 

 

Terry White Chemists Perindopril

 

Tablet containing perindopril arginine 5 mg

Oral

30

5

Coversyl 5mg

 

Tablet containing perindopril erbumine 8 mg

Oral

30

5

Chem mart Perindopril

 

 

 

 

 

GenRx Perindopril

 

 

 

 

 

Indopril 8

 

 

 

 

 

Ozapace

 

 

 

 

 

Perindo

 

 

 

 

 

Perindopril 8

 

 

 

 

 

Perindopril-DP

 

 

 

 

 

Perindopril-GA

 

 

 

 

 

Terry White Chemists Perindopril

 

Tablet containing perindopril arginine 10 mg

Oral

30

5

Coversyl 10mg

Perindopril with amlodipine

Tablet containing 5 mg perindopril arginine with 5 mg amlodipine (as besylate)

Oral

30

5

Coveram

 

Tablet containing 5 mg perindopril arginine with 10 mg amlodipine (as besylate)

Oral

30

5

Coveram

 

Tablet containing 10 mg perindopril arginine with 5 mg amlodipine (as besylate)

Oral

30

5

Coveram

 

Tablet containing 10 mg perindopril arginine with 10 mg amlodipine (as besylate)

Oral

30

5

Coveram

Perindopril with Indapamide

Tablet containing perindopril arginine 2.5 mg with indapamide hemihydrate 0.625 mg

Oral

30

5

Coversyl Plus LD 2.5mg/0.625mg

 

Tablet containing perindopril erbumine 4 mg with indapamide hemihydrate 1.25 mg

Oral

30

5

Chem mart Perindopril/ Indapamide 4/1.25

 

 

 

 

 

GenRx Perindopril/ Indapamide 4/1.25

 

 

 

 

 

Perindo Combi 4/1.25

 

 

 

 

 

Terry White Chemists Perindopril/ Indapamide 4/1.25

 

Tablet containing perindopril arginine 5 mg with indapamide hemihydrate 1.25 mg

Oral

30

5

Coversyl Plus 5mg/1.25mg

Permethrin

Cream 50 mg per g, 30 g

Application

1

1

Lyclear

Phenelzine

Tablet 15 mg (as sulfate)

Oral

100

1

Nardil

Phenobarbitone

Tablet 30 mg

Oral

200

4

Sigma Pharmaceuticals (Australia) Pty Ltd

 

Injection containing phenobarbitone sodium 200 mg in 1 mL

Injection

5

..

Fawns and McAllan Proprietary Limited

Phenoxybenzamine

Capsule containing phenoxybenzamine hydrochloride 10 mg

Oral

100

5

Dibenyline

 

Capsules containing phenoxybenzamine hydrochloride 10 mg, 30

Oral

3

5

Dibenyline

 

Capsules containing phenoxybenzamine hydrochloride 10 mg, 100

Oral

1

5

Dibenzyline

Phenoxymethylpenicillin

Tablet 250 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Abbocillin-VK Filmtab

 

Tablet 500 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Abbocillin-VK Filmtab

 

Capsule 250 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Cilicaine VK

 

 

 

 

 

Cilopen VK

 

 

 

 

 

LPV

 

Capsule 500 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Cilicaine VK

 

 

 

 

 

Cilopen VK

 

 

 

 

 

LPV

 

Oral suspension 150 mg (as benzathine) per 5 mL, 100 mL

Oral

2

1

Abbocillin-V

 

 

 

 

 

Cilicaine V

Phenylalanine with carbohydrate

Sachets of oral powder 4 g containing 50 mg phenylalanine, 30 (Phenylalanine Amino Acid Supplement)

Oral

4

5

Phenylalanine Amino Acid Supplement

Phenytoin

Tablet 50 mg

Oral

200

2

Dilantin Infatabs

 

Capsule containing phenytoin sodium 30 mg

Oral

200

2

Dilantin Sodium

 

Capsule containing phenytoin sodium 100 mg

Oral

200

2

Dilantin Sodium

 

Oral suspension 30 mg per 5 mL, 500 mL

Oral

1

3

Dilantin

Pilocarpine

Eye drops containing pilocarpine hydrochloride 10 mg per mL, 15 mL

Application to the eye

1

5

Isopto Carpine

 

Eye drops containing pilocarpine hydrochloride 20 mg per mL, 15 mL

Application to the eye

1

5

Isopto Carpine

 

Eye drops containing pilocarpine hydrochloride 40 mg per mL, 15 mL

Application to the eye

1

5

Isopto Carpine

Pimecrolimus

Cream 10 mg per g, 15 g

Application

1

1

Elidel

Pindolol

Tablet 5 mg

Oral

100

5

Barbloc 5

 

 

 

 

 

Visken 5

 

Tablet 15 mg

Oral

50

5

Barbloc 15

 

 

 

 

 

Visken 15

Pioglitazone

Tablet 15 mg (as hydrochloride)

Oral

28

5

Actos

 

Tablet 30 mg (as hydrochloride)

Oral

28

5

Actos

 

Tablet 45 mg (as hydrochloride)

Oral

28

5

Actos

Piroxicam

Dispersible tablet 10 mg

Oral

50

3

Mobilis D-10

 

Dispersible tablet 20 mg

Oral

25

3

Feldene-D

 

 

 

 

 

Mobilis D-20

 

Capsule 10 mg

Oral

50

3

Chem mart Piroxicam

 

 

 

 

 

Feldene

 

 

 

 

 

GenRx Piroxicam

 

 

 

 

 

Mobilis 10

 

 

 

 

 

Terry White Chemists Piroxicam

 

Capsule 20 mg

Oral

25

3

Chem mart Piroxicam

 

 

 

 

 

Feldene

 

 

 

 

 

GenRx Piroxicam

 

 

 

 

 

Mobilis 20

 

 

 

 

 

Terry White Chemists Piroxicam

Pizotifen

Tablet 500 micrograms (as malate)

Oral

100

2

Sandomigran 0.5

Pneumococcal Vaccine - Polyvalent

Injection 0.5 mL (23 valent)

Injection

1

..

Pneumovax 23

Polyethylene glycol 400

Eye drops 2.5 mg per mL, 15 mL

Application to the eye

1

5

Blink Intensive Tears

 

Eye drops 2.5 mg per mL, single dose units 0.4 mL, 20

Application to the eye

5

5

Blink Intensive Tears

Polyethylene Glycol 400 with Propylene Glycol

Eye drops 4 mg-3 mg per mL, 15 mL

Application to the eye

1

5

Systane

 

Eye drops 4 mg-3 mg per mL, single dose units 0.8 mL, 28

Application to the eye

2

5

Systane

Polygeline

I.V. infusion 17.5 g per 500 mL with electrolytes, 500 mL

Injection

3

..

Haemaccel

Poly-l-lactic acid

Powder for injection 150 mg

Injection

2

..

Sculptra

Polyvinyl Alcohol

Eye drops 14 mg per mL, 15 mL

Application to the eye

1

5

Liquifilm Tears

 

 

 

 

 

PVA Tears

 

Eye drops 14 mg per mL, 15 mL (contains sodium chlorite/hydrogen peroxide as preservative)

Application to the eye

1

5

Vistil

 

Eye drops 30 mg per mL, 15 mL

Application to the eye

1

5

Liquifilm Forte

 

 

 

 

 

PVA Forte

 

Eye drops 30 mg per mL, 15 mL (contains sodium chlorite/hydrogen peroxide as preservative)

Application to the eye

1

5

Vistil Forte

Posaconazole

Oral suspension 40 mg per mL, 105 mL

Oral

1

..

Noxafil

Potassium Chloride

Tablet 600 mg (sustained release)

Oral

200

1

Duro-K

 

 

 

 

 

Slow-K

 

 

 

 

 

Span-K

Potassium Chloride with Potassium Bicarbonate

Tablet, effervescent, 14 mmol potassium and 8 mmol chloride

Oral

60

1

Chlorvescent

Pramipexole

Tablet containing pramipexole hydrochloride 125 micrograms

Oral

30

..

Sifrol

 

Tablet containing pramipexole hydrochloride 250 micrograms

Oral

100

2

Sifrol

 

Tablet containing pramipexole hydrochloride 1 mg

Oral

100

5

Sifrol

Prasugrel

Tablet 5 mg (as hydrochloride)

Oral

28

5

Effient

 

Tablet 10 mg (as hydrochloride)

Oral

28

5

Effient

Pravastatin

Tablet containing pravastatin sodium 10 mg

Oral

30

5

APO-Pravastatin

 

 

 

 

 

Chem mart Pravastatin

 

 

 

 

 

Cholstat 10

 

 

 

 

 

GenRx Pravastatin

 

 

 

 

 

Lipostat 10

 

 

 

 

 

Liprachol

 

 

 

 

 

Pravachol

 

 

 

 

 

Pravastatin 10

 

 

 

 

 

Pravastatin-GA 10

 

 

 

 

 

Pravastatin generichealth

 

 

 

 

 

Pravastatin Winthrop

 

 

 

 

 

Terry White Chemists Pravastatin

 

Tablet containing pravastatin sodium 20 mg

Oral

30

5

APO-Pravastatin

 

 

 

 

 

Chem mart Pravastatin

 

 

 

 

 

Cholstat 20

 

 

 

 

 

GenRx Pravastatin

 

 

 

 

 

Lipostat 20

 

 

 

 

 

Pravachol

 

 

 

 

 

Pravastatin 20

 

 

 

 

 

Pravastatin-GA 20

 

 

 

 

 

Pravastatin generichealth

 

 

 

 

 

Pravastatin Sandoz

 

 

 

 

 

Pravastatin Winthrop

 

 

 

 

 

Terry White Chemists Pravastatin

 

 

 

 

 

Vastoran

 

Tablet containing pravastatin sodium 40 mg

Oral

30

5

APO-Pravastatin

 

 

 

 

 

Chem mart Pravastatin

 

 

 

 

 

Cholstat 40

 

 

 

 

 

GenRx Pravastatin

 

 

 

 

 

Lipostat 40

 

 

 

 

 

Pravachol

 

 

 

 

 

Pravastatin 40

 

 

 

 

 

Pravastatin-GA 40

 

 

 

 

 

Pravastatin generichealth

 

 

 

 

 

Pravastatin Sandoz

 

 

 

 

 

Pravastatin Winthrop

 

 

 

 

 

Terry White Chemists Pravastatin

 

 

 

 

 

Vastoran

 

Tablet containing pravastatin sodium 80 mg

Oral

30

5

APO-Pravastatin

 

 

 

 

 

Chem mart Pravastatin

 

 

 

 

 

Lipostat 80

 

 

 

 

 

Pravachol

 

 

 

 

 

Pravastatin-GA 80

 

 

 

 

 

Pravastatin generichealth

 

 

 

 

 

Pravastatin Sandoz

 

 

 

 

 

Terry White Chemists Pravastatin

Praziquantel

Tablet 600 mg

Oral

8

..

Biltricide

Prazosin

Tablet 1 mg (as hydrochloride)

Oral

100

5

Chem mart Prazosin

 

 

 

 

 

GenRx Prazosin

 

 

 

 

 

Minipress

 

 

 

 

 

Pressin 1

 

 

 

 

 

Terry White Chemists Prazosin

 

Tablet 2 mg (as hydrochloride)

Oral

100

5

Chem mart Prazosin

 

 

 

 

 

GenRx Prazosin

 

 

 

 

 

Minipress

 

 

 

 

 

Pressin 2

 

 

 

 

 

Terry White Chemists Prazosin

 

Tablet 5 mg (as hydrochloride)

Oral

100

5

Chem mart Prazosin

 

 

 

 

 

GenRx Prazosin

 

 

 

 

 

Minipress

 

 

 

 

 

Pressin 5

 

 

 

 

 

Terry White Chemists Prazosin

Prednisolone

Tablet 1 mg

Oral

100

4

Panafcortelone

 

 

 

 

 

Predsolone

 

Tablet 5 mg

Oral

60

4

Panafcortelone

 

 

 

 

 

Solone

 

Tablet 25 mg

Oral

30

4

Panafcortelone

 

 

 

 

 

Solone

 

Oral solution 5 mg (as sodium phosphate) per mL, 30 mL

Oral

1

5

PredMix

 

 

 

 

 

Redipred

 

Enema, retention, 20 mg (as sodium phosphate) in 100 mL

Rectal

28

3

Predsol

 

Suppositories 5 mg (as sodium phosphate), 10

Rectal

3

3

Predsol

Prednisolone with Phenylephrine

Eye drops containing prednisolone acetate 10 mg with phenylephrine hydrochloride 1.2 mg per mL, 10 mL

Application to the eye

1

2

Prednefrin Forte

Prednisone

Tablet 1 mg

Oral

100

4

Panafcort

 

 

 

 

 

Predsone

 

Tablet 5 mg

Oral

60

4

Panafcort

 

 

 

 

 

Sone

 

Tablet 25 mg

Oral

30

4

Panafcort

 

 

 

 

 

Sone

Primidone

Tablet 250 mg

Oral

200

2

Mysoline

Probenecid

Tablet 500 mg

Oral

100

5

Pro-Cid

Procaine Penicillin

Injection 1.5 g in disposable syringe

Injection

5

..

Cilicaine

Prochlorperazine

Tablet containing prochlorperazine maleate 5 mg

Oral

25

..

Stemetil

 

 

 

 

 

Stemzine

 

Injection containing prochlorperazine mesylate 12.5 mg in 1 mL

Injection

10

..

Stemetil

 

Suppositories containing prochlorperazine equivalent to 25 mg prochlorperazine maleate, 5

Rectal

1

2

Stemetil

Promethazine

Injection containing promethazine hydrochloride 50 mg in 2 mL

Injection

10

..

Hospira Pty Limited

Propantheline

Tablet containing propantheline bromide 15 mg

Oral

200

5

Pro-Banthine

Propranolol

Tablet containing propranolol hydrochloride 10 mg

Oral

100

5

Deralin 10

 

 

 

 

 

Inderal

 

Tablet containing propranolol hydrochloride 40 mg

Oral

100

5

Deralin 40

 

 

 

 

 

Inderal

 

Tablet containing propranolol hydrochloride 160 mg

Oral

50

5

Deralin 160

Propylthiouracil

Tablet 50 mg

Oral

200

2

PTU

Protein hydrolysate formula with medium chain triglycerides

Oral powder 400 g (Alfaré)

Oral

8

5

Alfaré

 

Oral powder 450 g (Pepti-Junior Gold)

Oral

8

5

Pepti-Junior Gold

Pyrantel

Tablet 125 mg (as embonate)

Oral

6

..

Anthel 125

 

Tablet 250 mg (as embonate)

Oral

6

..

Anthel 250

Pyridostigmine

Tablet containing pyridostigmine bromide 10 mg

Oral

100

5

Mestinon

 

Tablet containing pyridostigmine bromide 60 mg

Oral

150

5

Mestinon

 

Tablet containing pyridostigmine bromide 180 mg (modified release)

Oral

100

5

Mestinon Timespan

Pyrimethamine

Tablet 25 mg

Oral

50

..

Daraprim

Quetiapine

Tablet 25 mg (as fumarate)

Oral

60

5

Seroquel

 

Tablet 100 mg (as fumarate)

Oral

90

5

Seroquel

 

Tablet 200 mg (as fumarate)

Oral

60

5

Seroquel

 

Tablet 300 mg (as fumarate)

Oral

60

5

Seroquel

 

Tablet (modified release) 50 mg (as fumarate)

Oral

60

5

Seroquel XR

 

Tablet (modified release) 200 mg (as fumarate)

Oral

60

5

Seroquel XR

 

Tablet (modified release) 300 mg (as fumarate)

Oral

60

5

Seroquel XR

 

Tablet (modified release) 400 mg (as fumarate)

Oral

60

5

Seroquel XR

Quinagolide

Pack containing 3 tablets quinagolide 25 micrograms (as hydrochloride) and 3 tablets quinagolide 50 micrograms (as hydrochloride)

Oral

1

..

Norprolac

 

Tablet 75 micrograms (as hydrochloride)

Oral

30

5

Norprolac

Quinapril

Tablet 5 mg (as hydrochloride)

Oral

30

5

Accupril

 

 

 

 

 

Acquin 5

 

 

 

 

 

APO-Quinapril

 

 

 

 

 

Filpril

 

 

 

 

 

Pharmacor Quinapril 5

 

 

 

 

 

Qpril 5

 

 

 

 

 

Quinapril-DP

 

 

 

 

 

Quinapril generichealth

 

 

 

 

 

Quinapril Sandoz

 

Tablet 10 mg (as hydrochloride)

Oral

30

5

Accupril

 

 

 

 

 

Acquin 10

 

 

 

 

 

APO-Quinapril

 

 

 

 

 

Filpril

 

 

 

 

 

Pharmacor Quinapril 10

 

 

 

 

 

Qpril 10

 

 

 

 

 

Quinapril-DP

 

 

 

 

 

Quinapril generichealth

 

Tablet 20 mg (as hydrochloride)

Oral

30

5

Accupril

 

 

 

 

 

Acquin 20

 

 

 

 

 

APO-Quinapril

 

 

 

 

 

Filpril

 

 

 

 

 

Pharmacor Quinapril 20

 

 

 

 

 

Qpril 20

 

 

 

 

 

Quinapril-GA

 

 

 

 

 

Quinapril generichealth

 

 

 

 

 

Quinapril Sandoz

Quinapril with Hydrochlorothiazide

Tablet 10 mg quinapril (as hydrochloride) with 12.5 mg hydrochlorothiazide

Oral

30

5

Accuretic 10/12.5mg

 

Tablet 20 mg quinapril (as hydrochloride) with 12.5 mg hydrochlorothiazide

Oral

30

5

Accuretic 20/12.5mg

Quinine

Tablet containing quinine bisulfate 300 mg

Oral

50

2

Quinbisul

 

Tablet containing quinine sulfate 300 mg

Oral

50

2

Quinate

Rabeprazole

Tablet containing rabeprazole sodium 20 mg (enteric coated)

Oral

30

2

Pariet

 

Tablet containing rabeprazole sodium 10 mg (enteric coated)

Oral

28

5

Pariet

Raloxifene

Tablet containing raloxifene hydrochloride 60 mg

Oral

28

5

Evista

Raltitrexed

Powder for I.V. infusion 2 mg in single use vial

Injection

3

2

Tomudex

Ramipril

Tablet 1.25 mg

Oral

30

5

APO-Ramipril

 

 

 

 

 

Chem mart Ramipril

 

 

 

 

 

Prilace 1.25

 

 

 

 

 

Ramace 1.25 mg

 

 

 

 

 

Ramipril Sandoz

 

 

 

 

 

Ramipril Winthrop

 

 

 

 

 

Terry White Chemists Ramipril

 

 

 

 

 

Tritace 1.25 mg

 

 

 

 

 

Tryzan Tabs 1.25

 

Capsule 1.25 mg

Oral

30

5

Pharmacor Ramipril 1.25

 

 

 

 

 

Ramipril-DP

 

 

 

 

 

Ramipril-GA

 

 

 

 

 

Ramipril generichealth

 

 

 

 

 

Tryzan Caps 1.25

 

Tablet 2.5 mg

Oral

30

5

APO-Ramipril

 

 

 

 

 

Chem mart Ramipril

 

 

 

 

 

Prilace 2.5

 

 

 

 

 

Ramace 2.5 mg

 

 

 

 

 

Ramipril Sandoz

 

 

 

 

 

Ramipril Winthrop

 

 

 

 

 

Terry White Chemists Ramipril

 

 

 

 

 

Tritace 2.5 mg

 

 

 

 

 

Tryzan Tabs 2.5

 

Capsule 2.5 mg

Oral

30

5

Pharmacor Ramipril 2.5

 

 

 

 

 

Ramipril-DP

 

 

 

 

 

Ramipril generichealth

 

 

 

 

 

Tryzan Caps 2.5

 

Tablet 5 mg

Oral

30

5

APO-Ramipril

 

 

 

 

 

Chem mart Ramipril

 

 

 

 

 

Prilace 5

 

 

 

 

 

Ramace 5 mg

 

 

 

 

 

Ramipril Sandoz

 

 

 

 

 

Ramipril Winthrop

 

 

 

 

 

Terry White Chemists Ramipril

 

 

 

 

 

Tritace 5 mg

 

 

 

 

 

Tryzan Tabs 5

 

Capsule 5 mg

Oral

30

5

Pharmacor Ramipril 5

 

 

 

 

 

Ramipril-DP

 

 

 

 

 

Ramipril generichealth

 

 

 

 

 

Tryzan Caps 5

 

Tablet 10 mg

Oral

30

5

APO-Ramipril

 

 

 

 

 

Chem mart Ramipril

 

 

 

 

 

Ramipril Sandoz

 

 

 

 

 

Terry White Chemists Ramipril

 

 

 

 

 

Tritace

 

 

 

 

 

Tryzan Tabs 10

 

Capsule 10 mg

Oral

30

5

GenRx Ramipril

 

 

 

 

 

Pharmacor Ramipril 10

 

 

 

 

 

Prilace 10

 

 

 

 

 

Ramace 10 mg

 

 

 

 

 

Ramipril-DP

 

 

 

 

 

Ramipril generichealth

 

 

 

 

 

Ramipril Sandoz

 

 

 

 

 

Ramipril Winthrop

 

 

 

 

 

Tritace 10 mg

 

 

 

 

 

Tryzan Caps 10

 

Pack containing 7 tablets 2.5 mg, 21 tablets 5 mg and 10 capsules 10 mg

Oral

1

..

Tritace Titration Pack

Ramipril with Felodipine

Tablet 2.5 mg-2.5 mg (modified release)

Oral

30

5

Triasyn 2.5/2.5

 

Tablet 5 mg-5 mg (modified release)

Oral

30

5

Triasyn 5.0/5.0

Ranibizumab

Solution for intravitreal injection 2.3 mg in 0.23 mL

Injection

1

2

Lucentis

Ranitidine

Tablet 150 mg (as hydrochloride)

Oral

60

5

Ausran

 

 

 

 

 

Chem mart Ranitidine

 

 

 

 

 

GenRx Ranitidine

 

 

 

 

 

Rani 2

 

 

 

 

 

Ranihexal

 

 

 

 

 

Ranoxyl

 

 

 

 

 

Terry White Chemists Ranitidine

 

 

 

 

 

Ulcaid

 

 

 

 

 

Zantac

 

Tablet, effervescent, 150 mg (as hydrochloride)

Oral

60

5

Zantac

 

Tablet 300 mg (as hydrochloride)

Oral

30

5

Ausran

 

 

 

 

 

Chem mart Ranitidine

 

 

 

 

 

GenRx Ranitidine

 

 

 

 

 

Rani 2

 

 

 

 

 

Ranihexal

 

 

 

 

 

Terry White Chemists Ranitidine

 

 

 

 

 

Ulcaid

 

 

 

 

 

Zantac

 

Syrup 150 mg (as hydrochloride) per 10 mL, 300 mL

Oral

2

5

Zantac Syrup

Reboxetine

Tablet 4 mg (as mesilate)

Oral

60

5

Edronax

Reteplase

Pack containing 2 vials powder for injection 10 units, 2 single use pre-filled syringes with solvent, 2 reconstitution spikes and 2 needles

Injection

1

..

Rapilysin 10 U

Rifampicin

Capsule 150 mg

Oral

10

..

Rimycin 150

 

Capsule 300 mg

Oral

10

..

Rimycin 300

 

Syrup 100 mg per 5 mL, 60 mL

Oral

1

..

Rifadin

Riluzole

Tablet 50 mg

Oral

56

5

Rilutek

Risedronic Acid

Tablet containing risedronate sodium 5 mg

Oral

28

5

Actonel

 

Tablet containing risedronate sodium 35 mg

Oral

4

5

Actonel Once-a-Week

 

Tablet containing risedronate sodium 150 mg

Oral

1

5

Actonel Once-a-Month

 

Tablet containing risedronate sodium 30 mg

Oral

28

1

Actonel

 

 

 

 

 

 

Risedronic Acid and Calcium

Pack containing 4 tablets risedronate sodium 35 mg and 24 tablets calcium 500 mg (as carbonate)

Oral

1

5

Actonel Combi

Risedronic acid and calcium with colecalciferol

Pack containing 4 tablets risedronate sodium 35 mg and 24 sachets containing granules of calcium carbonate 2.5 g with colecalciferol 22 micrograms

Oral

1

5

Actonel Combi D

Risperidone

Tablet 0.5 mg

Oral

60

2

APO-Risperidone

 

 

 

 

 

Ozidal

 

 

 

 

 

Resdone 0.5

 

 

 

 

 

Rispa

 

 

 

 

 

Risperdal

 

 

 

 

 

Risperidone-GA

 

 

 

 

 

Rixadone

 

Tablet 0.5 mg (orally disintegrating)

Oral

56

2

Risperdal Quicklet

 

Tablet 1 mg

Oral

60

2

APO-Risperidone

 

 

 

 

 

Ozidal

 

 

 

 

 

Resdone 1

 

 

 

 

 

Rispa

 

 

 

 

 

Risperdal

 

 

 

 

 

Risperidone-GA

 

 

 

 

 

Risperidone generichealth

 

 

 

 

 

Rixadone

 

Tablet 1 mg (orally disintegrating)

Oral

56

2

Risperdal Quicklet

 

Tablet 2 mg

Oral

60

2

APO-Risperidone

 

 

 

 

 

Ozidal

 

 

 

 

 

Resdone 2

 

 

 

 

 

Rispa

 

 

 

 

 

Risperdal

 

 

 

 

 

Risperidone-GA

 

 

 

 

 

Risperidone generichealth

 

 

 

 

 

Rixadone

 

Tablet 2 mg (orally disintegrating)

Oral

56

2

Risperdal Quicklet

 

Tablet 3 mg

Oral

60

5

APO-Risperidone

 

 

 

 

 

Ozidal

 

 

 

 

 

Resdone 3

 

 

 

 

 

Rispa

 

 

 

 

 

Risperdal

 

 

 

 

 

Risperidone-GA

 

 

 

 

 

Risperidone generichealth

 

 

 

 

 

Rixadone

 

Tablet 3 mg (orally disintegrating)

Oral

56

5

Risperdal Quicklet

 

Tablet 4 mg

Oral

60

5

APO-Risperidone

 

 

 

 

 

Ozidal

 

 

 

 

 

Resdone 4

 

 

 

 

 

Rispa

 

 

 

 

 

Risperdal

 

 

 

 

 

Risperidone-GA

 

 

 

 

 

Risperidone generichealth

 

 

 

 

 

Rixadone

 

Tablet 4 mg (orally disintegrating)

Oral

56

5

Risperdal Quicklet

 

Oral solution 1 mg per mL, 100 mL

Oral

1

2

Risperdal

 

I.M. injection (modified release), set containing 1 vial powder for injection 25 mg and 1 pre-filled syringe diluent 2 mL

Injection

2

5

Risperdal Consta

 

I.M. injection (modified release), set containing 1 vial powder for injection 37.5 mg and 1 pre-filled syringe diluent 2 mL

Injection

2

5

Risperdal Consta

 

I.M. injection (modified release), set containing 1 vial powder for injection 50 mg and 1 pre-filled syringe diluent 2 mL

Injection

2

5

Risperdal Consta

Rituximab

Solution for I.V. infusion 100 mg in 10 mL

Injection

2

3

Mabthera

 

Solution for I.V. infusion 500 mg in 50 mL

Injection

1

3

Mabthera

Rivaroxaban

Tablets 10 mg, 30

Oral

1

..

Xarelto

 

Tablets 10 mg, 10

Oral

1

..

Xarelto

 

Tablet 10 mg

Oral

15

..

Xarelto

Rivastigmine

Capsule 1.5 mg (as hydrogen tartrate)

Oral

56

5

Exelon

 

Capsule 3 mg (as hydrogen tartrate)

Oral

56

5

Exelon

 

Capsule 4.5 mg (as hydrogen tartrate)

Oral

56

5

Exelon

 

Capsule 6 mg (as hydrogen tartrate)

Oral

56

5

Exelon

 

Oral solution 2 mg (as hydrogen tartrate) per mL, 120 mL

Oral

1

5

Exelon

 

Transdermal patch 9 mg

Transdermal

30

5

Exelon Patch 5

 

Transdermal patch 18 mg

Transdermal

30

5

Exelon Patch 10

Rizatriptan

Wafer 10 mg (as benzoate)

Oral

4

5

Maxalt

Rosiglitazone

Tablet 4 mg (as maleate)

Oral

28

5

Avandia

 

Tablet 8 mg (as maleate)

Oral

28

5

Avandia

Rosiglitazone with Metformin

Tablet 2 mg rosiglitazone (as maleate) with 500 mg metformin hydrochloride

Oral

56

5

Avandamet

 

Tablet 2 mg rosiglitazone (as maleate) with 1 g metformin hydrochloride

Oral

56

5

Avandamet

 

Tablet 4 mg rosiglitazone (as maleate) with 500 mg metformin hydrochloride

Oral

56

5

Avandamet

 

Tablet 4 mg rosiglitazone (as maleate) with 1 g metformin hydrochloride

Oral

56

5

Avandamet

Rosuvastatin

Tablet 5 mg (as calcium)

Oral

30

5

Crestor

 

Tablet 10 mg (as calcium)

Oral

30

5

Crestor

 

Tablet 20 mg (as calcium)

Oral

30

5

Crestor

 

Tablet 40 mg (as calcium)

Oral

30

5

Crestor

Roxithromycin

Tablet for oral suspension 50 mg

Oral

10

1

Rulide D

 

Tablet 150 mg

Oral

10

1

APO-Roxithromycin

 

 

 

 

 

Biaxsig

 

 

 

 

 

Chem mart Roxithromycin

 

 

 

 

 

Roxar 150

 

 

 

 

 

Roxide

 

 

 

 

 

Roximycin

 

 

 

 

 

Roxithromycin-GA

 

 

 

 

 

Rulide

 

 

 

 

 

Terry White Chemists Roxithromycin

 

Tablet 300 mg

Oral

5

1

APO-Roxithromycin

 

 

 

 

 

Biaxsig

 

 

 

 

 

Chem mart Roxithromycin

 

 

 

 

 

Roxar 300

 

 

 

 

 

Roxide

 

 

 

 

 

Roximycin

 

 

 

 

 

Roxithromycin-GA

 

 

 

 

 

Rulide

 

 

 

 

 

Terry White Chemists Roxithromycin

Salbutamol

Oral solution 2 mg (as sulfate) per 5 mL, 150 mL

Oral

2

5

Ventolin

 

Capsule containing powder for oral inhalation 200 micrograms (as sulfate) (for use in Ventolin Rotahaler)

Inhalation by mouth

200

5

Ventolin Rotacaps

 

Pressurised inhalation 100 micrograms (as sulfate) per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

2

5

Airomir

 

 

 

 

 

Asmol CFC-free

 

 

 

 

 

Ventolin CFC-free

 

Pressurised inhalation in breath actuated device 100 micrograms (as sulfate) per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

2

5

Airomir Autohaler

 

Nebuliser solution 2.5 mg (as sulfate) in 2.5 mL single dose units, 30

Inhalation

2

5

Asmol 2.5 uni-dose

Butamol 2.5

GenRx Salbutamol

Pfizer Australia Pty Ltd

Pharmacor Salbutamol 2.5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salbutamol-GA

 

 

 

 

 

Salbutamol Sandoz

Ventolin Nebules

 

Nebuliser solution 5 mg (as sulfate) in 2.5 mL single dose units, 30

Inhalation

2

5

Asmol 5 uni-dose

Butamol 5

GenRx Salbutamol

Pharmacor Salbutamol 5

Salbutamol-GA

Salbutamol Sandoz

Ventolin Nebules

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nebuliser solution 5 mg (as sulfate) per mL, 30 mL

Inhalation

2

2

Pfizer Australia Pty Ltd

Salcatonin

Injection 50 I.U. in 1 mL ampoule

Injection

30

5

Miacalcic 50

 

Injection 100 I.U. in 1 mL ampoule

Injection

15

5

Miacalcic 100

Salmeterol

Powder for oral inhalation in breath actuated device 50 micrograms (as xinafoate) per dose, 60 doses

Inhalation by mouth

1

5

Serevent Accuhaler

Selegiline

Tablet containing selegiline hydrochloride 5 mg

Oral

100

5

Eldepryl

 

 

 

 

 

Selgene

Sertraline

Tablet 50 mg (as hydrochloride)

Oral

30

5

Chem mart Sertraline

 

 

 

 

 

Concorz

 

 

 

 

 

Eleva 50

 

 

 

 

 

GenRx Sertraline

 

 

 

 

 

Sertra 50

 

 

 

 

 

Sertraline 50

 

 

 

 

 

Sertraline-GA

 

 

 

 

 

Sertraline generichealth

 

 

 

 

 

Sertraline Winthrop

 

 

 

 

 

Setrona

 

 

 

 

 

Terry White Chemists Sertraline

 

 

 

 

 

Xydep 50

 

 

 

 

 

Zoloft

 

Tablet 100 mg (as hydrochloride)

Oral

30

5

Chem mart Sertraline

 

 

 

 

 

Concorz

 

 

 

 

 

Eleva 100

 

 

 

 

 

GenRx Sertraline

 

 

 

 

 

Sertra 100

 

 

 

 

 

Sertraline 100

 

 

 

 

 

Sertraline-GA

 

 

 

 

 

Sertraline generichealth

 

 

 

 

 

Setrona

 

 

 

 

 

Terry White Chemists Sertraline

 

 

 

 

 

Xydep 100

 

 

 

 

 

Zoloft

Sevelamer

Tablet containing sevelamer hydrochloride 800 mg

Oral

180

5

Renagel

Silver sulfadiazine

Cream 10 mg per g, 50 g

Application

1

..

Flamazine

Simvastatin

Tablet 5 mg

Oral

30

5

Simvabell

 

 

 

 

 

Simvahexal

 

 

 

 

 

Simvasyn

 

 

 

 

 

Zimstat

 

 

 

 

 

Zocor

 

Tablet 10 mg

Oral

30

5

APO-Simvastatin

 

 

 

 

 

Chem mart Simvastatin

 

 

 

 

 

GenRx Simvastatin

 

 

 

 

 

Lipex 10

 

 

 

 

 

Pharmacor Simvastatin 10

 

 

 

 

 

Ransim

 

 

 

 

 

Simvabell

 

 

 

 

 

Simvahexal

 

 

 

 

 

Simvar 10

 

 

 

 

 

Simvastatin-DP

 

 

 

 

 

Simvastatin-GA 10

 

 

 

 

 

Simvastatin generichealth

 

 

 

 

 

Simvastatin-Spirit 10

 

 

 

 

 

Simvastatin Winthrop

 

 

 

 

 

Simvasyn

 

 

 

 

 

Terry White Chemists Simvastatin

 

 

 

 

 

Zimstat

 

 

 

 

 

Zocor

 

Tablet 20 mg

Oral

30

5

APO-Simvastatin

 

 

 

 

 

Chem mart Simvastatin

 

 

 

 

 

GenRx Simvastatin

 

 

 

 

 

Lipex 20

 

 

 

 

 

Pharmacor Simvastatin 20

 

 

 

 

 

Ransim

 

 

 

 

 

Simvabell

 

 

 

 

 

Simvahexal

 

 

 

 

 

Simvar 20

 

 

 

 

 

Simvastatin-DP

 

 

 

 

 

Simvastatin-GA 20

 

 

 

 

 

Simvastatin generichealth

 

 

 

 

 

Simvastatin-Spirit 20

 

 

 

 

 

Simvastatin Winthrop

 

 

 

 

 

Simvasyn

 

 

 

 

 

Terry White Chemists Simvastatin

 

 

 

 

 

Zimstat

 

 

 

 

 

Zocor

 

Tablet 40 mg

Oral

30

5

APO-Simvastatin

 

 

 

 

 

Chem mart Simvastatin

 

 

 

 

 

GenRx Simvastatin

 

 

 

 

 

Lipex 40

 

 

 

 

 

Pharmacor Simvastatin 40

 

 

 

 

 

Ransim

 

 

 

 

 

Simvabell

 

 

 

 

 

Simvahexal

 

 

 

 

 

Simvar 40

 

 

 

 

 

Simvastatin-DP

 

 

 

 

 

Simvastatin-GA 40

 

 

 

 

 

Simvastatin generichealth

 

 

 

 

 

Simvastatin-Spirit 40

 

 

 

 

 

Simvastatin Winthrop

 

 

 

 

 

Simvasyn

 

 

 

 

 

Terry White Chemists Simvastatin

 

 

 

 

 

Zimstat

 

 

 

 

 

Zocor

 

Tablet 80 mg

Oral

30

5

APO-Simvastatin

 

 

 

 

 

Chem mart Simvastatin

 

 

 

 

 

GenRx Simvastatin

 

 

 

 

 

Lipex 80

 

 

 

 

 

Pharmacor Simvastatin 80

 

 

 

 

 

Ransim

 

 

 

 

 

Simvabell

 

 

 

 

 

Simvahexal

 

 

 

 

 

Simvar 80

 

 

 

 

 

Simvastatin-DP

 

 

 

 

 

Simvastatin-GA 80

 

 

 

 

 

Simvastatin generichealth

 

 

 

 

 

Simvastatin-Spirit 80

 

 

 

 

 

Simvastatin Winthrop

 

 

 

 

 

Simvasyn

 

 

 

 

 

Terry White Chemists Simvastatin

 

 

 

 

 

Zimstat

 

 

 

 

 

Zocor

Sirolimus

Tablet 1 mg

Oral

100

3

Rapamune

 

Tablet 2 mg

Oral

100

3

Rapamune

 

Oral solution 1 mg per mL, 60 mL

Oral

1

3

Rapamune

Sitagliptin

Tablet 25 mg (as phosphate monohydrate)

Oral

28

5

Januvia

 

Tablet 50 mg (as phosphate monohydrate)

Oral

28

5

Januvia

 

Tablet 100 mg (as phosphate monohydrate)

Oral

28

5

Januvia

Sitagliptin with metformin

Tablet containing 50 mg sitagliptin (as phosphate monohydrate) with 500 mg metformin hydrochloride

Oral

56

5

Janumet

 

Tablet containing 50 mg sitagliptin (as phosphate monohydrate) with 850 mg metformin hydrochloride

Oral

56

5

Janumet

 

Tablet containing 50 mg sitagliptin (as phosphate monohydrate) with 1000 mg metformin hydrochloride

Oral

56

5

Janumet

Sodium Acid Phosphate

Tablet, compound effervescent, equivalent to 500 mg phosphorus

Oral

100

5

Phosphate Sandoz

Sodium bicarbonate

Capsule 840 mg

Oral

100

2

Sodibic

Sodium Chloride

Injection 9 mg per mL, 10 mL

Injection/solvent for injectables

5

1

Pfizer Australia Pty Ltd

 

I.V. infusion 38.5 mmol per 250 mL, 250 mL

Injection

5

1

B. Braun Australia Pty Ltd

 

 

 

 

 

Sodium Chloride 0.9% Freeflex

 

I.V. infusion 77 mmol per 500 mL, 500 mL

Injection

5

1

B. Braun Australia Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

 

I.V. infusion 154 mmol per L, 1 L

Injection

5

1

B. Braun Australia Pty Ltd

 

 

 

 

 

Baxter Healthcare Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

 

I.V. infusion 513 mmol per L, 1 L

Injection

2

1

Baxter Healthcare Pty Ltd

Sodium Chloride Compound

I.V. infusion containing approximately 148 mmol sodium (as chloride), 4 mmol potassium (as chloride), 2 mmol calcium (as chloride) and 156 mmol chloride per L, 1 L

Injection

4

1

Baxter Healthcare Pty Ltd

Sodium Chloride with Glucose

I.V. infusion 31 mmol-222 mmol (anhydrous) per L, 1 L

Injection

5

1

Baxter Healthcare Pty Ltd

 

I.V. infusion 19 mmol-104 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

1

Baxter Healthcare Pty Ltd

 

I.V. infusion 39 mmol-69 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

1

Baxter Healthcare Pty Ltd

Sodium Lactate Compound

I.V. infusion containing approximately 65 mmol sodium (as lactate and chloride), 2.7 mmol potassium (as chloride), 0.9 mmol calcium (as chloride), 14 mmol bicarbonate (as lactate) and 56 mmol chloride per 500 mL, 500 mL

Injection

5

1

B. Braun Australia Pty Ltd

Fresenius Kabi Australia Pty Limited

 

I.V. infusion containing approximately 131 mmol sodium (as lactate and chloride), 5 mmol potassium (as chloride), 2 mmol calcium (as chloride), 29 mmol bicarbonate (as lactate) and 111 mmol chloride per L, 1 L

Injection

5

1

B. Braun Australia Pty Ltd

Baxter Healthcare Pty Ltd

Fresenius Kabi Australia Pty Limited

Sorafenib

Tablet 200 mg (as tosylate)

Oral

120

2

Nexavar

Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate

Enemas 3.125 g-450 mg-45 mg in 5 mL, 12

Rectal

2

2

Microlax

Sotalol

Tablet containing sotalol hydrochloride 80 mg

Oral

60

5

GenRx Sotalol

 

 

 

 

 

Solavert

 

 

 

 

 

Sotacor

 

 

 

 

 

Sotalol Sandoz

 

Tablet containing sotalol hydrochloride 160 mg

Oral

60

5

Cardol

 

 

 

 

 

Chem mart Sotalol

 

 

 

 

 

GenRx Sotalol

 

 

 

 

 

Solavert

 

 

 

 

 

Sotacor

 

 

 

 

 

Sotalol Sandoz

 

 

 

 

 

Terry White Chemists Sotalol

Soy lecithin

Eye spray 10 mg per mL, 10 mL

Application

2

5

tearsagain

Soy protein and fat formula with vitamins and minerals — carbohydrate free

Oral liquid 384 mL (RCF)

Oral

120

5

RCF

Spironolactone

Tablet 25 mg

Oral

100

5

Aldactone

 

 

 

 

 

Spiractin 25

 

Tablet 100 mg

Oral

100

5

Aldactone

 

 

 

 

 

Spiractin 100

Sterculia with Frangula Bark

Granules 620 mg-80 mg per g, 500 g

Oral

1

1

Normacol Plus

Strontium

Sachet containing granules for oral suspension containing strontium ranelate 2 g

Oral

28

5

Protos 2 g

Sucralfate

Tablet equivalent to 1 g anhydrous sucralfate

Oral

120

2

Carafate

 

 

 

 

 

Ulcyte

Sulfacetamide

Eye drops containing sulfacetamide sodium 100 mg per mL, 15 mL

Application to the eye

1

2

Bleph 10

Sulfasalazine

Tablet 500 mg

Oral

200

5

Salazopyrin

 

Tablet 500 mg (enteric coated)

Oral

200

5

Pyralin EN

 

 

 

 

 

Salazopyrin-EN

Sulindac

Tablet 100 mg

Oral

100

3

Aclin

 

Tablet 200 mg

Oral

50

3

Aclin 200

Sulthiame

Tablet 50 mg

Oral

200

2

Ospolot

 

Tablet 200 mg

Oral

200

2

Ospolot

Sumatriptan

Tablet 50 mg (as succinate)

Oral

4

5

Imigran

 

 

 

 

 

Sumagran 50

 

 

 

 

 

Sumatab

 

Tablet (fast disintegrating) 50 mg (as succinate)

Oral

4

5

Imigran FDT

 

Nasal spray 20 mg in 0.1 mL single dose unit

Nasal

2

5

Imigran

Sunitinib

Capsule 12.5 mg (as malate)

Oral

28

1

Sutent

 

Capsule 25 mg (as malate)

Oral

28

1

Sutent

 

Capsule 50 mg (as malate)

Oral

28

1

Sutent

Tacrolimus

Capsule 500 micrograms

Oral

100

3

Prograf

 

Capsule 1 mg

Oral

100

3

Prograf

 

Capsule 5 mg

Oral

50

3

Prograf

Tamoxifen

Tablet 10 mg (as citrate)

Oral

60

5

Genox 10

 

Tablet 20 mg (as citrate)

Oral

60

5

Genox 20

 

 

 

 

 

GenRx Tamoxifen

 

 

 

 

 

Nolvadex-D

 

 

 

 

 

Tamosin

 

 

 

 

 

Tamoxen 20 mg

 

 

 

 

 

Tamoxifen Sandoz

Telmisartan

Tablet 40 mg

Oral

28

5

Micardis

 

Tablet 80 mg

Oral

28

5

Micardis

Telmisartan with Hydrochlorothiazide

Tablet 40 mg-12.5 mg

Oral

28

5

Micardis Plus 40/12.5 mg

 

Tablet 80 mg-12.5 mg

Oral

28

5

Micardis Plus 80/12.5 mg

 

Tablet 80 mg-25 mg

Oral

28

5

Micardis Plus 80/25 mg

Temazepam

Tablet 10 mg

Oral

25

..

APO-Temazepam

 

 

 

 

 

Normison

 

 

 

 

 

Temaze

 

 

 

 

 

Temtabs

Temozolomide

Capsule 5 mg

Oral

15

2

Temodal

 

Capsule 20 mg

Oral

15

2

Temodal

 

Capsule 100 mg

Oral

15

2

Temodal

 

Capsule 140 mg

Oral

15

2

Temodal

 

Capsule 250 mg

Oral

5

5

Temodal

Tenecteplase

Powder for injection 40 mg with solvent

Injection

1

..

Metalyse

 

Powder for injection 50 mg with solvent

Injection

1

..

Metalyse

Terbinafine

Tablet 250 mg (as hydrochloride)

Oral

42

..

GenRx Terbinafine

 

 

 

 

 

Lamisil (Novartis Pharmaceuticals Australia Pty Limited)

 

 

 

 

 

Sebifin 250

 

 

 

 

 

Tamsil

 

 

 

 

 

Terbihexal

 

 

 

 

 

Terbinafine 250

 

 

 

 

 

Terbinafine-DP

 

 

 

 

 

Terbinafine-GA

 

 

 

 

 

Terbix 250

 

 

 

 

 

Zabel

 

Cream containing terbinafine hydrochloride 10 mg per g, 15 g

Application

2

3

Lamisil (Novartis Consumer Health Australasia Pty Ltd)

Terbutaline

Injection containing terbutaline sulfate 500 micrograms in 1 mL

Injection

5

..

Bricanyl

 

Powder for oral inhalation in breath actuated device containing terbutaline sulfate 500 micrograms per dose, 200 doses

Inhalation by mouth

1

5

Bricanyl Turbuhaler

Teriparatide

Injection 250 micrograms per mL, 2.4 mL in multi-dose pre-filled pen

Injection

1

5

Forteo

Testosterone

Capsule containing testosterone undecanoate 40 mg

Oral

60

5

Andriol Testocaps

 

Subcutaneous implant 100 mg

Implantation

6

..

Schering-Plough Pty Limited

 

Injection containing testosterone enanthate 250 mg in 1 mL

Injection

3

3

Primoteston Depot

 

Injection containing testosterone esters (20 mg testosterone propionate, 40 mg testosterone phenylpropionate, 40 mg testosterone isocaproate) in 1 mL

Injection

3

3

Sustanon 100

 

I.M. injection containing testosterone undecanoate 1,000 mg in 4 mL

Injection

1

1

Reandron 1000

 

Subcutaneous implant 200 mg

Implantation

3

..

Schering-Plough Pty Limited

 

Injection containing testosterone esters (30 mg testosterone propionate, 60 mg testosterone phenylpropionate, 60 mg testosterone isocaproate, 100 mg testosterone decanoate) in 1 mL

Injection

3

3

Sustanon 250

 

Transdermal gel 50 mg in 5 g sachet, 30

Transdermal

1

5

Testogel

 

Transdermal patches 12.2 mg, 60

Transdermal

1

5

Androderm

 

Transdermal patches 24.3 mg, 30

Transdermal

1

5

Androderm

Tetrabenazine

Tablet 25 mg

Oral

112

5

Orphan Australia Pty Ltd

Tetracosactrin

Compound depot injection 1 mg in 1 mL

Injection

5

5

Synacthen Depot 1 mg/1 mL

Theophylline

Tablet 200 mg (sustained release)

Oral

100

5

Nuelin-SR 200

 

Tablet 250 mg (sustained release)

Oral

100

5

Nuelin-SR 250

 

Tablet 300 mg (sustained release)

Oral

100

5

Nuelin-SR 300

 

Oral solution 133.3 mg per 25 mL, 500 mL

Oral

1

5

Nuelin

Thiamine

Tablet containing thiamine hydrochloride 100 mg

Oral

100

2

Betamin

Thioguanine

Tablet 40 mg

Oral

25

1

Lanvis

Thiotepa

Powder for injection 15 mg

Injection/intravesical

2

1

Sigma Pharmaceuticals (Australia) Pty Ltd

Thyrotropin Alfa

Powder for injection 0.9 mg, 2

Injection

1

..

Thyrogen

Thyroxine

Tablet containing 50 micrograms anhydrous thyroxine sodium

Oral

200

1

Eutroxsig

 

 

 

 

 

Oroxine

 

Tablet containing 75 micrograms anhydrous thyroxine sodium

Oral

200

1

Eutroxsig

 

 

 

 

 

Oroxine

 

Tablet containing 100 micrograms anhydrous thyroxine sodium

Oral

200

1

Eutroxsig

 

 

 

 

 

Oroxine

 

Tablet containing 200 micrograms anhydrous thyroxine sodium

Oral

200

1

Eutroxsig

 

 

 

 

 

Oroxine

Tiagabine

Tablet 5 mg (as hydrochloride)

Oral

100

5

Gabitril

 

Tablet 10 mg (as hydrochloride)

Oral

100

5

Gabitril

 

Tablet 15 mg (as hydrochloride)

Oral

100

5

Gabitril

Tiaprofenic Acid

Tablet 300 mg

Oral

60

3

Surgam

Ticarcillin with Clavulanic Acid

Powder for injection containing ticarcillin 3 g (as sodium) with 100 mg clavulanic acid (as potassium clavulanate) (with any determined brand of sodium chloride injection as the required solvent)

Injection

10

..

Timentin

Ticlopidine

Tablet containing ticlopidine hydrochloride 250 mg

Oral

60

5

Tilodene

Tiludronic Acid

Tablet 200 mg (as tiludronate disodium)

Oral

56

2

Skelid

Timolol

Eye gel 1 mg (as maleate) per g, 5 g

Application to the eye

1

5

Nyogel

 

Eye drops 2.5 mg (as maleate) per mL, 5 mL

Application to the eye

1

5

Tenopt

 

 

 

 

 

Timoptol

 

Eye drops 5 mg (as maleate) per mL, 5 mL

Application to the eye

1

5

Tenopt

 

 

 

 

 

Timoptol

 

Eye drops (gellan gum solution) 2.5 mg (as maleate) per mL, 2.5 mL

Application to the eye

1

5

Timoptol XE

 

Eye drops (gellan gum solution) 5 mg (as maleate) per mL, 2.5 mL

Application to the eye

1

5

Timoptol XE

Tinidazole

Tablet 500 mg

Oral

4

..

Fasigyn

 

 

 

 

 

Simplotan

Tiotropium

Capsule containing powder for oral inhalation 18 micrograms (as bromide monohydrate) (for use in HandiHaler)

Inhalation by mouth

30

5

Spiriva

Tirofiban

Solution concentrate for I.V. infusion 12.5 mg (as hydrochloride) in 50 mL

Injection

1

2

Aggrastat

Tobramycin

Injection 80 mg (as sulfate) in 2 mL

Injection

10

1

Hospira Pty Limited

 

Injection 80 mg (as sulfate) in 2 mL (without preservative)

Injection

10

1

Pfizer Australia Pty Ltd

 

Injection 500 mg (as sulfate) in 5 mL (without preservative)

Injection

10

1

Tobra-Day

 

Eye drops 3 mg per mL, 5 mL

Application to the eye

1

2

Tobrex

 

Eye ointment 3 mg per g, 3.5 g

Application to the eye

1

..

Tobrex

Topiramate

Tablet 25 mg

Oral

60

5

APO-Topiramate

 

 

 

 

 

Epiramax 25

 

 

 

 

 

Tamate

 

 

 

 

 

Topamax

 

 

 

 

 

Topiramate-GA

 

 

 

 

 

Topiramate Sandoz

 

Tablet 50 mg

Oral

60

5

APO-Topiramate

 

 

 

 

 

Epiramax 50

 

 

 

 

 

Tamate

 

 

 

 

 

Topamax

 

 

 

 

 

Topiramate-GA

 

 

 

 

 

Topiramate Sandoz

 

Tablet 100 mg

Oral

60

5

APO-Topiramate

 

 

 

 

 

Epiramax 100

 

 

 

 

 

Tamate

 

 

 

 

 

Topamax

 

 

 

 

 

Topiramate-GA

 

 

 

 

 

Topiramate Sandoz

 

Tablet 200 mg

Oral

60

5

APO-Topiramate

 

 

 

 

 

Epiramax 200

 

 

 

 

 

Tamate

 

 

 

 

 

Topamax

 

 

 

 

 

Topiramate-GA

 

 

 

 

 

Topiramate Sandoz

 

Capsule 15 mg

Oral

60

5

Topamax Sprinkle

 

Capsule 25 mg

Oral

60

5

Topamax Sprinkle

 

Capsule 50 mg

Oral

60

5

Topamax Sprinkle

Topotecan

Powder for I.V. infusion 4 mg (as hydrochloride)

Injection

5

1

Hycamtin

Toremifene

Tablet 60 mg (as citrate)

Oral

30

5

Fareston

Tramadol

Capsule containing tramadol hydrochloride 50 mg

Oral

20

..

Chem mart Tramadol

 

 

 

 

 

GA Tramadol 50mg

 

 

 

 

 

GenRx Tramadol

 

 

 

 

 

Lodam 50

 

 

 

 

 

Terry White Chemists Tramadol

 

 

 

 

 

Tramal

 

 

 

 

 

Tramedo

 

 

 

 

 

Zydol

 

Tablet (sustained release) containing tramadol hydrochloride 50 mg

Oral

20

..

Tramal SR 50

 

Tablet (sustained release) containing tramadol hydrochloride 100 mg

Oral

20

..

APO-Tramadol SR

 

 

 

 

 

Chem mart Tramadol SR

 

 

 

 

 

GA Tramadol SR 100mg

 

 

 

 

 

Lodam SR 100

 

 

 

 

 

Terry White Chemists Tramadol SR

 

 

 

 

 

Tramahexal SR

 

 

 

 

 

Tramal SR 100

 

 

 

 

 

Tramedo SR 100

 

 

 

 

 

Zydol SR 100

 

Tablet (extended release) containing tramadol hydrochloride 100 mg

Oral

10

..

Durotram XR

 

Tablet (sustained release) containing tramadol hydrochloride 150 mg

Oral

20

..

APO-Tramadol SR

 

 

 

 

 

Chem mart Tramadol SR

 

 

 

 

 

GA Tramadol SR 150mg

 

 

 

 

 

Lodam SR 150

 

 

 

 

 

Terry White Chemists Tramadol SR

 

 

 

 

 

Tramahexal SR

 

 

 

 

 

Tramal SR 150

 

 

 

 

 

Tramedo SR 150

 

 

 

 

 

Zydol SR 150

 

Tablet (sustained release) containing tramadol hydrochloride 200 mg

Oral

20

..

APO-Tramadol SR

 

 

 

 

 

Chem mart Tramadol SR

 

 

 

 

 

GA Tramadol SR 200mg

 

 

 

 

 

Lodam SR 200

 

 

 

 

 

Terry White Chemists Tramadol SR

 

 

 

 

 

Tramahexal SR

 

 

 

 

 

Tramal SR 200

 

 

 

 

 

Tramedo SR 200

 

 

 

 

 

Zydol SR 200

 

Tablet (extended release) containing tramadol hydrochloride 200 mg

Oral

10

..

Durotram XR

 

Tablet (extended release) containing tramadol hydrochloride 300 mg

Oral

10

..

Durotram XR

 

Oral drops containing tramadol hydrochloride 100 mg per mL, 10 mL

Oral

1

..

Tramal

 

Injection containing tramadol hydrochloride 100 mg in 2 mL

Injection

5

..

Tramahexal

 

 

 

 

 

Tramal 100

Trandolapril

Capsule 500 micrograms

Oral

28

5

APO-Trandolapril

 

 

 

 

 

Dolapril 0.5

 

 

 

 

 

Gopten

 

 

 

 

 

Tranalpha

 

 

 

 

 

Trandolapril-DP

 

 

 

 

 

Trandolapril generichealth

 

Capsule 1 mg

Oral

28

5

APO-Trandolapril

 

 

 

 

 

Dolapril 1

 

 

 

 

 

Gopten

 

 

 

 

 

Tranalpha

 

 

 

 

 

Trandolapril-DP

 

 

 

 

 

Trandolapril generichealth

 

Capsule 2 mg

Oral

28

5

APO-Trandolapril

 

 

 

 

 

Dolapril 2

 

 

 

 

 

Gopten

 

 

 

 

 

Tranalpha

 

 

 

 

 

Trandolapril-DP

 

 

 

 

 

Trandolapril generichealth

 

Capsule 4 mg

Oral

28

5

APO-Trandolapril

 

 

 

 

 

Dolapril 4

 

 

 

 

 

Gopten

 

 

 

 

 

Tranalpha

 

 

 

 

 

Trandolapril-DP

 

 

 

 

 

Trandolapril generichealth

Trandolapril with Verapamil

Tablet containing trandolapril 2 mg with verapamil hydrochloride 180 mg (sustained release)

Oral

28

5

Tarka 2/180

 

Tablet containing trandolapril 4 mg with verapamil hydrochloride 240 mg (sustained release)

Oral

28

5

Tarka 4/240

Tranexamic Acid

Tablet 500 mg

Oral

100

2

Cyklokapron

Tranylcypromine

Tablet 10 mg (as sulfate)

Oral

50

2

Parnate

Travoprost

Eye drops 40 micrograms per mL, 2.5 mL

Application to the eye

1

5

Travatan

Travoprost with Timolol

Eye drops 40 micrograms travoprost with timolol 5 mg (as maleate) per mL, 2.5 mL

Application to the eye

1

5

Duotrav

Triamcinolone

Injection containing triamcinolone acetonide 10 mg in 1 mL

Injection

5

..

Kenacort-A10

 

Cream containing triamcinolone acetonide 200 micrograms per g, 100 g

Application

2

..

Aristocort 0.02%

 

 

 

 

 

Tricortone

 

Ointment containing triamcinolone acetonide 200 micrograms per g, 100 g

Application

2

..

Aristocort 0.02%

 

 

 

 

 

Tricortone

Triamcinolone with Neomycin, Gramicidin and Nystatin

Ear drops containing triamcinolone acetonide 1 mg with neomycin 2.5 mg (as sulfate), gramicidin 250 micrograms and nystatin 100,000 units per g, 7.5 mL

Application to the ear

1

2

Kenacomb Otic

 

 

 

 

 

Otocomb Otic

 

 

 

 

 

 

 

 

 

 

 

 

 

Ear ointment containing triamcinolone acetonide 1 mg with neomycin 2.5 mg (as sulfate), gramicidin 250 micrograms and nystatin 100,000 units per g, 5 g

Application to the ear

1

2

Kenacomb Otic

Otocomb Otic

Trifluoperazine

Tablet 1 mg (as hydrochloride)

Oral

100

5

Stelazine

 

Tablet 2 mg (as hydrochloride)

Oral

100

5

Stelazine

 

Tablet 5 mg (as hydrochloride)

Oral

100

5

Stelazine

Triglycerides, long chain with glucose polymer

Oral liquid 250 mL, 18 (ProZero)

Oral

6

5

ProZero

 

Oral liquid 1 L, 6 (ProZero)

Oral

4

5

ProZero

Triglycerides, medium chain

Oil 500 mL (MCT Oil)

Oral

2

5

MCT Oil

 

Oral emulsion 250 mL (Liquigen)

Oral

8

5

Liquigen

Triglycerides, medium chain and long chain with glucose polymer

Oral powder 400 g (Duocal)

Oral

8

5

Duocal

Triglycerides — medium chain, formula

Sachets containing oral powder 16 g, 25 (MCT Pro-Cal)

Oral

4

5

MCT Pro-Cal

 

Oral powder 400 g (Monogen)

Oral

8

5

Monogen

 

Oral powder 420 g (Caprilon)

Oral

8

5

Caprilon

Trimethoprim

Tablet 300 mg

Oral

7

1

Alprim

 

 

 

 

 

Triprim

Trimethoprim with Sulfamethoxazole

Tablet 80 mg-400 mg

Oral

10

1

Resprim

 

Tablet 160 mg-800 mg

Oral

10

1

Bactrim DS

 

 

 

 

 

Resprim Forte

 

 

 

 

 

Septrin Forte

 

Paediatric oral suspension 40 mg-200 mg per 5 mL, 100 mL

Oral

1

1

Bactrim

 

 

 

 

 

Septrin

Triptorelin

Powder for I.M. injection (prolonged release) 3.75 mg (as embonate) with solvent, syringe and needles

Injection

1

5

Diphereline

 

Powder for I.M. injection (prolonged release) 11.25 mg (as embonate) with solvent, syringe and needles

Injection

1

1

Diphereline

Tropisetron

Capsule 5 mg (as hydrochloride)

Oral

2

..

Navoban

 

I.V. injection 5 mg (as hydrochloride) in 5 mL

Injection

1

..

Navoban

Tyrosine with carbohydrate

Sachets of oral powder 4 g containing 1 g tyrosine, 30 (Tyrosine Amino Acid Supplement)

Oral

4

5

Tyrosine Amino Acid Supplement

Ursodeoxycholic Acid

Capsule 250 mg

Oral

200

2

Ursofalk

Ustekinumab

Injection 45 mg in 0.5 mL

Injection

1

1

Stelara

Valaciclovir

Tablet 500 mg (as hydrochloride)

Oral

20

..

Valtrex

Valine with carbohydrate

Sachets of oral powder 4 g containing 50 mg valine, 30 (Valine Amino Acid Supplement)

Oral

4

5

Valine Amino Acid Supplement

 

Sachets of oral powder 4 g containing 1 g valine, 30 (Valine 1000 Amino Acid Supplement)

Oral

4

5

Valine 1000 Amino Acid Supplement

Valproic Acid

Tablet, crushable, containing sodium valproate 100 mg

Oral

200

2

Epilim

 

Tablet (enteric coated) containing sodium valproate 200 mg

Oral

200

2

Epilim EC

 

 

 

 

 

Sodium Valproate Sandoz

 

 

 

 

 

Valprease 200

 

 

 

 

 

Valpro 200

 

 

 

 

 

Valproate Winthrop EC 200

 

Tablet (enteric coated) containing sodium valproate 500 mg

Oral

200

2

Epilim EC

 

 

 

 

 

Sodium Valproate Sandoz

 

 

 

 

 

Valprease 500

 

 

 

 

 

Valpro 500

 

 

 

 

 

Valproate Winthrop EC 500

 

Oral liquid containing sodium valproate 200 mg per 5 mL, 300 mL

Oral

2

2

Epilim Liquid

 

Oral solution containing sodium valproate 200 mg per 5 mL, 300 mL

Oral

2

2

Epilim Syrup

Valsartan

Tablet 40 mg

Oral

28

..

Diovan

 

Tablet 80 mg

Oral

28

5

Diovan

 

Tablet 160 mg

Oral

28

5

Diovan

 

Tablet 320 mg

Oral

28

5

Diovan

Valsartan with hydrochlorothiazide

Tablet 80 mg-12.5 mg

Oral

28

5

Co-Diovan 80/12.5

 

Tablet 160 mg-12.5 mg

Oral

28

5

Co-Diovan 160/12.5

 

Tablet 160 mg-25 mg

Oral

28

5

Co-Diovan 160/25

 

Tablet 320 mg-12.5 mg

Oral

28

5

Co-Diovan 320/12.5

 

Tablet 320 mg-25 mg

Oral

28

5

Co-Diovan 320/25

Vancomycin

Capsule 125 mg (125,000 I.U.) (as hydrochloride)

Oral

40

..

Vancocin

 

Capsule 250 mg (250,000 I.U.) (as hydrochloride)

Oral

40

..

Vancocin

 

Powder for injection 500 mg (500,000 I.U.) (as hydrochloride)

Injection

2

..

Hospira Pty Limited

 

 

 

 

 

Vancocin CP

 

 

 

 

 

Vancomycin Sandoz

 

Powder for injection 1 g (1,000,000 I.U.) (as hydrochloride)

Injection

1

..

Hospira Pty Limited

 

 

 

 

 

Vancomycin Sandoz

Varenicline

Box containing 11 tablets 0.5 mg (as tartrate) and 14 tablets 1 mg (as tartrate) in the first pack and 28 tablets 1 mg (as tartrate) in the second pack

Oral

1

..

Champix

 

Tablet 1 mg (as tartrate)

Oral

112

..

Champix

Venlafaxine

Capsule (modified release) 37.5 mg (as hydrochloride)

Oral

28

..

Efexor-XR

 

Capsule (modified release) 75 mg (as hydrochloride)

Oral

28

5

Efexor-XR

 

Capsule (modified release) 150 mg (as hydrochloride)

Oral

28

5

Efexor-XR

Verapamil

Tablet containing verapamil hydrochloride 40 mg

Oral

100

5

Anpec 40

 

 

 

 

 

Isoptin

 

Tablet containing verapamil hydrochloride 80 mg

Oral

100

5

Anpec 80

 

 

 

 

 

Isoptin

 

Tablet containing verapamil hydrochloride 120 mg

Oral

100

5

Isoptin

 

Tablet containing verapamil hydrochloride 160 mg

Oral

60

5

Isoptin

 

Tablet containing verapamil hydrochloride 180 mg (sustained release)

Oral

30

5

Cordilox 180 SR

 

 

 

 

 

Isoptin 180 SR

 

Tablet containing verapamil hydrochloride 240 mg (sustained release)

Oral

30

5

Anpec SR

 

 

 

 

 

Cordilox SR

 

 

 

 

 

Isoptin SR

 

Capsule containing verapamil hydrochloride 160 mg (sustained release)

Oral

30

5

Veracaps SR

 

Capsule containing verapamil hydrochloride 240 mg (sustained release)

Oral

30

5

Veracaps SR

 

Injection containing verapamil hydrochloride 5 mg in 2 mL

Injection

5

..

Isoptin

Verteporfin

Powder for I.V. infusion 15 mg

Injection

1

..

Visudyne

Vigabatrin

Tablet 500 mg

Oral

100

5

Sabril

 

Oral powder, sachet 500 mg

Oral

60

5

Sabril

Vinblastine

Solution for I.V. injection containing vinblastine sulfate 10 mg in 10 mL

Injection

5

..

Hospira Pty Limited

Vincristine

I.V. injection containing vincristine sulfate 1 mg in 1 mL

Injection

10

..

Hospira Pty Limited

 

 

 

 

 

Pfizer Australia Pty Ltd

Vinorelbine

Capsule 20 mg (as tartrate)

Oral

20

2

Navelbine

 

Capsule 30 mg (as tartrate)

Oral

16

2

Navelbine

 

Solution for I.V. infusion 10 mg (as tartrate) in 1 mL

Injection

16

2

Hospira Pty Limited

 

 

 

 

 

Navelbine

 

 

 

 

 

Vinorelbine Ebewe

 

 

 

 

 

Vinorelbine Link

 

Solution for I.V. infusion 50 mg (as tartrate) in 5 mL

Injection

4

2

Hospira Pty Limited

 

 

 

 

 

Navelbine

 

 

 

 

 

Vinorelbine Ebewe

 

 

 

 

 

Vinorelbine Link

Vitamins, minerals and trace elements with carbohydrate

Oral powder 200 g (Paediatric Seravit)

Oral

6

5

Paediatric Seravit

Voriconazole

Tablet 50 mg

Oral

56

2

Vfend

 

Tablet 200 mg

Oral

56

2

Vfend

 

Powder for oral suspension 40 mg per mL, 70 mL

Oral

1

..

Vfend

Warfarin

Tablet containing warfarin sodium 1 mg

Oral

50

2

Coumadin

 

 

 

 

 

Marevan

 

Tablet containing warfarin sodium 2 mg

Oral

50

2

Coumadin

 

Tablet containing warfarin sodium 3 mg

Oral

50

2

Marevan

 

Tablet containing warfarin sodium 5 mg

Oral

50

2

Coumadin

 

 

 

 

 

Marevan

Whey protein formula supplemented with amino acids, long chain polyunsaturated fatty acids, vitamins and minerals, and low in protein, phosphate, potassium and lactose

Sachets containing oral powder 100 g, 10 (RenaStart)

Oral

8

5

RenaStart

Whey protein formula supplemented with amino acids, vitamins and minerals, and low in protein, phosphate, potassium and lactose

Oral powder 400 g (Kindergen)

Oral

16

5

Kindergen

Ziprasidone

Capsule 20 mg (as hydrochloride)

Oral

60

5

Zeldox

 

Capsule 40 mg (as hydrochloride)

Oral

60

5

Zeldox

 

Capsule 60 mg (as hydrochloride)

Oral

60

5

Zeldox

 

Capsule 80 mg (as hydrochloride)

Oral

60

5

Zeldox

Zoledronic acid

Solution for I.V. infusion 5 mg (as monohydrate) in 100 mL

Injection

1

..

Aclasta

Zolmitriptan

Tablet 2.5 mg

Oral

4

5

Zomig

Zuclopenthixol Decanoate

Oily I.M. injection 200 mg in 1 mL ampoule

Injection

5

..

Clopixol Depot

 

SCHEDULE 1 - PART 2

Listed Drug

Form

(strength, type, size, etc.)

Streamlined authority code

Purposes

Manner of adminis-
tration

Maximum quantity

Maximum number of repeats

Brand

Aciclovir

Tablet 200 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Oral

90

5

Aciclovir 200

Acihexal

Acyclo-V 200

Chem mart Aciclovir

GenRx Aciclovir

Lovir

Ozvir

Terry White Chemists AciclovirZovirax 200 mg

 

Tablet 800 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Patients with advanced human immunodeficiency virus disease (CD4 cell counts of less than 150 million per L)

Oral

120

5

Acihexal

Acyclo-V 800

Lovir

Adalimumab

Injection 40 mg in 0.8 mL pre-filled syringe

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have severe active rheumatoid arthritis; and

 (b) have not previously received PBS-subsidised treatment with a bDMARD for this condition, or, where the patient has previously received PBS-subsidised treatment with a bDMARD for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised bDMARD treatment for this condition was approved; and

 (c) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (c) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 all tests and assessments should be performed preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (c) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (c) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a signed patient acknowledgment;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have a documented history of severe active rheumatoid arthritis; and

 (b) have received prior PBS-subsidised treatment with a bDMARD for this condition in this Treatment Cycle and are eligible to receive further bDMARD therapy within this Treatment Cycle; and

 (c) have not failed previous PBS-subsidised treatment with adalimumab during this Treatment Cycle; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD Treatment Cycle with that therapy;

 patients are eligible to receive further bDMARD therapy within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with adalimumab within this bDMARD Treatment Cycle are eligible to recommence therapy with this drug within this same cycle provided that:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment of rheumatoid arthritis, to their most recent course of PBS-subsidised adalimumab treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 patients who demonstrate a response to a course of PBS-subsidised treatment with rituximab and who wish to transfer to treatment with adalimumab are not eligible to commence treatment with adalimumab until they have completed a period free from PBS-subsidised bDMARD treatment of at least 22 weeks duration, immediately following the second rituximab infusion;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form and, in the case of patients recommencing therapy with adalimumab in this Treatment Cycle, evidence of the patient's response to their most recent course of PBS-subsidised adalimumab therapy;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

3

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment with adalimumab within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults:

 (a) who have a documented history of severe active rheumatoid arthritis; and

 (b) who have demonstrated an adequate response to treatment with adalimumab; and

 (c) whose most recent course of PBS-subsidised bDMARD treatment in this bDMARD Treatment Cycle was with adalimumab; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD treatment cycle with that therapy;

 an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 a patient will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16-week initial treatment course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of adalimumab therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 the patient has not failed to demonstrate response to a course of PBS-subsidised adalimumab in this Treatment Cycle;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

5

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have severe active psoriatic arthritis; and

 (2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to either sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months or leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with methotrexate or sulfasalazine or leflunomide, at an adequate dose, for a minimum of 3 months; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and

 (3) have not failed treatment with adalimumab during the current Treatment Cycle; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with adalimumab within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with adalimumab, to their most recent course of PBS-subsidised adalimumab treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

3

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of adalimumab for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) were receiving treatment with adalimumab prior to 16 March 2006; and

 (3) have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgment form;

 the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults:

 (1) who have a documented history of severe active psoriatic arthritis; and

 (2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with adalimumab; and

 (3) who, at the time of application, demonstrate an adequate response to treatment with adalimumab; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to treatment with adalimumab is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of adalimumab therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

5

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and:

 (a) who has not received any treatment with adalimumab, etanercept or infliximab subsidised under the Pharmaceutical Benefits Scheme (PBS), or, where the patient has previously received PBS-subsidised treatment with one of these drugs, has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised treatment was approved; and

 (b) who has 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

 (c) who has 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 at least 3 months, unless the patient has had a break in PBS-subsidised therapy with adalimumab, etanercept and infliximab of at least 5 years duration, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 NSAID, at an adequate dose, for a minimum of 3 consecutive months; and

 (d) who has signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with adalimumab, etanercept and infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by:

 (a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of at least 4 on a 0-10 scale, where the BASDAI score is determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment, and is no more than 1 month old at the time of application; 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;

 both ESR and CRP measurements are included in the authority application and are no more than 1 month old;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reason why this criterion cannot be satisfied;

 the authority application includes 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 Therapeutic Goods Administration (TGA)-approved Product Information, the authority application includes the reason why a higher dose cannot be used;

 if treatment with NSAIDs is contraindicated according to the relevant TGA-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to NSAID treatment develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the nature and severity of this intolerance;

 an appropriate minimum exercise program includes stretch and range of motion exercises at least 5 times per week, and either aerobic exercise of at least 20 minutes duration at least 3 times per week or a group exercise class at least once per week;

 if a patient is unable to complete the minimum exercise program, the authority application includes the clinical reasons for this and details what, if any, exercise program has been followed;

 the application for authorisation includes:

 (a) a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes 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 signed patient acknowledgment form; and

 (iv) a completed Exercise Program Self Certification Form detailing the program followed and the dates over which it was followed, and including confirmation by the prescribing doctor that, to the best of their knowledge, the patient has followed the exercise program detailed;

 a course of initial treatment commencing a treatment cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, in this treatment cycle, has received prior PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition and has not failed PBS-subsidised therapy with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment of ankylosing spondylitis with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 the authority application includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their assessment;

 the application is accompanied by the results of the patient's most recent course of PBS-subsidised adalimumab, etanercept or infliximab therapy, where:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course was ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 if the response assessment to the previous course of treatment with adalimumab, etanercept or infliximab is not submitted as detailed above, the patient is deemed to have failed therapy with that particular course of treatment;

 a course of initial treatment within an ongoing treatment cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

3

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a treatment cycle with an initial PBS-subsidised course of adalimumab for continuing treatment, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, who was receiving treatment with adalimumab prior to 1 November 2006; and

 (a) who is receiving treatment with adalimumab at the time of application; and

 (b) who has not received prior PBS-subsidised treatment with infliximab or etanercept; and

 (c) whose current Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score is either less than or equal to 5 on a 0-10 scale or improved by at least 2 from baseline; and

 (d) who has:

 (i) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or

 (ii) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or

 (iii) an ESR or CRP measurement reduced by at least 20% from pre-treatment baseline; and

 (e) who has signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with adalimumab, etanercept and infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 the BASDAI assessment and the ESR and CRP measurements provided are no more than 1 month old at the time of application;

 the application for authorisation includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes 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 signed patient acknowledgment form;

 the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who was receiving non-PBS-subsidised treatment with adalimumab prior to 1 November 2006 and at the time of the initial application for PBS-subsidised therapy and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who has demonstrated a response to treatment with adalimumab, and whose most recent course of PBS-subsidised therapy in this treatment cycle was with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 response is defined as an improvement from baseline of at least 2 in the patient's Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and 1 of the following:

 (a) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or

 (b) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or

 (c) an ESR or CRP measurement reduced by at least 20% from baseline;

 if the patient commenced treatment with adalimumab prior to 1 November 2006, was subsequently commenced on PBS-subsidised treatment and is continuing to receive PBS-subsidised treatment in their first treatment cycle, and where pre-treatment baselines are not available, response to treatment is defined as a BASDAI score no more than 20% greater than the score included in the initial application for PBS-subsidised treatment, or no greater than 2, 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;

 all measurements provided are no more than 1 month old at the time of application;

 the same acute phase reactant used to establish baseline at the commencement of an initial treatment course is measured and supplied for all subsequent continuing treatment applications for the patient;

 patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the application for authorisation includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their continuing treatment assessment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

5

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a treatment cycle with an initial PBS-subsidised course of adalimumab for continuing treatment, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease and was receiving treatment with adalimumab prior to 9 November 2007; and

 (b)  had a Crohn Disease Activity Index (CDAI) Score of greater than or equal to 300 prior to commencing treatment with adalimumab; and

 (c)  has signed a patient acknowledgement indicating that they understand and acknowledge that PBS-subsidised treatment will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment; and

 (d)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as a reduction in Crohn Disease Activity Index (CDAI) Score to no greater than 150;

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and baseline Crohn Disease Activity Index (CDAI) Score calculation sheet including the date of the assessment of the patient's condition; and

 (ii) the signed patient acknowledgment;

 the current CDAI assessment is no more than 1 month old at the time of application;

 the baseline CDAI assessment is from immediately prior to commencing treatment with adalimumab;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 a patient may qualify for PBS-subsidised treatment under this restriction once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing treatment cycle, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease; and

 (b)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as a reduction in Crohn Disease Activity Index (CDAI) Score to a level no greater than 150;

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the completed Crohn Disease Activity Index (CDAI) Score calculation sheet including the date of the assessment of the patient's condition;

 the CDAI assessment is no more than 1 month old at the time of application;

 the CDAI assessment of the patient's response to a course of treatment is provided to the Medicare Australia CEO no later than 4 weeks from the date of completion of the course, and, if the course of treatment is a 16-week initial course, the assessment is made following a minimum of 12 weeks of therapy;

 where an assessment is not submitted to the Medicare Australia CEO as detailed above the patient is deemed to have failed to respond, or to have failed to sustain a response, to treatment with adalimumab, despite demonstrating a response as defined above;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment;

 patients are eligible to receive continuing adalimumab treatment in courses of up to 24 weeks providing they continue to sustain the response

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing  treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment in an ongoing treatment cycle, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease with intestinal inflammation and with short gut syndrome or with an ileostomy or colostomy; and

 (b)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as:

 (a)  improvement of intestinal inflammation as demonstrated by:

 (i)  blood: normalisation of the platelet count, or 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; and/or

 (ii)  faeces: normalisation of lactoferrin or calprotectin level; and/or

 (iii)  evidence of mucosal healing, as demonstrated by diagnostic imaging findings, compared to the baseline assessment; or

 (b)  reversal of high faecal output state; or

 (c)  avoidance of the need for surgery or total parenteral nutrition (TPN);

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the reports and dates of the pathology or diagnostic imaging test(s) used to assess response to therapy or the date of clinical assessment;

 the patient's assessment is no more than 1 month old at the time of application;

 the assessment of the patient's response to a course of treatment is provided to the Medicare Australia CEO no later than 4 weeks from the date of completion of the course, and, if the course of treatment is a 16-week initial course, the assessment is made following a minimum of 12 weeks of therapy;

 where an assessment is not submitted to the Medicare Australia CEO as detailed above the patient is deemed to have failed to respond, or to have failed to sustain a response, to treatment with adalimumab, despite demonstrating a response as defined above;

 the same baseline criterion used to determine response to an initial course of adalimumab treatment is used to determine response, and thus eligibility for continued PBS-subsidised therapy, to subsequent courses of treatment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment;

 patients are eligible to receive continuing adalimumab treatment in courses of up to 24 weeks providing they continue to sustain the response

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease with short gut syndrome or an ileostomy or colostomy, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment in an ongoing treatment cycle, by a gastroenterologist, or consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease with extensive intestinal inflammation affecting more than 50 cm of the small intestine; and

 (b)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as:

 (a)  a reduction in Crohn Disease Activity Index (CDAI) Score to no greater than 150; or

 (b)  improvement of intestinal inflammation as demonstrated by:

 (i)  blood: normalisation of the platelet count, or 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; and/or

 (ii)  faeces: normalisation of lactoferrin or calprotectin level; and/or

 (iii)  evidence of mucosal healing, as demonstrated by diagnostic imaging findings, compared to the baseline assessment; or

 (c)  reversal of high faecal output state; or

 (d)  avoidance of the need for surgery or total parenteral nutrition (TPN);

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed Crohn Disease Activity Index (CDAI) Score calculation sheet including the date of the assessment of the patient's condition; or

 (ii) the reports and dates of the pathology test or diagnostic imaging test(s) used to assess response to therapy; or

 (iii) the date of clinical assessment;

 all assessments are no more than 1 month old at the time of application;

 the assessment of the patient's response to a course of treatment is provided to the Medicare Australia CEO no later than 4 weeks from the date of completion of the course, and, if the course of treatment is a 16-week initial course, the assessment is made following a minimum of 12 weeks of therapy;

 where an assessment is not submitted to the Medicare Australia CEO as detailed above the patient is deemed to have failed to respond, or to have failed to sustain a response, to treatment with adalimumab, despite demonstrating a response as defined above;

 the same baseline criterion used to determine response to an initial course of adalimumab treatment is used to determine response, and thus eligibility for continued PBS-subsidised therapy, to subsequent courses of treatment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment;

 patients are eligible to receive continuing adalimumab treatment in courses of up to 24 weeks providing they continue to sustain the response

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing  treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease with extensive small intestine disease, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a treatment cycle with an initial PBS-subsidised course of adalimumab for continuing treatment, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease and was receiving treatment with adalimumab prior to 9 November 2007; and

 (b)  (1) has a history of extensive small intestinal disease with radiological evidence of intestinal inflammation affecting more than 50 cm of the small intestine; or

 (2) has diagnostic imaging or surgical evidence of short gut syndrome or has an ileostomy or colostomy with a documented history of intestinal inflammation; and

 (c)  has signed a patient acknowledgement indicating that they understand and acknowledge that PBS-subsidised treatment will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment; and

 (d)  has demonstrated or sustained an adequate response to treatment with adalimumab according to the criteria included in the relevant continuation restriction; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as:

 (a)  a reduction in Crohn Disease Activity Index (CDAI) Score to no greater than 150; or

 (b)  improvement of intestinal inflammation as demonstrated by:

 (i)  blood: normalisation of the platelet count, or 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; and/or

 (ii)  faeces: normalisation of lactoferrin or calprotectin level; and/or

 (iii)  evidence of mucosal healing, as demonstrated by diagnostic imaging findings, compared to the baseline assessment; or

 (c)  reversal of high faecal output state; or

 (d)  avoidance of the need for surgery or total parenteral nutrition (TPN);

 the same criteria used to determine an inadequate response to prior treatment at baseline are used to determine response to treatment and eligibility for continuing therapy, according to the criteria included in the continuing treatment restriction;

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the following:

 (i)  (1) the completed current and baseline Crohn Disease Activity Index (CDAI) Score calculation sheet, where relevant, including the date of the assessment of the patient's condition; or

 (2) the reports and dates of the current and baseline pathology or diagnostic imaging test(s) in order to assess response to therapy; or

 (3) the date of clinical assessment(s); and

 (ii)  the signed patient acknowledgement;

 the patient's assessment is no more than 1 month old at the time of application;

 the baseline assessment is from immediately prior to commencing treatment with adalimumab;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 a patient may qualify for PBS-subsidised treatment under this restriction once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease with extensive small intestine disease, short gut syndrome or an ileostomy or colostomy, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

2

5

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Chronic plaque psoriasis (whole body) — initial treatment 1

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment as systemic monotherapy (other than methotrexate), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have severe chronic plaque psoriasis where lesions have been present for at least 6 months from the time of initial diagnosis; and

 (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the whole body; and

 (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments:

 (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

 (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or

 (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or

 (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

 unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is indicated by a current Psoriasis Area and Severity Index (PASI) score of greater than 15, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment, and is demonstrated in the patient at the time of the authority application;

 a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment as systemic monotherapy (other than methotrexate), in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with adalimumab for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Chronic plaque psoriasis (whole body) — initial treatment 2

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis; and

 (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and

 (c) have not failed PBS-subsidised therapy with adalimumab for the treatment of this condition in the current Treatment Cycle; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who have previously demonstrated a response to PBS-subsidised treatment with adalimumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised adalimumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 agent treatment, including dosage, date and duration of treatment;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 1

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment as systemic monotherapy (other than methotrexate), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and

 (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the face, hand or foot; and

 (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments:

 (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

 (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or

 (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or

 (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

 unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated in the patient at the time of the authority application and is indicated by chronic plaque psoriasis classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where:

 (i) at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling are rated as severe or very severe, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment; or

 (ii) the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment;

 a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area diagrams including the dates of assessment of the patient's condition; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment as systemic monotherapy (other than methotrexate), in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with adalimumab for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 2

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and

 (c) have not failed PBS-subsidised therapy with adalimumab for the treatment of this condition in the current Treatment Cycle; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who have previously demonstrated a response to PBS-subsidised treatment with adalimumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised adalimumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 agent treatment, including dosage, date and duration of treatment;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

2

4

Humira

 

Injection 40 mg in 0.8 mL pre-filled syringe

 

Chronic plaque psoriasis (whole body) — initial treatment 3

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of adalimumab for continuing treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis and were receiving treatment with adalimumab prior to 1 March 2009; and

 (b) had a Psoriasis Area and Severity Index (PASI) score of greater than 15 prior to commencing treatment with adalimumab; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the whole body; and

 (d) have demonstrated a response as specified in the criterion included in the restriction for continuing PBS-subsidised treatment with adalimumab of psoriasis affecting the whole body; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed Psoriasis Area and Severity Index (PASI) calculation sheet including the date of the assessment of the patient's condition at baseline (prior to initiation of adalimumab therapy) and the most recent PASI assessment; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and were receiving non-PBS-subsidised treatment with adalimumab prior to 1 March 2009, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (whole body) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with adalimumab; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with adalimumab; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab 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 pre-biological treatment baseline value for this Treatment Cycle;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with adalimumab;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 3

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of adalimumab for continuing treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and were receiving treatment with adalimumab prior to 1 March 2009; and

 (b) whose disease, prior to treatment with adalimumab, was classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where either at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling were rated as severe or very severe, or the skin area affected was 30% or more of the face, palm of a hand or sole of a foot; and

 (c) who have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the face, hand or foot; and

 (d) who have demonstrated a response as specified in the criterion included in the restriction for continuing PBS-subsidised treatment with adalimumab of psoriasis affecting the face, hand or foot; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 at baseline (prior to initiation of adalimumab therapy) and the most recent PASI assessment; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 the PASI assessment is performed on the same affected body area as assessed at baseline or prior to initiation of adalimumab treatment;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and were receiving non-PBS-subsidised treatment with adalimumab prior to 1 March 2009, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with adalimumab; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with adalimumab; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as the plaque or plaques assessed prior to biological agent treatment showing:

 (i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, 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;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with adalimumab;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

2

5

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have severe active rheumatoid arthritis; and

 (b) have not previously received PBS-subsidised treatment with a bDMARD for this condition, or, where the patient has previously received PBS-subsidised treatment with a bDMARD for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised bDMARD treatment for this condition was approved; and

 (c) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (c) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 all tests and assessments should be performed preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (c) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (c) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a signed patient acknowledgment;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have a documented history of severe active rheumatoid arthritis; and

 (b) have received prior PBS-subsidised treatment with a bDMARD for this condition in this Treatment Cycle and are eligible to receive further bDMARD therapy within this Treatment Cycle; and

 (c) have not failed previous PBS-subsidised treatment with adalimumab during this Treatment Cycle; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD Treatment Cycle with that therapy;

 patients are eligible to receive further bDMARD therapy within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with adalimumab within this bDMARD Treatment Cycle are eligible to recommence therapy with this drug within this same cycle provided that:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment of rheumatoid arthritis, to their most recent course of PBS-subsidised adalimumab treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 patients who demonstrate a response to a course of PBS-subsidised treatment with rituximab and who wish to transfer to treatment with adalimumab are not eligible to commence treatment with adalimumab until they have completed a period free from PBS-subsidised bDMARD treatment of at least 22 weeks duration, immediately following the second rituximab infusion;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form and, in the case of patients recommencing therapy with adalimumab in this Treatment Cycle, evidence of the patient's response to their most recent course of PBS-subsidised adalimumab therapy;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

3

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment with adalimumab within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults:

 (a) who have a documented history of severe active rheumatoid arthritis; and

 (b) who have demonstrated an adequate response to treatment with adalimumab; and

 (c) whose most recent course of PBS-subsidised bDMARD treatment in this bDMARD Treatment Cycle was with adalimumab; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD treatment cycle with that therapy;

 an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 a patient will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16-week initial treatment course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of adalimumab therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 the patient has not failed to demonstrate response to a course of PBS-subsidised adalimumab in this Treatment Cycle;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

5

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have severe active psoriatic arthritis; and

 (2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to either sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months or leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with methotrexate or sulfasalazine or leflunomide, at an adequate dose, for a minimum of 3 months; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and

 (3) have not failed treatment with adalimumab during the current Treatment Cycle; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with adalimumab within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with adalimumab, to their most recent course of PBS-subsidised adalimumab treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

3

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of adalimumab for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) were receiving treatment with adalimumab prior to 16 March 2006; and

Injection

2

5

Humira

 

 

 

 (3) have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgment form;

 the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults:

 (1) who have a documented history of severe active psoriatic arthritis; and

 (2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with adalimumab; and

 (3) who, at the time of application, demonstrate an adequate response to treatment with adalimumab; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to treatment with adalimumab is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of adalimumab therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

 

 

 

 

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and:

 (a) who has not received any treatment with adalimumab, etanercept or infliximab subsidised under the Pharmaceutical Benefits Scheme (PBS), or, where the patient has previously received PBS-subsidised treatment with one of these drugs, has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised treatment was approved; and

 (b) who has 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

 (c) who has 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 at least 3 months, unless the patient has had a break in PBS-subsidised therapy with adalimumab, etanercept and infliximab of at least 5 years duration, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 NSAID, at an adequate dose, for a minimum of 3 consecutive months; and

 (d) who has signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with adalimumab, etanercept and infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by:

 (a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of at least 4 on a 0-10 scale, where the BASDAI score is determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment, and is no more than 1 month old at the time of application; 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;

 both ESR and CRP measurements are included in the authority application and are no more than 1 month old;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reason why this criterion cannot be satisfied;

 the authority application includes 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 Therapeutic Goods Administration (TGA)-approved Product Information, the authority application includes the reason why a higher dose cannot be used;

 if treatment with NSAIDs is contraindicated according to the relevant TGA-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to NSAID treatment develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the nature and severity of this intolerance;

 an appropriate minimum exercise program includes stretch and range of motion exercises at least 5 times per week, and either aerobic exercise of at least 20 minutes duration at least 3 times per week or a group exercise class at least once per week;

 if a patient is unable to complete the minimum exercise program, the authority application includes the clinical reasons for this and details what, if any, exercise program has been followed;

 the application for authorisation includes:

 (a) a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes 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 signed patient acknowledgment form; and

 (iv) a completed Exercise Program Self Certification Form detailing the program followed and the dates over which it was followed, and including confirmation by the prescribing doctor that, to the best of their knowledge, the patient has followed the exercise program detailed;

 a course of initial treatment commencing a treatment cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, in this treatment cycle, has received prior PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition and has not failed PBS-subsidised therapy with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment of ankylosing spondylitis with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 the authority application includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their assessment;

 the application is accompanied by the results of the patient's most recent course of PBS-subsidised adalimumab, etanercept or infliximab therapy, where:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course was ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 if the response assessment to the previous course of treatment with adalimumab, etanercept or infliximab is not submitted as detailed above, the patient is deemed to have failed therapy with that particular course of treatment;

 a course of initial treatment within an ongoing treatment cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

3

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a treatment cycle with an initial PBS-subsidised course of adalimumab for continuing treatment, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, who was receiving treatment with adalimumab prior to 1 November 2006; and

 (a) who is receiving treatment with adalimumab at the time of application; and

 (b) who has not received prior PBS-subsidised treatment with infliximab or etanercept; and

 (c) whose current Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score is either less than or equal to 5 on a 0-10 scale or improved by at least 2 from baseline; and

 (d) who has:

 (i) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or

 (ii) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or

 (iii) an ESR or CRP measurement reduced by at least 20% from pre-treatment baseline; and

 (e) who has signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with adalimumab, etanercept and infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 the BASDAI assessment and the ESR and CRP measurements provided are no more than 1 month old at the time of application;

 the application for authorisation includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes 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 signed patient acknowledgment form;

 the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who was receiving non-PBS-subsidised treatment with adalimumab prior to 1 November 2006 and at the time of the initial application for PBS-subsidised therapy and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who has demonstrated a response to treatment with adalimumab, and whose most recent course of PBS-subsidised therapy in this treatment cycle was with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 response is defined as an improvement from baseline of at least 2 in the patient's Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and 1 of the following:

 (a) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or

 (b) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or

 (c) an ESR or CRP measurement reduced by at least 20% from baseline;

 if the patient commenced treatment with adalimumab prior to 1 November 2006, was subsequently commenced on PBS-subsidised treatment and is continuing to receive PBS-subsidised treatment in their first treatment cycle, and where pre-treatment baselines are not available, response to treatment is defined as a BASDAI score no more than 20% greater than the score included in the initial application for PBS-subsidised treatment, or no greater than 2, 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;

 all measurements provided are no more than 1 month old at the time of application;

 the same acute phase reactant used to establish baseline at the commencement of an initial treatment course is measured and supplied for all subsequent continuing treatment applications for the patient;

 patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the application for authorisation includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their continuing treatment assessment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

5

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a treatment cycle with an initial PBS-subsidised course of adalimumab for continuing treatment, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease and was receiving treatment with adalimumab prior to 9 November 2007; and

 (b)  had a Crohn Disease Activity Index (CDAI) Score of greater than or equal to 300 prior to commencing treatment with adalimumab; and

 (c)  has signed a patient acknowledgement indicating that they understand and acknowledge that PBS-subsidised treatment will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment; and

Injection

2

5

Humira

 

 

 

 (d)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as a reduction in Crohn Disease Activity Index (CDAI) Score to no greater than 150;

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and baseline Crohn Disease Activity Index (CDAI) Score calculation sheet including the date of the assessment of the patient's condition; and

 (ii) the signed patient acknowledgment;

 the current CDAI assessment is no more than 1 month old at the time of application;

 the baseline CDAI assessment is from immediately prior to commencing treatment with adalimumab;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 a patient may qualify for PBS-subsidised treatment under this restriction once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing treatment cycle, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease; and

 (b)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as a reduction in Crohn Disease Activity Index (CDAI) Score to a level no greater than 150;

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the completed Crohn Disease Activity Index (CDAI) Score calculation sheet including the date of the assessment of the patient's condition;

 the CDAI assessment is no more than 1 month old at the time of application;

 the CDAI assessment of the patient's response to a course of treatment is provided to the Medicare Australia CEO no later than 4 weeks from the date of completion of the course, and, if the course of treatment is a 16-week initial course, the assessment is made following a minimum of 12 weeks of therapy;

 where an assessment is not submitted to the Medicare Australia CEO as detailed above the patient is deemed to have failed to respond, or to have failed to sustain a response, to treatment with adalimumab, despite demonstrating a response as defined above;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment;

 patients are eligible to receive continuing adalimumab treatment in courses of up to 24 weeks providing they continue to sustain the response

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing  treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment in an ongoing treatment cycle, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease with intestinal inflammation and with short gut syndrome or with an ileostomy or colostomy; and

 (b)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as:

 (a)  improvement of intestinal inflammation as demonstrated by:

 (i)  blood: normalisation of the platelet count, or 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; and/or

 (ii)  faeces: normalisation of lactoferrin or calprotectin level; and/or

 (iii)  evidence of mucosal healing, as demonstrated by diagnostic imaging findings, compared to the baseline assessment; or

 (b)  reversal of high faecal output state; or

 (c)  avoidance of the need for surgery or total parenteral nutrition (TPN);

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the reports and dates of the pathology or diagnostic imaging test(s) used to assess response to therapy or the date of clinical assessment;

 the patient's assessment is no more than 1 month old at the time of application;

 the assessment of the patient's response to a course of treatment is provided to the Medicare Australia CEO no later than 4 weeks from the date of completion of the course, and, if the course of treatment is a 16-week initial course, the assessment is made following a minimum of 12 weeks of therapy;

 where an assessment is not submitted to the Medicare Australia CEO as detailed above the patient is deemed to have failed to respond, or to have failed to sustain a response, to treatment with adalimumab, despite demonstrating a response as defined above;

 the same baseline criterion used to determine response to an initial course of adalimumab treatment is used to determine response, and thus eligibility for continued PBS-subsidised therapy, to subsequent courses of treatment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment;

 patients are eligible to receive continuing adalimumab treatment in courses of up to 24 weeks providing they continue to sustain the response

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease with short gut syndrome or an ileostomy or colostomy, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment in an ongoing treatment cycle, by a gastroenterologist, or consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease with extensive intestinal inflammation affecting more than 50 cm of the small intestine; and

 (b)  has demonstrated or sustained an adequate response to treatment with adalimumab; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as:

 (a)  a reduction in Crohn Disease Activity Index (CDAI) Score to no greater than 150; or

 (b)  improvement of intestinal inflammation as demonstrated by:

 (i)  blood: normalisation of the platelet count, or 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; and/or

 (ii)  faeces: normalisation of lactoferrin or calprotectin level; and/or

 (iii)  evidence of mucosal healing, as demonstrated by diagnostic imaging findings, compared to the baseline assessment; or

 (c)  reversal of high faecal output state; or

 (d)  avoidance of the need for surgery or total parenteral nutrition (TPN);

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed Crohn Disease Activity Index (CDAI) Score calculation sheet including the date of the assessment of the patient's condition; or

 (ii) the reports and dates of the pathology test or diagnostic imaging test(s) used to assess response to therapy; or

 (iii) the date of clinical assessment;

 all assessments are no more than 1 month old at the time of application;

 the assessment of the patient's response to a course of treatment is provided to the Medicare Australia CEO no later than 4 weeks from the date of completion of the course, and, if the course of treatment is a 16-week initial course, the assessment is made following a minimum of 12 weeks of therapy;

 where an assessment is not submitted to the Medicare Australia CEO as detailed above the patient is deemed to have failed to respond, or to have failed to sustain a response, to treatment with adalimumab, despite demonstrating a response as defined above;

 the same baseline criterion used to determine response to an initial course of adalimumab treatment is used to determine response, and thus eligibility for continued PBS-subsidised therapy, to subsequent courses of treatment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment;

 patients are eligible to receive continuing adalimumab treatment in courses of up to 24 weeks providing they continue to sustain the response

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing  treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease with extensive small intestine disease, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Crohn disease

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a treatment cycle with an initial PBS-subsidised course of adalimumab for continuing treatment, by a gastroenterologist, a consultant physician in internal (or general) medicine specialising in gastroenterology or other consultant physician in consultation with a gastroenterologist, of a patient who:

 (a)  has a documented history of severe refractory Crohn disease and was receiving treatment with adalimumab prior to 9 November 2007; and

 (b)  (1) has a history of extensive small intestinal disease with radiological evidence of intestinal inflammation affecting more than 50 cm of the small intestine; or

 (2) has diagnostic imaging or surgical evidence of short gut syndrome or has an ileostomy or colostomy with a documented history of intestinal inflammation; and

 (c)  has signed a patient acknowledgement indicating that they understand and acknowledge that PBS-subsidised treatment will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment; and

 (d)  has demonstrated or sustained an adequate response to treatment with adalimumab according to the criteria included in the relevant continuation restriction; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab or infliximab for Crohn disease in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab or infliximab, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised courses of treatment with adalimumab or infliximab up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as:

 (a)  a reduction in Crohn Disease Activity Index (CDAI) Score to no greater than 150; or

 (b)  improvement of intestinal inflammation as demonstrated by:

 (i)  blood: normalisation of the platelet count, or 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; and/or

 (ii)  faeces: normalisation of lactoferrin or calprotectin level; and/or

 (iii)  evidence of mucosal healing, as demonstrated by diagnostic imaging findings, compared to the baseline assessment; or

 (c)  reversal of high faecal output state; or

 (d)  avoidance of the need for surgery or total parenteral nutrition (TPN);

 the same criteria used to determine an inadequate response to prior treatment at baseline are used to determine response to treatment and eligibility for continuing therapy, according to the criteria included in the continuing treatment restriction;

 the application for authorisation includes a completed copy of the appropriate Crohn Disease PBS Authority Application - Supporting Information Form which includes the following:

 (i)  (1) the completed current and baseline Crohn Disease Activity Index (CDAI) Score calculation sheet, where relevant, including the date of the assessment of the patient's condition; or

 (2) the reports and dates of the current and baseline pathology or diagnostic imaging test(s) in order to assess response to therapy; or

 (3) the date of clinical assessment(s); and

 (ii)  the signed patient acknowledgement;

 the patient's assessment is no more than 1 month old at the time of application;

 the baseline assessment is from immediately prior to commencing treatment with adalimumab;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 a patient may qualify for PBS-subsidised treatment under this restriction once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a treatment cycle, by a gastroenterologist, a consultant physician as specified above, or other consultant physician in consultation with a gastroenterologist, of a patient who has a documented history of severe refractory Crohn disease with extensive small intestine disease, short gut syndrome or an ileostomy or colostomy, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Chronic plaque psoriasis (whole body) — initial treatment 1

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment as systemic monotherapy (other than methotrexate), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have severe chronic plaque psoriasis where lesions have been present for at least 6 months from the time of initial diagnosis; and

 (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the whole body; and

 (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments:

 (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

 (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or

 (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or

 (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

 unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is indicated by a current Psoriasis Area and Severity Index (PASI) score of greater than 15, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment, and is demonstrated in the patient at the time of the authority application;

 a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment as systemic monotherapy (other than methotrexate), in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with adalimumab for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Chronic plaque psoriasis (whole body) — initial treatment 2

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis; and

 (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and

 (c) have not failed PBS-subsidised therapy with adalimumab for the treatment of this condition in the current Treatment Cycle; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who have previously demonstrated a response to PBS-subsidised treatment with adalimumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised adalimumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 agent treatment, including dosage, date and duration of treatment;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 1

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment as systemic monotherapy (other than methotrexate), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and

 (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the face, hand or foot; and

 (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments:

 (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

 (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or

 (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or

 (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

 unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated in the patient at the time of the authority application and is indicated by chronic plaque psoriasis classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where:

 (i) at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling are rated as severe or very severe, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment; or

 (ii) the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment;

 a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area diagrams including the dates of assessment of the patient's condition; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment as systemic monotherapy (other than methotrexate), in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with adalimumab for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 2

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and

 (c) have not failed PBS-subsidised therapy with adalimumab for the treatment of this condition in the current Treatment Cycle; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who have previously demonstrated a response to PBS-subsidised treatment with adalimumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised adalimumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 agent treatment, including dosage, date and duration of treatment;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with adalimumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

2

4

Humira

 

Injection 40 mg in 0.8 mL pre-filled pen

 

Chronic plaque psoriasis (whole body) — initial treatment 3

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of adalimumab for continuing treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis and were receiving treatment with adalimumab prior to 1 March 2009; and

 (b) had a Psoriasis Area and Severity Index (PASI) score of greater than 15 prior to commencing treatment with adalimumab; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the whole body; and

 (d) have demonstrated a response as specified in the criterion included in the restriction for continuing PBS-subsidised treatment with adalimumab of psoriasis affecting the whole body; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed Psoriasis Area and Severity Index (PASI) calculation sheet including the date of the assessment of the patient's condition at baseline (prior to initiation of adalimumab therapy) and the most recent PASI assessment; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and were receiving non-PBS-subsidised treatment with adalimumab prior to 1 March 2009, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (whole body) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with adalimumab; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with adalimumab; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab 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 pre-biological treatment baseline value for this Treatment Cycle;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with adalimumab;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 3

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of adalimumab for continuing treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and were receiving treatment with adalimumab prior to 1 March 2009; and

 (b) whose disease, prior to treatment with adalimumab, was classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where either at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling were rated as severe or very severe, or the skin area affected was 30% or more of the face, palm of a hand or sole of a foot; and

 (c) who have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the face, hand or foot; and

 (d) who have demonstrated a response as specified in the criterion included in the restriction for continuing PBS-subsidised treatment with adalimumab of psoriasis affecting the face, hand or foot; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 at baseline (prior to initiation of adalimumab therapy) and the most recent PASI assessment; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 the PASI assessment is performed on the same affected body area as assessed at baseline or prior to initiation of adalimumab treatment;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy (other than methotrexate) by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and were receiving non-PBS-subsidised treatment with adalimumab prior to 1 March 2009, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with adalimumab; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with adalimumab; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to adalimumab treatment is defined as the plaque or plaques assessed prior to biological agent treatment showing:

 (i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, 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;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with adalimumab;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with adalimumab for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

2

5

Humira

Albendazole

Tablet 200 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

6

1

Zentel

 

 

1525

 Treatment of tapeworm infestation

 

 

 

 

Amino acids — synthetic, formula

Oral powder 400 g (EleCare)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Initial treatment for up to 3 months, by a clinical immunologist, suitably qualified allergist or gastroenterologist in a patient 18 years of age or less with eosinophilic oesophagitis who requires an amino acid based formula as a component of a dietary elimination programme, and where:

 eosinophilic oesophagitis is demonstrated by the following criteria:

 (i) chronic symptoms of reflux that persisted despite a 2-month trial of a proton pump inhibitor or chronic dysphagia; and

 (ii) a lack of demonstrable anatomic abnormality with the exception of stricture, which can be attributable to eosinophilic oesophagitis; and

 (iii) eosinophilic infiltration of the oesophagus, demonstrated by oesophageal biopsy specimens obtained by endoscopy and where the most densely involved oesophageal biopsy specimen had 20 or more eosinophils in any single 400 x high powered field, along with normal antral and duodenal biopsies;

 the date of birth of the patient is included in the authority application;

 treatment with oral steroids is not commenced during the period of initial treatment

Continuing treatment by a clinical immunologist, suitably qualified allergist or gastroenterologist in a patient 18 years of age or less with eosinophilic oesophagitis who has responded to an initial course of PBS-subsidised treatment, and where:

 response to initial treatment is demonstrated by oesophageal biopsy specimens obtained by endoscopy, where the most densely involved oesophageal biopsy specimen has 5 or less eosinophils in any single 400 x high powered field, along with normal antral and duodenal biopsies;

 the response criteria will be deemed to have been not met if the patient commenced oral steroids during initial treatment

Oral

12

5

EleCare

 

Oral powder 400 g (EleCare)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Continuing treatment for severe intolerance (not infant colic) to cows' milk protein in a child up to the age of 2 years, where the child has been assessed by a paediatric gastroenterologist or specialist allergist and soy protein and protein hydrolysate formulae are not tolerated or not likely to be tolerated, and where the date of birth of the patient is included in the authority application

Treatment for severe intolerance (not infant colic) to cows' milk protein in a child aged 2 years and over, where the child is assessed by a paediatric gastroenterologist or specialist allergist at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

Oral

8

5

EleCare

 

Oral powder 400 g (Neocate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Continuing treatment for severe intolerance (not infant colic) to cows' milk protein in a child up to the age of 2 years, where the child has been assessed by a paediatric gastroenterologist or specialist allergist and soy protein and protein hydrolysate formulae are not tolerated or not likely to be tolerated, and where the date of birth of the patient is included in the authority application

Treatment for severe intolerance (not infant colic) to cows' milk protein in a child aged 2 years and over, where the child is assessed by a paediatric gastroenterologist or specialist allergist at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

Oral

8

5

Neocate

 

Oral powder 400 g (Neocate Advance)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Continuing treatment for severe intolerance (not infant colic) to cows' milk protein in a child up to the age of 2 years, where the child has been assessed by a paediatric gastroenterologist or specialist allergist and soy protein and protein hydrolysate formulae are not tolerated or not likely to be tolerated, and where the date of birth of the patient is included in the authority application

Treatment for severe intolerance (not infant colic) to cows' milk protein in a child aged 2 years and over, where the child is assessed by a paediatric gastroenterologist or specialist allergist at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

Oral

8

5

Neocate Advance

 

Oral powder 400 g (Neocate Advance Tropical Flavour)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Continuing treatment for severe intolerance (not infant colic) to cows' milk protein in a child up to the age of 2 years, where the child has been assessed by a paediatric gastroenterologist or specialist allergist and soy protein and protein hydrolysate formulae are not tolerated or not likely to be tolerated, and where the date of birth of the patient is included in the authority application

Treatment for severe intolerance (not infant colic) to cows' milk protein in a child aged 2 years and over, where the child is assessed by a paediatric gastroenterologist or specialist allergist at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

Oral

8

5

Neocate Advance Tropical Flavour

Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids

Oral powder 400 g (Neocate LCP)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Continuing treatment for severe intolerance (not infant colic) to cows' milk protein in a child up to the age of 2 years, where the child has been assessed by a paediatric gastroenterologist or specialist allergist and soy protein and protein hydrolysate formulae are not tolerated or not likely to be tolerated, and where the date of birth of the patient is included in the authority application

Treatment for severe intolerance (not infant colic) to cows' milk protein in a child aged 2 years and over, where the child is assessed by a paediatric gastroenterologist or specialist allergist at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

Oral

8

5

Neocate LCP

 

Oral powder 400 g (EleCare LCP)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in a child aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Continuing treatment for severe intolerance (not infant colic) to cows' milk protein in a child up to the age of 2 years, where the child has been assessed by a paediatric gastroenterologist or specialist allergist and soy protein and protein hydrolysate formulae are not tolerated or not likely to be tolerated, and where the date of birth of the patient is included in the authority application

Treatment for severe intolerance (not infant colic) to cows' milk protein in a child aged 2 years and over, where the child is assessed by a paediatric gastroenterologist or specialist allergist at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

Oral

8

5

EleCare LCP

Amoxycillin

Powder for paediatric oral drops 100 mg (as trihydrate) per mL, 20 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of infections suspected or proven to be due to a susceptible organism in patients who require a liquid formulation and in whom the syrup formulations are unsuitable

Oral

1

1

Amoxil

Anakinra

Injection 100 mg in 0.67 mL single use pre-filled syringe

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment with anakinra within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults:

 (a) who have a documented history of severe active rheumatoid arthritis; and

 (b) who have demonstrated an adequate response to treatment with anakinra; and

 (c) whose most recent course of PBS-subsidised bDMARD treatment in this bDMARD Treatment Cycle was with anakinra; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly;

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD treatment cycle with that therapy;

 an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 a patient will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16-week initial treatment course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with anakinra, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of anakinra therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 the patient has not failed to demonstrate response to a course of PBS-subsidised anakinra in this Treatment Cycle;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

28

5

Kineret

Atorvastatin

Tablet 10 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Lipitor

 

Tablet 20 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Lipitor

 

Tablet 40 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Lipitor

 

Tablet 80 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Lipitor

Azithromycin

Tablet 500 mg (as dihydrate)

 

Trachoma

Oral

2

2

Azithromycin Sandoz

Zithromax

Bortezomib

Powder for injection 3.5 mg (with any determined brand of sodium chloride injection as the required solvent)

 

In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment, as monotherapy or in combination with a corticosteroid and/or cyclophosphamide, of a patient with a histological diagnosis of multiple myeloma who has progressive disease after at least 1 prior therapy, who has undergone or is ineligible for a primary stem cell transplant and who has experienced treatment failure after a trial of at least 4 weeks of thalidomide at a dose of at least 100 mg daily or who has failed to achieve at least a minimal response after 8 or more weeks of thalidomide-based therapy for progressive disease; and

 where progressive disease is defined as at least 1 of the following:

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

 (b)  at least a 25% increase in 24-hour urinary light chain M protein excretion, and an absolute increase of at least 200 mg per 24 hours; or

 (c)  in oligo-secretory and non-secretory myeloma patients only, at least a 50% increase of the difference between involved free light chain and uninvolved free light chain; or

 (d)  at least a 25% relative increase and at least a 10% absolute increase in plasma cells in a bone marrow aspirate or on biopsy; or

 (e)  an increase in the size or number of lytic bone lesions (not including compression fractures); or

 (f)  at least a 25% increase in the size of an existing, or the development of a new, soft tissue plasmacytoma (determined by clinical examination or diagnostic imaging); or

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

 where oligo-secretory and non-secretory patients are defined as having active disease with less than 10 g per L serum M protein and less than 200 mg per 24 hour Bence-Jones proteinuria;

 where thalidomide treatment failure is defined as:

 (1)  confirmed disease progression during thalidomide treatment or within 6 months of discontinuing thalidomide treatment; or

 (2)  severe intolerance or toxicity unresponsive to clinically appropriate dose adjustment;

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

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

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

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

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

 where the following conditions apply:

 the patient is not receiving concomitant PBS-subsidised lenalidomide;

 the authority application includes:

 (1)  a completed copy of the appropriate Multiple Myeloma Authority Application - Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma, prior treatments including name(s) of drug(s) and date of most recent treatment cycle and record of prior stem cell transplant or ineligibility for prior stem cell transplant; details of thalidomide treatment failure; details of the basis of the diagnosis of progressive disease or failure to respond; and nomination of which disease activity parameters will be used to assess response; and

 (2)  duration of thalidomide and daily dose prescribed; and

 (3)  a signed patient acknowledgment;

 if the dosing requirement for thalidomide cannot be met, the authority application states the reasons why this criterion cannot be satisfied;

 to enable confirmation of eligibility by the Medicare Australia CEO, current diagnostic reports of at least 1 of the following are required:

 (a)  the level of serum M protein (monoclonal protein); or

 (b)  Bence-Jones proteinuria — the results of 24-hour urinary light chain M protein excretion; or

 (c) the serum level of free kappa and lambda light chains; or

 (d)  bone marrow aspirate or trephine; or

 (e)  if present, the size and location of lytic bone lesions (not including compression fractures); or

 (f)  if present, the size and location of all soft tissue plasmacytomas by clinical or radiographic examination, i.e. magnetic resonance imaging or computed tomography scan; or

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

 as these parameters will be used to determine response, results of the above diagnostic reports must be provided with the authority application as follows:

 (i)  for all patients, results for (a) or (b) or (c) must be provided;

 (ii)  where the patient has oligo-secretory or non-secretory multiple myeloma, (c) or (d) or if relevant (e), (f) or (g) must be provided;

 where the prescriber plans to assess response in patients with oligo-secretory or non-secretory multiple myeloma with free light chain assays, evidence of the oligo-secretory or non-secretory nature of the multiple myeloma (either previous or current serum M protein less than 10 g per L and urinary Bence-Jones protein undetectable or less than 200 mg per 24 hours) must be provided

In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment, as monotherapy or in combination with a corticosteroid and/or cyclophosphamide, of multiple myeloma in a patient who has previously received 4 treatment cycles of bortezomib and who, at the time of application, has demonstrated at least a partial response to bortezomib; and

 where the following conditions apply:

 if serum M protein and urine Bence-Jones protein levels are measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as:

 (a)  at least a 50% reduction in the level of serum M protein (monoclonal protein); or

 (b)  at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours;

 if serum M protein and urine Bence-Jones protein levels are unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as:

 (c)  at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels;

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

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

 (e)  no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or

 (f)  at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. magnetic resonance imaging or computed tomography scan); or

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

 the same parameters provided for the diagnosis of progressive disease are used to demonstrate at least a partial response to treatment;

 a patient is eligible for continuing PBS-subsidised bortezomib treatment beyond 4 cycles if they have achieved at least a partial response at the completion of cycle 4, and the results of the response assessment are included in the application for authorisation of further treatment;

 where a response assessment is not submitted to the Medicare Australia CEO prior to cycle 5, patients will be deemed to have failed to respond to treatment with bortezomib;

 the authority application is made not later than 6 months after the application for initial treatment and includes:

 (1)  a completed copy of the appropriate Multiple Myeloma Authority Application - Supporting Information Form; and

 (2)  diagnostic reports, which are no more than 1 month old at the time of application, demonstrating that the patient has achieved at least a partial response;

 patients who fail to demonstrate at least a partial response after 8 cycles are not eligible to receive further PBS-subsidised treatment with bortezomib;

 a patient is eligible to receive no more than 2 cycles of treatment beyond the cycle at which a complete response, confirmed by 2 determinations a minimum of 6 weeks apart, was first achieved

Injection

4

3

Velcade

Bromocriptine

Tablet 2.5 mg (as mesylate)

 

Acromegaly

Parkinson's disease

Pathological hyperprolactinaemia where surgery is not indicated

Pathological hyperprolactinaemia where surgery has already been used with incomplete resolution

Pathological hyperprolactinaemia where radiotherapy is not indicated

Pathological hyperprolactinaemia where radiotherapy has already been used with incomplete resolution

Oral

60

5

Kripton 2.5

Parlodel

Buprenorphine

Transdermal patch 5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

4

..

Norspan

 

Transdermal patch 10 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

4

..

Norspan

 

Transdermal patch 20 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

4

..

Norspan

Bupropion

Tablet containing bupropion hydrochloride 150 mg (sustained release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Completion of short-term, sole PBS-subsidised therapy as an aid to achieving abstinence in a patient who has previously been issued with an authority prescription for this drug and who is enrolled in a comprehensive support and counselling program

Oral

90

..

Clorprax

Prexaton

Zyban

Cabergoline

Tablet 500 micrograms

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

8

5

Dostinex

Tinexa

 

 

2659

 Pathological hyperprolactinaemia where surgery is not indicated

 

 

 

 

 

 

2660

 Pathological hyperprolactinaemia where surgery has already been used with incomplete resolution

 

 

 

 

 

 

2661

 Pathological hyperprolactinaemia where radiotherapy is not indicated

 

 

 

 

 

 

2662

 Pathological hyperprolactinaemia where radiotherapy has already been used with incomplete resolution

 

 

 

 

Carbomer

Eye gel 2 mg per g, 10 g

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

GelTears

PAA

Viscotears

Carmellose

Eye drops containing carmellose sodium 5 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Refresh Tears Plus

 

Eye drops containing carmellose sodium 10 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Refresh Liquigel

Carmellose with glycerin

Eye drops containing carmellose sodium 5 mg with glycerin 9 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

7

Optive

Ceftriaxone

Powder for injection 500 mg (as sodium)

 

Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent

Septicaemia, suspected

Septicaemia, proven

Injection

5

..

Ceftriaxone ICP

Cetuximab

Solution for I.V. infusion 100 mg in 20 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment of stage III, IVa or IVb squamous cell cancer of the larynx, oropharynx or hypopharynx, in combination with radiotherapy, where cisplatin is either contraindicated or not tolerated

Injection

1

6

Erbitux

 

Solution for I.V. infusion 500 mg in 100 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment of stage III, IVa or IVb squamous cell cancer of the larynx, oropharynx or hypopharynx, in combination with radiotherapy, where cisplatin is either contraindicated or not tolerated

Injection

1

6

Erbitux

Cholestyramine

Sachets containing 4.7 g oral powder (equivalent to 4 g cholestyramine), 50

 

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

Oral

2

11

Questran Lite

Clopidogrel

Tablet 75 mg (as hydrogen sulfate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

28

5

Iscover

Plavix

 

 

3245

 Treatment of acute coronary syndromes (myocardial infarction or unstable angina) in combination with aspirin

 

 

 

 

 

 

3146

 Treatment in combination with aspirin following cardiac stent insertion

 

 

 

 

Codeine with Paracetamol

Tablet containing codeine phosphate 30 mg with paracetamol 500 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment (for up to 6 months) of severe disabling pain not responding to non-narcotic analgesics, at a dose not exceeding 8 tablets per day

Oral

60

..

APO- Paracetamol/Codeine 500/30

Codalgin Forte

Codapane Forte

Comfarol Forte

Dolaforte

Panadeine Forte

Prodeine Forte

Colestipol

Oral powder, sachets containing colestipol hydrochloride 5 g, 120

 

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

Oral

1

11

Colestid

Copper Sulfate

Tablets, diagnostic compound, 36

 

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

For external use

2

6

Clinitest

Cyproterone

Tablet containing cyproterone acetate 50 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

5

Androcur

Cyprohexal

Cyprone

Cyprostat

GenRx Cyproterone Acetate

Procur

 

 

 

1014

 Advanced carcinoma of the prostate

 

 

 

 

 

 

1404

 To reduce drive in sexual deviations in males

 

 

 

 

Dabigatran etexilate

Capsule 75 mg (as mesilate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Prevention of venous thromboembolism in a patient undergoing total hip replacement

Oral

20

1

Pradaxa

 

Capsule 110 mg (as mesilate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Prevention of venous thromboembolism in a patient undergoing total hip replacement

Oral

20

1

Pradaxa

Dalteparin

Injection containing dalteparin sodium 2,500 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

 

Haemodialysis

Injection

20

3

Fragmin

 

Injection containing dalteparin sodium 5,000 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

 

Haemodialysis

Injection

20

3

Fragmin

 

Injection containing dalteparin sodium 7,500 I.U. (anti-Xa) in 0.75 mL single dose pre-filled syringe

 

Haemodialysis

Injection

20

3

Fragmin

Dasatinib

Tablet 20 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, as the sole PBS-subsidised therapy, of a patient with chronic myeloid leukaemia in any disease phase bearing the Philadelphia chromosome or expressing the transcript BCR-ABL, and who:

 (a) has active leukaemia (as defined by the presence on current pathology assessments of either the Philadelphia chromosome on cytogenetic or fluorescence in situ hybridisation (FISH) analysis, or the presence of the transcript BCR-ABL greater than 1% on the international scale); and

 (b) has failed an adequate trial of imatinib, where failure of an adequate trial of imatinib is defined as:

 (i) lack of response to initial imatinib therapy, defined as either:

   failure to achieve a haematological response after a minimum of 3 months of therapy with imatinib, for patients initially treated in chronic phase; or

   failure to achieve any cytogenetic response after a minimum of 6 months of therapy with imatinib, for patients initially treated in chronic phase as demonstrated on bone marrow biopsy by presence of greater than 95% Philadelphia chromosome positive cells; or

   failure to achieve a major cytogenetic response or a peripheral blood BCR-ABL level of less than 1% after a minimum of 12 months of therapy with imatinib; or

 (ii) loss of a previously documented major cytogenetic response (demonstrated by the presence of greater than 35% Philadelphia positive cells on bone marrow biopsy), during ongoing imatinib therapy; or

 (iii) loss of a previously demonstrated molecular response (demonstrated by peripheral blood BCR-ABL levels increasing in value by at least 5 fold to a level of greater than 1% confirmed on a subsequent test), during ongoing imatinib therapy; or

 (iv) development of accelerated phase or blast crisis in a patient previously prescribed imatinib for any phase of chronic myeloid leukaemia, where:

 (1) accelerated phase is defined by the presence of 1 or more of the following:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 15% but less than 30%; or

   percentage of blasts plus promyelocytes in the peripheral blood or bone marrow greater than or equal to 30%; or

   peripheral basophils greater than or equal to 20%; or

   progressive splenomegaly to a size greater than or equal to 10 cm below the left costal margin to be confirmed on 2 occasions at least 4 weeks apart, or a greater than or equal to 50% increase in size below the left costal margin over 4 weeks; or

   karyotypic evolution (chromosomal abnormalities in addition to a single Philadelphia chromosome); and

 (2) blast crisis is defined as either:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 30%; or

   extramedullary involvement other than spleen and liver; or

 (v) disease progression (defined as a greater than or equal to 50% increase in peripheral white blood cell count, blast count, basophils or platelets) during first-line imatinib therapy in patients with accelerated phase or blast crisis chronic myeloid leukaemia; or

 (vi) grade 3 or 4 non-haematological toxicity that is imatinib related and necessitates permanent cessation of imatinib; and

 where the authority application includes:

 (a) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib PBS Authority Application - Supporting Information Form; and

 (b) a signed patient acknowledgement; and

 (c) a bone marrow biopsy pathology report demonstrating that the patient has active chronic myeloid leukaemia, either manifest as cytogenetic evidence of the Philadelphia chromosome, or RT-PCR level of BCR-ABL transcript greater than 1% on the international scale, and the date of the relevant pathology report; and

 (d)(1) where there has been a loss of response to imatinib, a copy of the current confirming pathology report, or reports, from an Approved Pathology Authority or details of the dates of assessment in the case of progressive splenomegaly or extramedullary involvement; or

 (2) details of Grade 3 or 4 non-haematological imatinib related toxicity;

 for patients with imatinib related toxicities, leukaemia activity does not need to be demonstrated

Oral

60

2

Sprycel

 

Tablet 20 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment, as the sole PBS-subsidised therapy, of a patient who has received initial treatment with dasatinib as a pharmaceutical benefit for chronic myeloid leukaemia, and who has demonstrated either a major cytogenetic response to dasatinib, or less than 1% BCR-ABL level in the blood, within 18 months of the commencement of treatment and at 12 monthly intervals thereafter; and

 where the following conditions apply:

 a major cytogenetic response is defined as less than 35% Philadelphia positive bone marrow cells;

 a bone marrow or peripheral blood BCR-ABL level of less than 1% on the international scale (Blood 108: 28-37, 2006) indicates a response, at least the biological equivalent of a major cytogenetic response;

 response to PBS-subsidised treatment with dasatinib is assessed by:

 (1) cytogenetic analysis indicating the number of Philadelphia positive [t (9;22)] cells in the bone marrow measured by standard karyotyping, or, in the case where standard karyotyping is not informative for technical reasons, cytogenetic analysis performed on the bone marrow by the use of fluorescence in situ hybridisation (FISH) with BCR-ABL specific probe; or

 (2) quantitative PCR indicating the relative level of BCR-ABL transcript in the peripheral blood using the international scale;

 the cytogenetic or peripheral blood quantitative PCR analyses demonstrating response are submitted as follows:

 (i) between 10 and 18 months of the commencement of treatment with dasatinib, at which time patients in whom a major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been demonstrated are eligible for a further 12 months of treatment; and

 (ii) at no greater than 12 month intervals thereafter, to demonstrate that the major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been sustained;

 the authority application includes:

 (1) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib Authority Application Form for continuing treatment; and

 (2) demonstration of continued response to treatment as evidenced by:

 (a) a copy of the cytogenetic analysis showing a major cytogenetic response, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; or

 (b) a copy of the quantitative PCR analysis showing a peripheral blood level of BCR-ABL of less than 1% on the international scale, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; and

 (3) if the cytogenetic analysis submitted with the application was conducted using FISH with BCR-ABL specific probe because standard karyotyping was not informative, a copy of the non-informative standard karyotype analysis;

 a patient who has previously received PBS-subsidised treatment with dasatinib and has at any time failed to meet the criteria for continuing treatment, is not eligible for PBS-subsidised re-treatment

Oral

60

5

Sprycel

 

Tablet 50 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, as the sole PBS-subsidised therapy, of a patient with chronic myeloid leukaemia in any disease phase bearing the Philadelphia chromosome or expressing the transcript BCR-ABL, and who:

 (a) has active leukaemia (as defined by the presence on current pathology assessments of either the Philadelphia chromosome on cytogenetic or fluorescence in situ hybridisation (FISH) analysis, or the presence of the transcript BCR-ABL greater than 1% on the international scale); and

 (b) has failed an adequate trial of imatinib, where failure of an adequate trial of imatinib is defined as:

 (i) lack of response to initial imatinib therapy, defined as either:

   failure to achieve a haematological response after a minimum of 3 months of therapy with imatinib, for patients initially treated in chronic phase; or

   failure to achieve any cytogenetic response after a minimum of 6 months of therapy with imatinib, for patients initially treated in chronic phase as demonstrated on bone marrow biopsy by presence of greater than 95% Philadelphia chromosome positive cells; or

   failure to achieve a major cytogenetic response or a peripheral blood BCR-ABL level of less than 1% after a minimum of 12 months of therapy with imatinib; or

 (ii) loss of a previously documented major cytogenetic response (demonstrated by the presence of greater than 35% Philadelphia positive cells on bone marrow biopsy), during ongoing imatinib therapy; or

 (iii) loss of a previously demonstrated molecular response (demonstrated by peripheral blood BCR-ABL levels increasing in value by at least 5 fold to a level of greater than 1% confirmed on a subsequent test), during ongoing imatinib therapy; or

 (iv) development of accelerated phase or blast crisis in a patient previously prescribed imatinib for any phase of chronic myeloid leukaemia, where:

 (1) accelerated phase is defined by the presence of 1 or more of the following:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 15% but less than 30%; or

   percentage of blasts plus promyelocytes in the peripheral blood or bone marrow greater than or equal to 30%; or

   peripheral basophils greater than or equal to 20%; or

   progressive splenomegaly to a size greater than or equal to 10 cm below the left costal margin to be confirmed on 2 occasions at least 4 weeks apart, or a greater than or equal to 50% increase in size below the left costal margin over 4 weeks; or

   karyotypic evolution (chromosomal abnormalities in addition to a single Philadelphia chromosome); and

 (2) blast crisis is defined as either:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 30%; or

   extramedullary involvement other than spleen and liver; or

 (v) disease progression (defined as a greater than or equal to 50% increase in peripheral white blood cell count, blast count, basophils or platelets) during first-line imatinib therapy in patients with accelerated phase or blast crisis chronic myeloid leukaemia; or

 (vi) grade 3 or 4 non-haematological toxicity that is imatinib related and necessitates permanent cessation of imatinib; and

 where the authority application includes:

 (a) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib PBS Authority Application - Supporting Information Form; and

 (b) a signed patient acknowledgement; and

 (c) a bone marrow biopsy pathology report demonstrating that the patient has active chronic myeloid leukaemia, either manifest as cytogenetic evidence of the Philadelphia chromosome, or RT-PCR level of BCR-ABL transcript greater than 1% on the international scale, and the date of the relevant pathology report; and

 (d)(1) where there has been a loss of response to imatinib, a copy of the current confirming pathology report, or reports, from an Approved Pathology Authority or details of the dates of assessment in the case of progressive splenomegaly or extramedullary involvement; or

 (2) details of Grade 3 or 4 non-haematological imatinib related toxicity;

 for patients with imatinib related toxicities, leukaemia activity does not need to be demonstrated

Oral

60

2

Sprycel

 

Tablet 50 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment, as the sole PBS-subsidised therapy, of a patient who has received initial treatment with dasatinib as a pharmaceutical benefit for chronic myeloid leukaemia, and who has demonstrated either a major cytogenetic response to dasatinib, or less than 1% BCR-ABL level in the blood, within 18 months of the commencement of treatment and at 12 monthly intervals thereafter; and

 where the following conditions apply:

 a major cytogenetic response is defined as less than 35% Philadelphia positive bone marrow cells;

 a bone marrow or peripheral blood BCR-ABL level of less than 1% on the international scale (Blood 108: 28-37, 2006) indicates a response, at least the biological equivalent of a major cytogenetic response;

 response to PBS-subsidised treatment with dasatinib is assessed by:

 (1) cytogenetic analysis indicating the number of Philadelphia positive [t (9;22)] cells in the bone marrow measured by standard karyotyping, or, in the case where standard karyotyping is not informative for technical reasons, cytogenetic analysis performed on the bone marrow by the use of fluorescence in situ hybridisation (FISH) with BCR-ABL specific probe; or

 (2) quantitative PCR indicating the relative level of BCR-ABL transcript in the peripheral blood using the international scale;

 the cytogenetic or peripheral blood quantitative PCR analyses demonstrating response are submitted as follows:

 (i) between 10 and 18 months of the commencement of treatment with dasatinib, at which time patients in whom a major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been demonstrated are eligible for a further 12 months of treatment; and

 (ii) at no greater than 12 month intervals thereafter, to demonstrate that the major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been sustained;

 the authority application includes:

 (1) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib Authority Application Form for continuing treatment; and

 (2) demonstration of continued response to treatment as evidenced by:

 (a) a copy of the cytogenetic analysis showing a major cytogenetic response, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; or

 (b) a copy of the quantitative PCR analysis showing a peripheral blood level of BCR-ABL of less than 1% on the international scale, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; and

 (3) if the cytogenetic analysis submitted with the application was conducted using FISH with BCR-ABL specific probe because standard karyotyping was not informative, a copy of the non-informative standard karyotype analysis;

 a patient who has previously received PBS-subsidised treatment with dasatinib and has at any time failed to meet the criteria for continuing treatment, is not eligible for PBS-subsidised re-treatment

Oral

60

5

Sprycel

 

Tablet 70 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, as the sole PBS-subsidised therapy, of a patient with chronic myeloid leukaemia in any disease phase bearing the Philadelphia chromosome or expressing the transcript BCR-ABL, and who:

 (a) has active leukaemia (as defined by the presence on current pathology assessments of either the Philadelphia chromosome on cytogenetic or fluorescence in situ hybridisation (FISH) analysis, or the presence of the transcript BCR-ABL greater than 1% on the international scale); and

 (b) has failed an adequate trial of imatinib, where failure of an adequate trial of imatinib is defined as:

 (i) lack of response to initial imatinib therapy, defined as either:

   failure to achieve a haematological response after a minimum of 3 months of therapy with imatinib, for patients initially treated in chronic phase; or

   failure to achieve any cytogenetic response after a minimum of 6 months of therapy with imatinib, for patients initially treated in chronic phase as demonstrated on bone marrow biopsy by presence of greater than 95% Philadelphia chromosome positive cells; or

   failure to achieve a major cytogenetic response or a peripheral blood BCR-ABL level of less than 1% after a minimum of 12 months of therapy with imatinib; or

 (ii) loss of a previously documented major cytogenetic response (demonstrated by the presence of greater than 35% Philadelphia positive cells on bone marrow biopsy), during ongoing imatinib therapy; or

 (iii) loss of a previously demonstrated molecular response (demonstrated by peripheral blood BCR-ABL levels increasing in value by at least 5 fold to a level of greater than 1% confirmed on a subsequent test), during ongoing imatinib therapy; or

 (iv) development of accelerated phase or blast crisis in a patient previously prescribed imatinib for any phase of chronic myeloid leukaemia, where:

 (1) accelerated phase is defined by the presence of 1 or more of the following:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 15% but less than 30%; or

   percentage of blasts plus promyelocytes in the peripheral blood or bone marrow greater than or equal to 30%; or

   peripheral basophils greater than or equal to 20%; or

   progressive splenomegaly to a size greater than or equal to 10 cm below the left costal margin to be confirmed on 2 occasions at least 4 weeks apart, or a greater than or equal to 50% increase in size below the left costal margin over 4 weeks; or

   karyotypic evolution (chromosomal abnormalities in addition to a single Philadelphia chromosome); and

 (2) blast crisis is defined as either:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 30%; or

   extramedullary involvement other than spleen and liver; or

 (v) disease progression (defined as a greater than or equal to 50% increase in peripheral white blood cell count, blast count, basophils or platelets) during first-line imatinib therapy in patients with accelerated phase or blast crisis chronic myeloid leukaemia; or

 (vi) grade 3 or 4 non-haematological toxicity that is imatinib related and necessitates permanent cessation of imatinib; and

 where the authority application includes:

 (a) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib PBS Authority Application - Supporting Information Form; and

 (b) a signed patient acknowledgement; and

 (c) a bone marrow biopsy pathology report demonstrating that the patient has active chronic myeloid leukaemia, either manifest as cytogenetic evidence of the Philadelphia chromosome, or RT-PCR level of BCR-ABL transcript greater than 1% on the international scale, and the date of the relevant pathology report; and

 (d)(1) where there has been a loss of response to imatinib, a copy of the current confirming pathology report, or reports, from an Approved Pathology Authority or details of the dates of assessment in the case of progressive splenomegaly or extramedullary involvement; or

 (2) details of Grade 3 or 4 non-haematological imatinib related toxicity;

 for patients with imatinib related toxicities, leukaemia activity does not need to be demonstrated

Oral

60

2

Sprycel

 

Tablet 70 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment, as the sole PBS-subsidised therapy, of a patient who has received initial treatment with dasatinib as a pharmaceutical benefit for chronic myeloid leukaemia, and who has demonstrated either a major cytogenetic response to dasatinib, or less than 1% BCR-ABL level in the blood, within 18 months of the commencement of treatment and at 12 monthly intervals thereafter; and

 where the following conditions apply:

 a major cytogenetic response is defined as less than 35% Philadelphia positive bone marrow cells;

 a bone marrow or peripheral blood BCR-ABL level of less than 1% on the international scale (Blood 108: 28-37, 2006) indicates a response, at least the biological equivalent of a major cytogenetic response;

 response to PBS-subsidised treatment with dasatinib is assessed by:

 (1) cytogenetic analysis indicating the number of Philadelphia positive [t (9;22)] cells in the bone marrow measured by standard karyotyping, or, in the case where standard karyotyping is not informative for technical reasons, cytogenetic analysis performed on the bone marrow by the use of fluorescence in situ hybridisation (FISH) with BCR-ABL specific probe; or

 (2) quantitative PCR indicating the relative level of BCR-ABL transcript in the peripheral blood using the international scale;

 the cytogenetic or peripheral blood quantitative PCR analyses demonstrating response are submitted as follows:

 (i) between 10 and 18 months of the commencement of treatment with dasatinib, at which time patients in whom a major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been demonstrated are eligible for a further 12 months of treatment; and

 (ii) at no greater than 12 month intervals thereafter, to demonstrate that the major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been sustained;

 the authority application includes:

 (1) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib Authority Application Form for continuing treatment; and

 (2) demonstration of continued response to treatment as evidenced by:

 (a) a copy of the cytogenetic analysis showing a major cytogenetic response, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; or

 (b) a copy of the quantitative PCR analysis showing a peripheral blood level of BCR-ABL of less than 1% on the international scale, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; and

 (3) if the cytogenetic analysis submitted with the application was conducted using FISH with BCR-ABL specific probe because standard karyotyping was not informative, a copy of the non-informative standard karyotype analysis;

 a patient who has previously received PBS-subsidised treatment with dasatinib and has at any time failed to meet the criteria for continuing treatment, is not eligible for PBS-subsidised re-treatment

Oral

60

5

Sprycel

 

Tablet 100 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, as the sole PBS-subsidised therapy, of a patient with chronic myeloid leukaemia in any disease phase bearing the Philadelphia chromosome or expressing the transcript BCR-ABL, and who:

 (a) has active leukaemia (as defined by the presence on current pathology assessments of either the Philadelphia chromosome on cytogenetic or fluorescence in situ hybridisation (FISH) analysis, or the presence of the transcript BCR-ABL greater than 1% on the international scale); and

 (b) has failed an adequate trial of imatinib, where failure of an adequate trial of imatinib is defined as:

 (i) lack of response to initial imatinib therapy, defined as either:

   failure to achieve a haematological response after a minimum of 3 months of therapy with imatinib, for patients initially treated in chronic phase; or

   failure to achieve any cytogenetic response after a minimum of 6 months of therapy with imatinib, for patients initially treated in chronic phase as demonstrated on bone marrow biopsy by presence of greater than 95% Philadelphia chromosome positive cells; or

   failure to achieve a major cytogenetic response or a peripheral blood BCR-ABL level of less than 1% after a minimum of 12 months of therapy with imatinib; or

 (ii) loss of a previously documented major cytogenetic response (demonstrated by the presence of greater than 35% Philadelphia positive cells on bone marrow biopsy), during ongoing imatinib therapy; or

 (iii) loss of a previously demonstrated molecular response (demonstrated by peripheral blood BCR-ABL levels increasing in value by at least 5 fold to a level of greater than 1% confirmed on a subsequent test), during ongoing imatinib therapy; or

 (iv) development of accelerated phase or blast crisis in a patient previously prescribed imatinib for any phase of chronic myeloid leukaemia, where:

 (1) accelerated phase is defined by the presence of 1 or more of the following:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 15% but less than 30%; or

   percentage of blasts plus promyelocytes in the peripheral blood or bone marrow greater than or equal to 30%; or

   peripheral basophils greater than or equal to 20%; or

   progressive splenomegaly to a size greater than or equal to 10 cm below the left costal margin to be confirmed on 2 occasions at least 4 weeks apart, or a greater than or equal to 50% increase in size below the left costal margin over 4 weeks; or

   karyotypic evolution (chromosomal abnormalities in addition to a single Philadelphia chromosome); and

 (2) blast crisis is defined as either:

   percentage of blasts in the peripheral blood or bone marrow greater than or equal to 30%; or

   extramedullary involvement other than spleen and liver; or

 (v) disease progression (defined as a greater than or equal to 50% increase in peripheral white blood cell count, blast count, basophils or platelets) during first-line imatinib therapy in patients with accelerated phase or blast crisis chronic myeloid leukaemia; or

 (vi) grade 3 or 4 non-haematological toxicity that is imatinib related and necessitates permanent cessation of imatinib; and

 where the authority application includes:

 (a) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib PBS Authority Application - Supporting Information Form; and

 (b) a signed patient acknowledgement; and

 (c) a bone marrow biopsy pathology report demonstrating that the patient has active chronic myeloid leukaemia, either manifest as cytogenetic evidence of the Philadelphia chromosome, or RT-PCR level of BCR-ABL transcript greater than 1% on the international scale, and the date of the relevant pathology report; and

 (d)(1) where there has been a loss of response to imatinib, a copy of the current confirming pathology report, or reports, from an Approved Pathology Authority or details of the dates of assessment in the case of progressive splenomegaly or extramedullary involvement; or

 (2) details of Grade 3 or 4 non-haematological imatinib related toxicity;

 for patients with imatinib related toxicities, leukaemia activity does not need to be demonstrated

Oral

30

2

Sprycel

 

Tablet 100 mg

 

Chronic myeloid leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment, as the sole PBS-subsidised therapy, of a patient who has received initial treatment with dasatinib as a pharmaceutical benefit for chronic myeloid leukaemia, and who has demonstrated either a major cytogenetic response to dasatinib, or less than 1% BCR-ABL level in the blood, within 18 months of the commencement of treatment and at 12 monthly intervals thereafter; and

 where the following conditions apply:

 a major cytogenetic response is defined as less than 35% Philadelphia positive bone marrow cells;

 a bone marrow or peripheral blood BCR-ABL level of less than 1% on the international scale (Blood 108: 28-37, 2006) indicates a response, at least the biological equivalent of a major cytogenetic response;

 response to PBS-subsidised treatment with dasatinib is assessed by:

 (1) cytogenetic analysis indicating the number of Philadelphia positive [t (9;22)] cells in the bone marrow measured by standard karyotyping, or, in the case where standard karyotyping is not informative for technical reasons, cytogenetic analysis performed on the bone marrow by the use of fluorescence in situ hybridisation (FISH) with BCR-ABL specific probe; or

 (2) quantitative PCR indicating the relative level of BCR-ABL transcript in the peripheral blood using the international scale;

 the cytogenetic or peripheral blood quantitative PCR analyses demonstrating response are submitted as follows:

 (i) between 10 and 18 months of the commencement of treatment with dasatinib, at which time patients in whom a major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been demonstrated are eligible for a further 12 months of treatment; and

 (ii) at no greater than 12 month intervals thereafter, to demonstrate that the major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been sustained;

 the authority application includes:

 (1) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib Authority Application Form for continuing treatment; and

 (2) demonstration of continued response to treatment as evidenced by:

 (a) a copy of the cytogenetic analysis showing a major cytogenetic response, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; or

 (b) a copy of the quantitative PCR analysis showing a peripheral blood level of BCR-ABL of less than 1% on the international scale, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; and

 (3) if the cytogenetic analysis submitted with the application was conducted using FISH with BCR-ABL specific probe because standard karyotyping was not informative, a copy of the non-informative standard karyotype analysis;

 a patient who has previously received PBS-subsidised treatment with dasatinib and has at any time failed to meet the criteria for continuing treatment, is not eligible for PBS-subsidised re-treatment

Oral

60

5

Sprycel

Desmopressin

Tablet containing desmopressin acetate 200 micrograms

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

90

5

Minirin

 

 

1678

 Cranial diabetes insipidus

 

 

 

 

 

Nasal spray (pump pack) containing desmopressin acetate 10 micrograms per actuation, 60 actuations, 6 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Nasal

2

5

Minirin Nasal Spray

 

 

1678

 Cranial diabetes insipidus

 

 

 

 

Diazepam

Tablet 2 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Disabling spasticity

Malignant neoplasia (late stage)

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

Oral

100

..

Antenex 2

Valium

Valpam 2

 

Tablet 5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Disabling spasticity

Malignant neoplasia (late stage)

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

Oral

100

..

Antenex 5

Diazepam-GA

Ranzepam

Valium

Valpam 5

Docetaxel

Injection set containing 1 single use vial concentrate for I.V. infusion 20 mg (anhydrous) in 0.5 mL with solvent

 

In compliance with authority procedures set out in subparagraph 11 (d):

Adjuvant treatment of node-positive breast cancer in combination with an anthracycline and cyclophosphamide

Advanced breast cancer after failure of prior therapy

Advanced metastatic ovarian cancer after failure of prior therapy which includes a platinum compound

Locally advanced or metastatic non-small cell lung cancer

Treatment of HER2 positive early breast cancer in combination with trastuzumab

Treatment of androgen independent (hormone refractory) metastatic carcinoma of the prostate in a patient with a Karnofsky performance-status score of at least 60%, where docetaxel is used as first-line chemotherapy and administered in three weekly cycles

Adjuvant treatment of operable breast cancer in combination with cyclophosphamide

Injection

2

..

Taxotere

Doxycycline

Tablet 100 mg (as monohydrate)

 

Pelvic inflammatory disease

Oral

28

..

Chem mart Doxycycline

Doxyhexal

GenRx Doxycycline

Terry White Chemists Doxycycline

 

Tablet 100 mg (as monohydrate)

 

Urethritis

Oral

21

..

Chem mart Doxycycline

Doxyhexal

GenRx Doxycycline

Terry White Chemists Doxycycline

 

Tablet 100 mg (as hydrochloride)

 

Pelvic inflammatory disease

Oral

28

..

Doxsig

Doxy-100

Doxylin 100

Vibramycin

 

Tablet 100 mg (as hydrochloride)

 

Urethritis

Oral

21

..

Doxsig

Doxy-100

Doxylin 100

Vibramycin

 

Capsule 100 mg (as hydrochloride) (containing enteric coated pellets)

 

Pelvic inflammatory disease

Oral

28

..

DBL Doxycycline

Doryx

 

Capsule 100 mg (as hydrochloride) (containing enteric coated pellets)

 

Urethritis

Oral

21

..

DBL Doxycycline

Doryx

Enoxaparin

Injection containing enoxaparin sodium 20 mg (2,000 I.U. anti-Xa) in 0.2 mL pre-filled syringe

 

Haemodialysis

Injection

20

3

Clexane

 

Injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL pre-filled syringe

 

Haemodialysis

Injection

20

3

Clexane

 

Solution for injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL

 

Haemodialysis

Injection

20

3

Clexane

 

Injection containing enoxaparin sodium 60 mg (6,000 I.U. anti-Xa) in 0.6 mL pre-filled syringe

 

Haemodialysis

Injection

20

3

Clexane

Eprosartan

Tablet 400 mg (as mesylate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Drug interactions expected to occur with all of the base-priced drugs

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

Oral

56

5

Teveten

Escitalopram

Tablet 10 mg (as oxalate)

 

Moderate to severe generalised anxiety disorder (GAD), as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and for whom a GP Mental Health Care Plan, as described under item 2710 of the Medicare Benefits Schedule, has been prepared

Moderate to severe generalised anxiety disorder (GAD), as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and who has been assessed by a psychiatrist

Continuing PBS-subsidised treatment, for moderate to severe generalised anxiety disorder (GAD), of a patient commenced on escitalopram prior to 1 March 2008

Moderate to severe social anxiety disorder (social phobia, SAD), as described by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and for whom a GP Mental Health Care Plan, as described under item 2710 of the Medicare Benefits Schedule, has been prepared

Moderate to severe social anxiety disorder (social phobia, SAD), as described by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and who has been assessed by a psychiatrist

Continuing PBS-subsidised treatment, for moderate to severe social anxiety disorder (social phobia, SAD), of a patient commenced on escitalopram prior to 1 March 2008

Oral

28

5

Esipram

Lexapro

 

Tablet 20 mg (as oxalate)

 

Moderate to severe generalised anxiety disorder (GAD), as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and for whom a GP Mental Health Care Plan, as described under item 2710 of the Medicare Benefits Schedule, has been prepared

Moderate to severe generalised anxiety disorder (GAD), as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and who has been assessed by a psychiatrist

Continuing PBS-subsidised treatment, for moderate to severe generalised anxiety disorder (GAD), of a patient commenced on escitalopram prior to 1 March 2008

Moderate to severe social anxiety disorder (social phobia, SAD), as described by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and for whom a GP Mental Health Care Plan, as described under item 2710 of the Medicare Benefits Schedule, has been prepared

Moderate to severe social anxiety disorder (social phobia, SAD), as described by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, in a patient who has not responded to non-pharmacological therapy and who has been assessed by a psychiatrist

Continuing PBS-subsidised treatment, for moderate to severe social anxiety disorder (social phobia, SAD), of a patient commenced on escitalopram prior to 1 March 2008

Oral

28

5

Esipram

Lexapro

Esomeprazole

Tablet (enteric coated) 20 mg (as magnesium trihydrate)

 

Maintenance of healed gastro-oesophageal reflux disease

Scleroderma oesophagus

Pathological hypersecretory conditions including Zollinger-Ellison syndrome and idiopathic hypersecretion

Oral

30

5

Nexium

 

Tablet (enteric coated) 40 mg (as magnesium trihydrate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Pathological hypersecretory conditions including Zollinger-Ellison syndrome and idiopathic hypersecretion

Oral

30

5

Nexium

Etanercept

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and:

 (a) who has not received any treatment with adalimumab, etanercept or infliximab subsidised under the Pharmaceutical Benefits Scheme (PBS), or, where the patient has previously received PBS-subsidised treatment with one of these drugs, has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised treatment was approved; and

 (b) who has 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

 (c) who has 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 at least 3 months, unless the patient has had a break in PBS-subsidised therapy with adalimumab, etanercept and infliximab of at least 5 years duration, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 NSAID, at an adequate dose, for a minimum of 3 consecutive months; and

 (d) who has signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with adalimumab, etanercept and infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by:

 (a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of at least 4 on a 0-10 scale, where the BASDAI score is determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment, and is no more than 1 month old at the time of application; 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;

 both ESR and CRP measurements are included in the authority application and are no more than 1 month old;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reason why this criterion cannot be satisfied;

 the authority application includes 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 Therapeutic Goods Administration (TGA)-approved Product Information, the authority application includes the reason why a higher dose cannot be used;

 if treatment with NSAIDs is contraindicated according to the relevant TGA-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to NSAID treatment develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the nature and severity of this intolerance;

 an appropriate minimum exercise program includes stretch and range of motion exercises at least 5 times per week, and either aerobic exercise of at least 20 minutes duration at least 3 times per week or a group exercise class at least once per week;

 if a patient is unable to complete the minimum exercise program, the authority application includes the clinical reasons for this and details what, if any, exercise program has been followed;

 the application for authorisation includes:

 (a) a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes 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 signed patient acknowledgment form; and

 (iv) a completed Exercise Program Self Certification Form detailing the program followed and the dates over which it was followed, and including confirmation by the prescribing doctor that, to the best of their knowledge, the patient has followed the exercise program detailed;

 a course of initial treatment commencing a treatment cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, in this treatment cycle, has received prior PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition and has not failed PBS-subsidised therapy with etanercept; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment of ankylosing spondylitis with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 the authority application includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their assessment;

 the application is accompanied by the results of the patient's most recent course of PBS-subsidised adalimumab, etanercept or infliximab therapy, where:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course was ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 if the response assessment to the previous course of treatment with adalimumab, etanercept or infliximab is not submitted as detailed above, the patient is deemed to have failed therapy with that particular course of treatment;

 a course of initial treatment within an ongoing treatment cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

2

3

Enbrel

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who has demonstrated a response to treatment with etanercept, and whose most recent course of PBS-subsidised therapy in this treatment cycle was with etanercept; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 response is defined as an improvement from baseline of at least 2 in the patient's Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and 1 of the following:

 (a) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or

 (b) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or

 (c) an ESR or CRP measurement reduced by at least 20% from baseline;

 if the patient commenced treatment with etanercept prior to 1 July 2004, was commenced on PBS-subsidised treatment prior to 1 March 2007 and is continuing to receive PBS-subsidised treatment in their first treatment cycle, and where pre-treatment baselines are not available, response to treatment is defined as a BASDAI score no more than 20% greater than the score included in the initial application for PBS-subsidised treatment, or no greater than 2, 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;

 all measurements provided are no more than 1 month old at the time of application;

 the same acute phase reactant used to establish baseline at the commencement of an initial treatment course is measured and supplied for all subsequent continuing treatment applications for the patient;

 patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 the application for authorisation includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their continuing treatment assessment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

2

5

Enbrel

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have severe active psoriatic arthritis; and

 (2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to either sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months or leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to achieve an adequate response to treatment with methotrexate or sulfasalazine or leflunomide, at an adequate dose, for a minimum of 3 months; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and

 (3) have not failed treatment with etanercept during the current Treatment Cycle; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with etanercept, to their most recent course of PBS-subsidised etanercept treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

2

3

Enbrel

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of etanercept for continuing treatment, by a rheumatologist or by an immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) were receiving treatment with etanercept prior to 17 March 2005; and

 (3) have demonstrated a response to etanercept treatment as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgement form;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing Biological Treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults:

 (1) who have a documented history of severe active psoriatic arthritis; and

 (2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with etanercept; and

 (3) who, at the time of application, demonstrate an adequate response to treatment with etanercept; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to treatment with etanercept is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of etanercept therapy was a 16 week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

2

5

Enbrel

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have severe active rheumatoid arthritis; and

 (b) have not previously received PBS-subsidised treatment with a bDMARD for this condition, or, where the patient has previously received PBS-subsidised treatment with a bDMARD for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised bDMARD treatment for this condition was approved; and

 (c) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (c) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 all tests and assessments should be performed preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (c) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (c) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a signed patient acknowledgment;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have a documented history of severe active rheumatoid arthritis; and

 (b) have received prior PBS-subsidised treatment with a bDMARD for this condition in this Treatment Cycle and are eligible to receive further bDMARD therapy within this Treatment Cycle; and

 (c) have not failed previous PBS-subsidised treatment with etanercept during this Treatment Cycle; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD Treatment Cycle with that therapy;

 patients are eligible to receive further bDMARD therapy within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this bDMARD Treatment Cycle are eligible to recommence therapy with this drug within this same cycle provided that:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment of rheumatoid arthritis, to their most recent course of PBS-subsidised etanercept treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 patients who demonstrate a response to a course of PBS-subsidised treatment with rituximab and who wish to transfer to treatment with etanercept are not eligible to commence treatment with etanercept until they have completed a period free from PBS-subsidised bDMARD treatment of at least 22 weeks duration, immediately following the second rituximab infusion;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form and, in the case of patients recommencing therapy with etanercept in this Treatment Cycle, evidence of the patient's response to their most recent course of PBS-subsidised etanercept therapy;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, for up to 4 months, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, and who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against the predetermined response criteria does not support continuation of PBS-subsidised treatment; and

 where the patient has failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, has failed to achieve an adequate response to methotrexate in combination with 2 other disease modifying anti-rheumatic drugs for a minimum of 3 months, and has subsequently failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to the above treatment regimens; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by an elevated erythrocyte sedimentation rate greater than 25 mm per hour or a C-reactive protein level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints or at least 4 active joints from the following list:

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

 — shoulder, cervical spine 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 requirement to demonstrate an elevated erythrocyte sedimentation rate or C-reactive protein level cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 the authority application includes sufficient information to determine the patient's eligibility according to the above criteria and the date of joint assessment;

 where the patient is exempted from demonstrating an inadequate response to the treatment regimens specified above, the authority application includes details of the contraindication or intolerance, including the degree of toxicity

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Initial treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 4 months, and where approval of the application would enable the patient to complete a period of initial treatment of not more than 4 months of uninterrupted therapy

Injection

2

3

Enbrel

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment with etanercept within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults:

 (a) who have a documented history of severe active rheumatoid arthritis; and

 (b) who have demonstrated an adequate response to treatment with etanercept; and

 (c) whose most recent course of PBS-subsidised bDMARD treatment in this bDMARD Treatment Cycle was with etanercept; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD treatment cycle with that therapy;

 an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 a patient will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16-week initial treatment course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of etanercept therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 the patient has not failed to demonstrate response to a course of PBS-subsidised etanercept in this Treatment Cycle;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised supply for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who were receiving treatment with etanercept prior to 1 December 2002, who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against predetermined response criteria does not support continuation of PBS-subsidised treatment, and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and where the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who, at the time of application, demonstrate an adequate response to treatment with etanercept as manifested by an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and an active joint count of fewer than 10 active (swollen and tender) joints or a reduction in the active (swollen and tender) joint count by at least 50% from baseline or a reduction in the number of the following active joints, from at least 4, by at least 50%:

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

 — shoulder, cervical spine 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); and

 where the following conditions apply:

 the authority application includes sufficient information to determine the patient's response to treatment with etanercept according to the above criteria and the date of assessment of the patient;

 patients who have previously ceased treatment with etanercept due to failure to demonstrate an adequate response to treatment are not eligible to recommence treatment until a period of 12 months has elapsed since cessation of the previous treatment;

 authority applications for re-treatment with etanercept following a break in PBS-subsidised treatment with the drug include the reason for and date of cessation of the previous treatment course

Injection

2

5

Enbrel

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

 

Chronic plaque psoriasis (whole body) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with etanercept; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with etanercept; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to etanercept 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 pre-biological treatment baseline value for this Treatment Cycle;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with etanercept;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with etanercept; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with etanercept; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to etanercept treatment is defined as the plaque or plaques assessed prior to biological agent treatment showing:

 (i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, 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;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with etanercept;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

2

5

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and:

 (a) who has not received any treatment with adalimumab, etanercept or infliximab subsidised under the Pharmaceutical Benefits Scheme (PBS), or, where the patient has previously received PBS-subsidised treatment with one of these drugs, has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised treatment was approved; and

 (b) who has 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

 (c) who has 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 at least 3 months, unless the patient has had a break in PBS-subsidised therapy with adalimumab, etanercept and infliximab of at least 5 years duration, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 NSAID, at an adequate dose, for a minimum of 3 consecutive months; and

 (d) who has signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with adalimumab, etanercept and infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by:

 (a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of at least 4 on a 0-10 scale, where the BASDAI score is determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment, and is no more than 1 month old at the time of application; 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;

 both ESR and CRP measurements are included in the authority application and are no more than 1 month old;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reason why this criterion cannot be satisfied;

 the authority application includes 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 Therapeutic Goods Administration (TGA)-approved Product Information, the authority application includes the reason why a higher dose cannot be used;

 if treatment with NSAIDs is contraindicated according to the relevant TGA-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to NSAID treatment develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the nature and severity of this intolerance;

 an appropriate minimum exercise program includes stretch and range of motion exercises at least 5 times per week, and either aerobic exercise of at least 20 minutes duration at least 3 times per week or a group exercise class at least once per week;

 if a patient is unable to complete the minimum exercise program, the authority application includes the clinical reasons for this and details what, if any, exercise program has been followed;

 the application for authorisation includes:

 (a) a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes 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 signed patient acknowledgment form; and

 (iv) a completed Exercise Program Self Certification Form detailing the program followed and the dates over which it was followed, and including confirmation by the prescribing doctor that, to the best of their knowledge, the patient has followed the exercise program detailed;

 a course of initial treatment commencing a treatment cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, in this treatment cycle, has received prior PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition and has not failed PBS-subsidised therapy with etanercept; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment of ankylosing spondylitis with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 the authority application includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their assessment;

 the application is accompanied by the results of the patient's most recent course of PBS-subsidised adalimumab, etanercept or infliximab therapy, where:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course was ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 if the response assessment to the previous course of treatment with adalimumab, etanercept or infliximab is not submitted as detailed above, the patient is deemed to have failed therapy with that particular course of treatment;

 a course of initial treatment within an ongoing treatment cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

1

3

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who has demonstrated a response to treatment with etanercept, and whose most recent course of PBS-subsidised therapy in this treatment cycle was with etanercept; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 response is defined as an improvement from baseline of at least 2 in the patient's Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and 1 of the following:

 (a) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or

 (b) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or

 (c) an ESR or CRP measurement reduced by at least 20% from baseline;

 if the patient commenced treatment with etanercept prior to 1 July 2004, was commenced on PBS-subsidised treatment prior to 1 March 2007 and is continuing to receive PBS-subsidised treatment in their first treatment cycle, and where pre-treatment baselines are not available, response to treatment is defined as a BASDAI score no more than 20% greater than the score included in the initial application for PBS-subsidised treatment, or no greater than 2, 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;

 all measurements provided are no more than 1 month old at the time of application;

 the same acute phase reactant used to establish baseline at the commencement of an initial treatment course is measured and supplied for all subsequent continuing treatment applications for the patient;

 patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 the application for authorisation includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their continuing treatment assessment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

1

5

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have severe active psoriatic arthritis; and

 (2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to either sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months or leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to achieve an adequate response to treatment with methotrexate or sulfasalazine or leflunomide, at an adequate dose, for a minimum of 3 months; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and

 (3) have not failed treatment with etanercept during the current Treatment Cycle; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with etanercept, to their most recent course of PBS-subsidised etanercept treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

1

3

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of etanercept for continuing treatment, by a rheumatologist or by an immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) were receiving treatment with etanercept prior to 17 March 2005; and

 (3) have demonstrated a response to etanercept treatment as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgement form;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing Biological Treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults:

 (1) who have a documented history of severe active psoriatic arthritis; and

 (2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with etanercept; and

 (3) who, at the time of application, demonstrate an adequate response to treatment with etanercept; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to treatment with etanercept is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of etanercept therapy was a 16 week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

1

5

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have severe active rheumatoid arthritis; and

 (b) have not previously received PBS-subsidised treatment with a bDMARD for this condition, or, where the patient has previously received PBS-subsidised treatment with a bDMARD for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised bDMARD treatment for this condition was approved; and

 (c) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (c) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 all tests and assessments should be performed preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (c) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (c) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a signed patient acknowledgment;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have a documented history of severe active rheumatoid arthritis; and

 (b) have received prior PBS-subsidised treatment with a bDMARD for this condition in this Treatment Cycle and are eligible to receive further bDMARD therapy within this Treatment Cycle; and

 (c) have not failed previous PBS-subsidised treatment with etanercept during this Treatment Cycle; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD Treatment Cycle with that therapy;

 patients are eligible to receive further bDMARD therapy within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this bDMARD Treatment Cycle are eligible to recommence therapy with this drug within this same cycle provided that:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment of rheumatoid arthritis, to their most recent course of PBS-subsidised etanercept treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 patients who demonstrate a response to a course of PBS-subsidised treatment with rituximab and who wish to transfer to treatment with etanercept are not eligible to commence treatment with etanercept until they have completed a period free from PBS-subsidised bDMARD treatment of at least 22 weeks duration, immediately following the second rituximab infusion;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form and, in the case of patients recommencing therapy with etanercept in this Treatment Cycle, evidence of the patient's response to their most recent course of PBS-subsidised etanercept therapy;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, for up to 4 months, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, and who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against the predetermined response criteria does not support continuation of PBS-subsidised treatment; and

 where the patient has failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, has failed to achieve an adequate response to methotrexate in combination with 2 other disease modifying anti-rheumatic drugs for a minimum of 3 months, and has subsequently failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to the above treatment regimens; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by an elevated erythrocyte sedimentation rate greater than 25 mm per hour or a C-reactive protein level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints or at least 4 active joints from the following list:

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

 — shoulder, cervical spine 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 requirement to demonstrate an elevated erythrocyte sedimentation rate or C-reactive protein level cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 the authority application includes sufficient information to determine the patient's eligibility according to the above criteria and the date of joint assessment;

 where the patient is exempted from demonstrating an inadequate response to the treatment regimens specified above, the authority application includes details of the contraindication or intolerance, including the degree of toxicity

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Initial treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 4 months, and where approval of the application would enable the patient to complete a period of initial treatment of not more than 4 months of uninterrupted therapy

Injection

1

3

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment with etanercept within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults:

 (a) who have a documented history of severe active rheumatoid arthritis; and

 (b) who have demonstrated an adequate response to treatment with etanercept; and

 (c) whose most recent course of PBS-subsidised bDMARD treatment in this bDMARD Treatment Cycle was with etanercept; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD treatment cycle with that therapy;

 an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 a patient will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16-week initial treatment course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of etanercept therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 the patient has not failed to demonstrate response to a course of PBS-subsidised etanercept in this Treatment Cycle;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised supply for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who were receiving treatment with etanercept prior to 1 December 2002, who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against predetermined response criteria does not support continuation of PBS-subsidised treatment, and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and where the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who, at the time of application, demonstrate an adequate response to treatment with etanercept as manifested by an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and an active joint count of fewer than 10 active (swollen and tender) joints or a reduction in the active (swollen and tender) joint count by at least 50% from baseline or a reduction in the number of the following active joints, from at least 4, by at least 50%:

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

 — shoulder, cervical spine 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); and

 where the following conditions apply:

 the authority application includes sufficient information to determine the patient's response to treatment with etanercept according to the above criteria and the date of assessment of the patient;

 patients who have previously ceased treatment with etanercept due to failure to demonstrate an adequate response to treatment are not eligible to recommence treatment until a period of 12 months has elapsed since cessation of the previous treatment;

 authority applications for re-treatment with etanercept following a break in PBS-subsidised treatment with the drug include the reason for and date of cessation of the previous treatment course

Injection

1

5

Enbrel

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

 

Chronic plaque psoriasis (whole body) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with etanercept; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with etanercept; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to etanercept 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 pre-biological treatment baseline value for this Treatment Cycle;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with etanercept;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with etanercept; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with etanercept; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to etanercept treatment is defined as the plaque or plaques assessed prior to biological agent treatment showing:

 (i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, 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;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with etanercept;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

1

5

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and:

 (a) who has not received any treatment with adalimumab, etanercept or infliximab subsidised under the Pharmaceutical Benefits Scheme (PBS), or, where the patient has previously received PBS-subsidised treatment with one of these drugs, has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised treatment was approved; and

 (b) who has 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

 (c) who has 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 at least 3 months, unless the patient has had a break in PBS-subsidised therapy with adalimumab, etanercept and infliximab of at least 5 years duration, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 NSAID, at an adequate dose, for a minimum of 3 consecutive months; and

 (d) who has signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with adalimumab, etanercept and infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by:

 (a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of at least 4 on a 0-10 scale, where the BASDAI score is determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment, and is no more than 1 month old at the time of application; 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;

 both ESR and CRP measurements are included in the authority application and are no more than 1 month old;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reason why this criterion cannot be satisfied;

 the authority application includes 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 Therapeutic Goods Administration (TGA)-approved Product Information, the authority application includes the reason why a higher dose cannot be used;

 if treatment with NSAIDs is contraindicated according to the relevant TGA-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to NSAID treatment develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the nature and severity of this intolerance;

 an appropriate minimum exercise program includes stretch and range of motion exercises at least 5 times per week, and either aerobic exercise of at least 20 minutes duration at least 3 times per week or a group exercise class at least once per week;

 if a patient is unable to complete the minimum exercise program, the authority application includes the clinical reasons for this and details what, if any, exercise program has been followed;

 the application for authorisation includes:

 (a) a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes 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 signed patient acknowledgment form; and

 (iv) a completed Exercise Program Self Certification Form detailing the program followed and the dates over which it was followed, and including confirmation by the prescribing doctor that, to the best of their knowledge, the patient has followed the exercise program detailed;

 a course of initial treatment commencing a treatment cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a treatment cycle, by a rheumatologist, of an adult with active ankylosing spondylitis who has radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, in this treatment cycle, has received prior PBS-subsidised treatment with adalimumab, etanercept or infliximab for this condition and has not failed PBS-subsidised therapy with etanercept; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment of ankylosing spondylitis with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 the authority application includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their assessment;

 the application is accompanied by the results of the patient's most recent course of PBS-subsidised adalimumab, etanercept or infliximab therapy, where:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course was ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 if the response assessment to the previous course of treatment with adalimumab, etanercept or infliximab is not submitted as detailed above, the patient is deemed to have failed therapy with that particular course of treatment;

 a course of initial treatment within an ongoing treatment cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

1

3

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

 

Ankylosing spondylitis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who has demonstrated a response to treatment with etanercept, and whose most recent course of PBS-subsidised therapy in this treatment cycle was with etanercept; and

 where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with adalimumab, etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with each of the 3 drugs once, at which point the patient is no longer eligible for treatment with adalimumab, etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and

 where the following conditions apply:

 a patient who commenced PBS-subsidised treatment with etanercept or infliximab prior to 1 March 2007 is deemed to have commenced their first treatment cycle with that therapy;

 response is defined as an improvement from baseline of at least 2 in the patient's Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and 1 of the following:

 (a) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or

 (b) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or

 (c) an ESR or CRP measurement reduced by at least 20% from baseline;

 if the patient commenced treatment with etanercept prior to 1 July 2004, was commenced on PBS-subsidised treatment prior to 1 March 2007 and is continuing to receive PBS-subsidised treatment in their first treatment cycle, and where pre-treatment baselines are not available, response to treatment is defined as a BASDAI score no more than 20% greater than the score included in the initial application for PBS-subsidised treatment, or no greater than 2, 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;

 all measurements provided are no more than 1 month old at the time of application;

 the same acute phase reactant used to establish baseline at the commencement of an initial treatment course is measured and supplied for all subsequent continuing treatment applications for the patient;

 patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) (i) if the course of therapy is a 16 week initial course, the assessment of response is made following a minimum of 12 weeks of treatment; or

 (ii) if the course of therapy is a 6 week initial course approved prior to 1 March 2007, the assessment of response is made following at least 4 weeks of treatment;

 the application for authorisation includes a completed copy of the appropriate Ankylosing Spondylitis PBS Authority Application - Supporting Information Form which includes a completed BASDAI Assessment Form with certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their continuing treatment assessment;

 a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of an adult with a documented history of active ankylosing spondylitis who, qualifying under the criteria specified above, has previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

1

5

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have severe active psoriatic arthritis; and

 (2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to either sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months or leflunomide at a dose of up to 20 mg daily for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to achieve an adequate response to treatment with methotrexate or sulfasalazine or leflunomide, at an adequate dose, for a minimum of 3 months; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and

 (3) have not failed treatment with etanercept during the current Treatment Cycle; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with etanercept, to their most recent course of PBS-subsidised etanercept treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

1

3

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

 

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of etanercept for continuing treatment, by a rheumatologist or by an immunologist with expertise in the management of psoriatic arthritis, of adults who:

 (1) have a documented history of severe active psoriatic arthritis; and

 (2) were receiving treatment with etanercept prior to 17 March 2005; and

 (3) have demonstrated a response to etanercept treatment as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and

 (4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgement form;

 the course of treatment is limited to a maximum of 24 weeks of treatment;

 patients are eligible for PBS-subsidised treatment under the above criteria once only

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Psoriatic arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment within an ongoing Biological Treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults:

 (1) who have a documented history of severe active psoriatic arthritis; and

 (2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with etanercept; and

 (3) who, at the time of application, demonstrate an adequate response to treatment with etanercept; and

 where biological agent means adalimumab or etanercept or infliximab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to treatment with etanercept is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of etanercept therapy was a 16 week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

1

5

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment commencing a biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have severe active rheumatoid arthritis; and

 (b) have not previously received PBS-subsidised treatment with a bDMARD for this condition, or, where the patient has previously received PBS-subsidised treatment with a bDMARD for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised bDMARD treatment for this condition was approved; and

 (c) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response to the treatment regimens specified at (c) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 all tests and assessments should be performed preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment;

 if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 if treatment with any of the drugs mentioned at (c) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (c) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a signed patient acknowledgment;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment in a bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with etanercept within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults who:

 (a) have a documented history of severe active rheumatoid arthritis; and

 (b) have received prior PBS-subsidised treatment with a bDMARD for this condition in this Treatment Cycle and are eligible to receive further bDMARD therapy within this Treatment Cycle; and

 (c) have not failed previous PBS-subsidised treatment with etanercept during this Treatment Cycle; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD Treatment Cycle with that therapy;

 patients are eligible to receive further bDMARD therapy within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this Treatment Cycle;

 patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this bDMARD Treatment Cycle are eligible to recommence therapy with this drug within this same cycle provided that:

 (i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment of rheumatoid arthritis, to their most recent course of PBS-subsidised etanercept treatment; and

 (ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and

 (iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and

 (iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;

 patients who demonstrate a response to a course of PBS-subsidised treatment with rituximab and who wish to transfer to treatment with etanercept are not eligible to commence treatment with etanercept until they have completed a period free from PBS-subsidised bDMARD treatment of at least 22 weeks duration, immediately following the second rituximab infusion;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form and, in the case of patients recommencing therapy with etanercept in this Treatment Cycle, evidence of the patient's response to their most recent course of PBS-subsidised etanercept therapy;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, for up to 4 months, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, and who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against the predetermined response criteria does not support continuation of PBS-subsidised treatment; and

 where the patient has failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, has failed to achieve an adequate response to methotrexate in combination with 2 other disease modifying anti-rheumatic drugs for a minimum of 3 months, and has subsequently failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide or cyclosporin, unless treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to the above treatment regimens; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated by an elevated erythrocyte sedimentation rate greater than 25 mm per hour or a C-reactive protein level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints or at least 4 active joints from the following list:

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

 — shoulder, cervical spine 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 requirement to demonstrate an elevated erythrocyte sedimentation rate or C-reactive protein level cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;

 the authority application includes sufficient information to determine the patient's eligibility according to the above criteria and the date of joint assessment;

 where the patient is exempted from demonstrating an inadequate response to the treatment regimens specified above, the authority application includes details of the contraindication or intolerance, including the degree of toxicity

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Initial treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 4 months, and where approval of the application would enable the patient to complete a period of initial treatment of not more than 4 months of uninterrupted therapy

Injection

1

3

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

 

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment with etanercept within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults:

 (a) who have a documented history of severe active rheumatoid arthritis; and

 (b) who have demonstrated an adequate response to treatment with etanercept; and

 (c) whose most recent course of PBS-subsidised bDMARD treatment in this bDMARD Treatment Cycle was with etanercept; and

 where bDMARD means abatacept, adalimumab, anakinra, etanercept, infliximab or rituximab; and

 where a bDMARD Treatment Cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who commenced PBS-subsidised bDMARD treatment prior to 1 March 2008 are deemed to have commenced their first bDMARD treatment cycle with that therapy;

 an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:

 — elbow, wrist, knee or ankle (assessed as active if swollen and tender); or

 — shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);

 the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 a patient will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:

 (a) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and

 (b) if the course of therapy is a 16-week initial treatment course, the assessment of response is made following a minimum of 12 weeks of treatment;

 the authority application includes a completed copy of the appropriate Rheumatoid Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 if the most recent course of etanercept therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;

 the patient has not failed to demonstrate response to a course of PBS-subsidised etanercept in this Treatment Cycle;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment within an ongoing bDMARD Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with a documented history of severe active rheumatoid arthritis, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised supply for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who were receiving treatment with etanercept prior to 1 December 2002, who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against predetermined response criteria does not support continuation of PBS-subsidised treatment, and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and where the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient

Rheumatoid arthritis

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who, at the time of application, demonstrate an adequate response to treatment with etanercept as manifested by an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and an active joint count of fewer than 10 active (swollen and tender) joints or a reduction in the active (swollen and tender) joint count by at least 50% from baseline or a reduction in the number of the following active joints, from at least 4, by at least 50%:

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

 — shoulder, cervical spine 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); and

 where the following conditions apply:

 the authority application includes sufficient information to determine the patient's response to treatment with etanercept according to the above criteria and the date of assessment of the patient;

 patients who have previously ceased treatment with etanercept due to failure to demonstrate an adequate response to treatment are not eligible to recommence treatment until a period of 12 months has elapsed since cessation of the previous treatment;

 authority applications for re-treatment with etanercept following a break in PBS-subsidised treatment with the drug include the reason for and date of cessation of the previous treatment course

Injection

1

5

Enbrel

 

Injection 50 mg in 1 mL single use auto-injector, 4

 

Chronic plaque psoriasis (whole body) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with etanercept; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with etanercept; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to etanercept 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 pre-biological treatment baseline value for this Treatment Cycle;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with etanercept;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — continuing treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:

 (a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with etanercept; and

 (c) who have demonstrated an adequate response to their most recent course of treatment with etanercept; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 an adequate response to etanercept treatment is defined as the plaque or plaques assessed prior to biological agent treatment showing:

 (i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, 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;

 the PASI assessment submitted to demonstrate response is performed on the same affected body area assessed to establish the baseline value;

 the PASI assessment of response is made after at least 12 weeks of treatment, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course, and is submitted to the Medicare Australia CEO no later than 1 month from the date of completion of the course of treatment;

 where an assessment of the patient's response to a course of PBS-subsidised treatment is not undertaken and submitted to the Medicare Australia CEO within the timeframes specified above, the patient will be deemed to have failed to respond to treatment with etanercept;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams along with the date of the assessment of the patient's condition;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an
authority prescription for continuing treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

1

5

Enbrel

Famciclovir

Tablet 250 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of patients with herpes zoster within 72 hours of the onset of the rash

Oral

21

..

Ezovir

Famciclovir Sandoz

Famvir

Favic 250

 

Tablet 250 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Oral

56

5

Ezovir

Famciclovir Sandoz

Famvir

Favic 250

 

Tablet 500 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes in immunocompromised patients, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Episodic treatment of moderate to severe recurrent oral or labial herpes in a patient with human immunodeficiency virus infection and a CD4 cell count of less than 500 million per L, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Suppressive therapy of moderate to severe recurrent oral or labial herpes in a patient with human immunodeficiency virus infection and a CD4 cell count of less than 150 million per L, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Suppressive therapy of moderate to severe recurrent oral or labial herpes in a patient with human immunodeficiency virus infection and other opportunistic infections or Acquired Immunodeficiency Syndrome defining tumours, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Oral

56

5

Ezovir

Famvir

Favic 500

Fenofibrate

Tablet 48 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

60

11

Lipidil

 

Tablet 145 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Lipidil

Fentanyl

Transdermal patch 2.1 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

10

..

Durogesic 12

 

Transdermal patch 4.2 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

10

..

Durogesic 25

 

Transdermal patch 8.4 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

10

..

Durogesic 50

 

Transdermal patch 12.6 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

10

..

Durogesic 75

 

Transdermal patch 16.8 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Transdermal

10

..

Durogesic 100

Fluvastatin

Capsule 20 mg (as sodium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

28

11

Lescol

Vastin

 

Capsule 40 mg (as sodium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

28

11

Lescol

Vastin

 

Tablet (prolonged release) 80 mg (as sodium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

28

11

Lescol XL

Gemfibrozil

Tablet 600 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

60

11

Ausgem

Chem mart Gemfibrozil

Gemhexal

GenRx Gemfibrozil

Jezil

Lipazil 600 mg

Lipigem

Lopid

Pharmacor Gemfibrozil 600

Terry White Chemists Gemfibrozil

Glucose and Ketone Indicator—Urine

Test strips, 50 (Keto-Diabur-Test 5000)

 

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

For external use

2

4

Keto-Diabur- Test 5000

 

Test strips, 50 (Keto-Diastix)

 

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

For external use

2

4

Keto-Diastix

Glucose Indicator—Blood

Test strips, 25 (On-Call Plus)

 

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

For external use

4

11

On-Call Plus

 

Test strips, 50 (Accu-Chek Go)

 

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

For external use

2

11

Accu-Chek Go

 

Test strips, 51 (Accu-Chek Integra)

 

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

For external use

2

11

Accu-Chek Integra

 

Test strips, 50 (Advantage II)

 

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

For external use

2

11

Advantage II

 

Test strips, 50 (Betachek)

 

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

For external use

2

11

Betachek

 

Test strips, 50 (Betachek G5)

 

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

For external use

2

11

Betachek G5

 

Test strips, 50 (Bionime Rightest)

 

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

For external use

2

11

Bionime Rightest

 

Test strips, 50 (CareSens)

 

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

For external use

2

11

CareSens

 

Test strips, 50 (CareSens N)

 

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

For external use

2

11

CareSens N

 

Test strips, 50 (FreeStyle)

 

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

For external use

2

11

FreeStyle

 

Test strips, 50 (Freestyle Papillon)

 

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

For external use

2

11

Freestyle Papillon

 

Test strips, 50 (Glucocard 01 Sensor)

 

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

For external use

2

11

Glucocard 01 Sensor

 

Test strips, 50 (Glucoflex-R)

 

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

For external use

2

11

Glucoflex-R

 

Test strips, 50 (GlucoOz)

 

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

For external use

2

11

GlucoOz

 

Test strips, 50 (Glucostix)

 

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

For external use

2

11

Glucostix

 

Test strips, 50 (Lifeline Attest)

 

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

For external use

2

11

Lifeline Attest

 

Test strips, 50 (MWD Pen Sensor Strips)

 

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

For external use

2

11

MWD Pen Sensor Strips

 

Test strips, 50 (MyGlucoHealth)

 

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

For external use

2

11

MyGlucoHealth

 

Test strips, 50 (Omnitest EZ)

 

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

For external use

2

11

Omnitest EZ

 

Test strips, 50 (Omnitest Plus)

 

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

For external use

2

11

Omnitest Plus

 

Test strips, 50 (Optium Omega)

 

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

For external use

2

11

Optium Omega

 

Test strips, 50 (SensoCard)

 

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

For external use

2

11

SensoCard

 

Test strips, 50 (TrueTrack)

 

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

For external use

2

11

TrueTrack

 

Test strips, 50 (WaveSense Jazz)

 

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

For external use

2

11

WaveSense Jazz

 

Test strips, 100 (Accu-Chek Active)

 

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

For external use

1

11

Accu-Chek Active

 

Test strips, 100 (Accu-Chek Mobile)

 

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

For external use

1

11

Accu-Chek Mobile

 

Test strips, 100 (Accu-Chek Performa)

 

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

For external use

1

11

Accu-Chek Performa

 

Test strips, 100 (FreeStyle Lite)

 

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

For external use

1

11

FreeStyle Lite

 

Test strips, 100 (Optium glucose)

 

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

For external use

1

11

Optium glucose

Glucose Indicator—Urine

Test strips, 50 (Clinistix)

 

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

For external use

2

4

Clinistix

 

Test strips, 50 (Diastix)

 

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

For external use

2

4

Diastix

Granisetron

Tablet 2 mg (as hydrochloride)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

5

1

Kytril

 

Concentrated injection 3 mg (as hydrochloride) in 3 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Injection

1

..

Kytril

Hydrocortisone

Injection 100 mg (as sodium succinate) with 2 mL solvent

 

For use in a hospital

Injection

6

..

Solu-Cortef

 

Injection 250 mg (as sodium succinate) with 2 mL solvent

 

For use in a hospital

Injection

6

..

Solu-Cortef

Hydromorphone

Tablet containing hydromorphone hydrochloride 2 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Dilaudid

 

Tablet containing hydromorphone hydrochloride 4 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Dilaudid

 

Tablet containing hydromorphone hydrochloride 8 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Dilaudid

 

Tablet (modified release) containing hydromorphone hydrochloride 4 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 8 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 16 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 32 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 64 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Jurnista

 

Oral liquid containing hydromorphone hydrochloride 1 mg per mL, 473 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

2

..

Dilaudid

Hypromellose

Eye drops 3 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Genteal

In a Wink Moisturising

 

Eye drops 5 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Methopt

Hypromellose with Carbomer 980

Ocular lubricating gel 3 mg-2 mg per g, 10 g

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Genteal gel

HPMC PAA

Hypromellose with Dextran

Eye drops containing 3 mg hypromellose 4500 with 1 mg dextran 70 per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Poly-Tears

Tears Naturale

Ibuprofen

Tablet 400 mg

 

Chronic arthropathies (including osteoarthritis) with an inflammatory component

Bone pain due to malignant disease

Oral

90

3

Brufen

Imatinib

Tablet 100 mg (as mesylate)

 

Chronic myeloid leukaemia (chronic phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment of patients in the chronic phase of chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, and who have a primary diagnosis of chronic myeloid leukaemia; and

 where the following conditions apply:

 treatment under this restriction is limited to a maximum of 18 months of therapy from the date the first application for initial treatment is approved;

 the application for authorisation includes:

 (1) a completed copy of the appropriate Imatinib Mesylate (Glivec) PBS Authority Application for Use in the Treatment of Chronic Myeloid Leukaemia - Supporting Information form; and

 (2) a pathology cytogenetic report conducted on peripheral blood or bone marrow supporting the diagnosis of chronic myeloid leukaemia to confirm eligibility for treatment, or a qualitative PCR report documenting the presence of the bcr-abl transcript in either peripheral blood or bone marrow; and

 (3) a copy of a signed patient acknowledgement form indicating that the patient understands and acknowledges that PBS-subsidised treatment with imatinib mesylate for the chronic phase of chronic myeloid leukaemia will cease if subsequent testing demonstrates that:

 (i) the patient has failed to achieve a major cytogenetic response within the initial 18 months of treatment; or

 (ii) the patient has failed to sustain a major cytogenetic response for 12 months from the date of the last pathology report that indicated that a major cytogenetic response had been achieved;

 the patient is not receiving concomitant PBS-subsidised interferon alfa therapy

Chronic myeloid leukaemia (chronic phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment of patients who have received initial treatment with imatinib mesylate as a pharmaceutical benefit for the chronic phase of chronic myeloid leukaemia and who have demonstrated either a major cytogenetic response or less than 1% bcr-abl level in the blood in the preceding 12 months; and

 where the following conditions apply:

 a major cytogenetic response is defined as less than 35% Philadelphia positive bone marrow cells;

 a peripheral blood bcr-abl level of less than 1% on the international scale (Blood 108: 28-37, 2006) indicates a response, at least the biological equivalent of a major cytogenetic response;

 response to PBS-subsidised treatment with imatinib mesylate is assessed by:

 (1) cytogenetic analysis indicating the number of Philadelphia positive [t (9;22)] cells in the bone marrow measured by standard karyotyping, or, in the case where standard karyotyping is not informative for technical reasons, cytogenetic analysis performed on the bone marrow by the use of fluorescence in situ hybridisation (FISH) with bcr-abl specific probe; or

 (2) quantitative PCR indicating the relative level of bcr-abl transcript in the peripheral blood using the international scale;

 the cytogenetic or peripheral blood quantitative PCR analyses demonstrating response are submitted as follows:

 (i) between 10 and 12 months of the commencement of treatment with imatinib mesylate, at which time patients in whom a major cytogenetic response or peripheral blood bcr-abl level of less than 1% has been demonstrated are eligible for a further 12 months of treatment; and

 (ii) within 18 months of the commencement of treatment with imatinib mesylate, in patients who have failed to demonstrate a major cytogenetic response or peripheral blood bcr-abl level of less than 1% at between 10 and 12 months (at which time patients in whom a major cytogenetic response or peripheral blood bcr-abl level of less than 1% is demonstrable by 18 months are eligible for a further 12 months of treatment); and

 (iii) at no greater than 12 month intervals thereafter, to demonstrate that the major cytogenetic response or peripheral blood bcr-abl level of less than 1% has been sustained;

 the authority application includes:

 (1) demonstration of continued response to treatment as evidenced by:

 (a) a copy of the cytogenetic analysis showing a major cytogenetic response, unless the relevant pathology report has been supplied within the previous 12 months, in which case only the date of this report need be provided; or

 (b) a copy of the quantitative PCR analysis showing a peripheral blood level of bcr-abl of less than 1% on the international scale, unless the relevant pathology report has been supplied within the previous 12 months, in which case only the date of this report need be provided; and

 (2) if the cytogenetic analysis submitted with the application was conducted using FISH with bcr-abl specific probe because standard karyotyping was not informative, a copy of the non-informative standard karyotype analysis;

 a patient who has previously received PBS-subsidised treatment with imatinib mesylate and has at any time failed to meet the criteria for continuing treatment of chronic myeloid leukaemia in the chronic phase, is not eligible for PBS-subsidised re-treatment

Oral

60

5

Glivec

 

Tablet 100 mg (as mesylate)

 

Chronic myeloid leukaemia (accelerated phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Treatment of patients in the accelerated phase of chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, and who have a primary diagnosis of chronic myeloid leukaemia; and

 where progress to the accelerated phase is defined by the presence of 1 or more of the following:

 (1) percentage of blasts in the peripheral blood or bone marrow greater than or equal to 15% but less than 30%; or

 (2) percentage of blasts plus promyelocytes in the peripheral blood or bone marrow greater than or equal to 30%; or

 (3) peripheral basophils greater than or equal to 20%; or

 (4) progressive splenomegaly to a size greater than or equal to 10 cm below the left costal margin confirmed on 2 occasions at least 4 weeks apart, or a greater than or equal to 50% increase in size below the left costal margin over 4 weeks; or

 (5) karyotypic evolution (chromosomal abnormalities in addition to a single Philadelphia chromosome); and

 where the application for authorisation includes:

 (a) a completed copy of the appropriate Imatinib Mesylate (Glivec) PBS Authority Application for Use in the Treatment of Chronic Myeloid Leukaemia - Supporting Information form, stating which of the above criteria are satisfied by the patient; and

 (b) a copy of the confirming pathology report from an Approved Pathology Authority in the case of criteria (1), (2), (3) and (5) above, or details of the dates of assessments in the case of progressive splenomegaly

Chronic myeloid leukaemia (blast phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Treatment of patients in the blast phase of chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, and who have a primary diagnosis of chronic myeloid leukaemia; and

 where progress to myeloid blast crisis is defined as either:

 (1) percentage of blasts in the peripheral blood or bone marrow greater than or equal to 30%; or

 (2) extramedullary involvement other than spleen and liver; and

 where the application for authorisation includes:

 (a) a completed copy of the appropriate Imatinib Mesylate (Glivec) PBS Authority Application for Use in the Treatment of Chronic Myeloid Leukaemia - Supporting Information form, stating which of the above criteria are satisfied by the patient; and

 (b) a copy of the confirming pathology report from an Approved Pathology Authority in the case of criterion (1) above, or details of the date of assessment in the case of extramedullary involvement

 

Chronic myeloid leukaemia (accelerated phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment of patients with chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, where the patient has previously received PBS-subsidised treatment with imatinib mesylate of the accelerated phase of chronic myeloid leukaemia

Chronic myeloid leukaemia (blast phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment of patients with chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, where the patient has previously received PBS-subsidised treatment with imatinib mesylate of the blast phase of chronic myeloid leukaemia

Oral

60

2

Glivec

 

Tablet 100 mg (as mesylate)

 

Acute lymphoblastic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment in combination with chemotherapy as induction or consolidation of a newly diagnosed patient with acute lymphoblastic leukaemia (ALL) bearing the Philadelphia chromosome or expressing the transcript, BCR-ABL; and

 where the authority application includes:

 (a) a completed copy of the appropriate Acute Lymphoblastic Leukaemia Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a pathology cytogenetic report conducted on peripheral blood or bone marrow supporting the diagnosis of acute lymphoblastic leukaemia to confirm eligibility for treatment, with either cytogenetic evidence of the Philadelphia chromosome, or a qualitative PCR report documenting the presence of the BCR-ABL transcript in either peripheral blood or bone marrow, along with the date of the relevant report; and

 (c) a signed patient acknowledgement

Acute lymphoblastic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment of a patient with acute lymphoblastic leukaemia bearing the Philadelphia chromosome or expressing the transcript BCR-ABL who was previously treated with imatinib mesylate under the Imatinib Compassionate Program and who meets all the PBS criteria; and

 where the authority application includes:

 (a) a completed copy of the appropriate Acute Lymphoblastic Leukaemia Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a pathology cytogenetic report conducted on peripheral blood or bone marrow supporting the diagnosis of acute lymphoblastic leukaemia to confirm eligibility for treatment, with either cytogenetic evidence of the Philadelphia chromosome, or a qualitative PCR report documenting the presence of the BCR-ABL transcript in either peripheral blood or bone marrow, along with the date of the relevant report; and

 (c) a signed patient acknowledgement

Acute lymphoblastic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment in combination with chemotherapy as maintenance of first complete remission of patients with acute lymphoblastic leukaemia (ALL) bearing the Philadelphia chromosome or expressing the transcript, BCR-ABL;

 imatinib mesylate is available with a lifetime maximum of 24 months for continuing treatment with imatinib mesylate therapy for patients with acute lymphoblastic leukaemia reimbursed through the PBS

Oral

60

2

Glivec

 

Tablet 100 mg (as mesylate)

 

Dermatofibrosarcoma protuberans

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 800 mg per day) of a patient with unresectable, locally recurrent or metastatic dermatofibrosarcoma protuberans, and where:

 (1) the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a signed patient acknowledgement; and

 (2) if the application for authority to prescribe is being sought on the basis of unresectable tumour, written evidence in support of that claim is provided; and

 (3) if the application for authority to prescribe is being sought on the basis of locally recurrent disease, the site of the local recurrence is specified; and

 (4) if the application for authority to prescribe is being sought on the basis of metastatic disease, the site(s) of metastatic disease are provided

Dermatofibrosarcoma protuberans

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 800 mg per day) of a patient with unresectable, locally recurrent or metastatic dermatofibrosarcoma protuberans who has previously been issued with an authority prescription for imatinib and who has demonstrated a response, but whose disease remains unresectable, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a statement that the disease has not progressed on imatinib therapy

Oral

60

2

Glivec

 

Tablet 100 mg (as mesylate)

 

Hypereosinophilic syndrome or chronic eosinophilic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with hypereosinophilic syndrome or chronic eosinophilic leukaemia requiring treatment and confirmed to carry the FIP1L1-PDGFRA fusion gene, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the pathology report confirming the presence of the FIP1L1-PDGFRA fusion gene; and

 (c) a copy of the full blood examination report confirming the presence of hypereosinophilic syndrome or chronic eosinophilic leukaemia; and

 (d) details of organ involvement requiring treatment, including a copy of the radiology, nuclear medicine, respiratory function or anatomical pathology reports as appropriate; and

 (e) a signed patient acknowledgement

Hypereosinophilic syndrome or chronic eosinophilic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with hypereosinophilic syndrome or chronic eosinophilic leukaemia who has previously been issued with an authority prescription for imatinib and who has achieved and maintained a complete haematological response, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the full blood examination report which demonstrates a complete haematological response, with a normal eosinophil count; and

 (c) a statement that the disease has not progressed on imatinib therapy

Oral

60

2

Glivec

 

Tablet 100 mg (as mesylate)

 

Myelodysplastic or myeloproliferative disorder

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with a myelodysplastic or myeloproliferative disorder where:

 (1) there is confirmed evidence of a platelet-derived growth factor receptor (PDGFR) gene re-arrangement either by standard karyotyping, or FISH, or PDGFRB fusion gene transcript; and

 (2) the patient has previously failed an adequate trial of 1 or more of the following conventional therapies:

 — cytarabine;

 — etoposide;

 — hydroxyurea; and

 (3) the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the pathology report confirming the platelet-derived growth factor receptor (PDGFR) gene re-arrangement; and

 (c) a copy of the bone marrow biopsy report which demonstrates the presence of a myelodysplastic or myeloproliferative disorder; and

 (d) details of the prior therapy trialled and the response; and

 (e) a signed patient acknowledgement

Myelodysplastic or myeloproliferative disorder

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with a PDGFRB fusion gene-positive myelodysplastic or myeloproliferative disorder who has previously been issued with an authority prescription for imatinib and who has demonstrated a complete haematological response, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the full blood examination report which demonstrates a complete haematological response; and

 (c) a statement that the disease has not progressed on imatinib therapy

Oral

60

2

Glivec

 

Tablet 100 mg (as mesylate)

 

Systemic mastocytosis with eosinophilia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with aggressive systemic mastocytosis with eosinophilia where:

 (1) there is confirmed evidence of the FIP1L1-PDGFRA fusion gene; and

 (2) the patient has previously failed an adequate trial of 1 or more of the following conventional therapies:

 — corticosteroids;

 — hydroxyurea; and

 (3) the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the pathology report confirming the presence of the FIP1L1-PDGFRA fusion gene; and

 (c) a copy of the bone marrow biopsy report and/or other tissue biopsy report confirming the diagnosis of aggressive systemic mastocytosis and a copy of the full blood examination report demonstrating eosinophilia; and

 (d) details of symptomatic organ involvement requiring treatment, including a copy of the radiology, nuclear medicine, respiratory function or anatomical pathology reports as appropriate; and

 (e) details of prior treatment trialled and the response; and

 (f) a signed patient acknowledgement

Systemic mastocytosis with eosinophilia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with aggressive systemic mastocytosis confirmed to carry the FIP1L1-PDGFRA fusion gene, who has previously been issued with an authority prescription for imatinib and who has demonstrated a complete haematological response, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the full blood examination report which demonstrates a complete haematological response; and

 (c) a statement that the disease has not progressed on imatinib therapy

Oral

60

2

Glivec

 

Tablet 400 mg (as mesylate)

 

Chronic myeloid leukaemia (chronic phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment of patients in the chronic phase of chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, and who have a primary diagnosis of chronic myeloid leukaemia; and

 where the following conditions apply:

 treatment under this restriction is limited to a maximum of 18 months of therapy from the date the first application for initial treatment is approved;

 the application for authorisation includes:

 (1) a completed copy of the appropriate Imatinib Mesylate (Glivec) PBS Authority Application for Use in the Treatment of Chronic Myeloid Leukaemia - Supporting Information form; and

 (2) a pathology cytogenetic report conducted on peripheral blood or bone marrow supporting the diagnosis of chronic myeloid leukaemia to confirm eligibility for treatment, or a qualitative PCR report documenting the presence of the bcr-abl transcript in either peripheral blood or bone marrow; and

 (3) a copy of a signed patient acknowledgement form indicating that the patient understands and acknowledges that PBS-subsidised treatment with imatinib mesylate for the chronic phase of chronic myeloid leukaemia will cease if subsequent testing demonstrates that:

 (i) the patient has failed to achieve a major cytogenetic response within the initial 18 months of treatment; or

 (ii) the patient has failed to sustain a major cytogenetic response for 12 months from the date of the last pathology report that indicated that a major cytogenetic response had been achieved;

 the patient is not receiving concomitant PBS-subsidised interferon alfa therapy

Chronic myeloid leukaemia (chronic phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment of patients who have received initial treatment with imatinib mesylate as a pharmaceutical benefit for the chronic phase of chronic myeloid leukaemia and who have demonstrated either a major cytogenetic response or less than 1% bcr-abl level in the blood in the preceding 12 months; and

 where the following conditions apply:

 a major cytogenetic response is defined as less than 35% Philadelphia positive bone marrow cells;

 a peripheral blood bcr-abl level of less than 1% on the international scale (Blood 108: 28-37, 2006) indicates a response, at least the biological equivalent of a major cytogenetic response;

 response to PBS-subsidised treatment with imatinib mesylate is assessed by:

 (1) cytogenetic analysis indicating the number of Philadelphia positive [t (9;22)] cells in the bone marrow measured by standard karyotyping, or, in the case where standard karyotyping is not informative for technical reasons, cytogenetic analysis performed on the bone marrow by the use of fluorescence in situ hybridisation (FISH) with bcr-abl specific probe; or

 (2) quantitative PCR indicating the relative level of bcr-abl transcript in the peripheral blood using the international scale;

 the cytogenetic or peripheral blood quantitative PCR analyses demonstrating response are submitted as follows:

 (i) between 10 and 12 months of the commencement of treatment with imatinib mesylate, at which time patients in whom a major cytogenetic response or peripheral blood bcr-abl level of less than 1% has been demonstrated are eligible for a further 12 months of treatment; and

 (ii) within 18 months of the commencement of treatment with imatinib mesylate, in patients who have failed to demonstrate a major cytogenetic response or peripheral blood bcr-abl level of less than 1% at between 10 and 12 months (at which time patients in whom a major cytogenetic response or peripheral blood bcr-abl level of less than 1% is demonstrable by 18 months are eligible for a further 12 months of treatment); and

 (iii) at no greater than 12 month intervals thereafter, to demonstrate that the major cytogenetic response or peripheral blood bcr-abl level of less than 1% has been sustained;

 the authority application includes:

 (1) demonstration of continued response to treatment as evidenced by:

 (a) a copy of the cytogenetic analysis showing a major cytogenetic response, unless the relevant pathology report has been supplied within the previous 12 months, in which case only the date of this report need be provided; or

 (b) a copy of the quantitative PCR analysis showing a peripheral blood level of bcr-abl of less than 1% on the international scale, unless the relevant pathology report has been supplied within the previous 12 months, in which case only the date of this report need be provided; and

 (2) if the cytogenetic analysis submitted with the application was conducted using FISH with bcr-abl specific probe because standard karyotyping was not informative, a copy of the non-informative standard karyotype analysis;

 a patient who has previously received PBS-subsidised treatment with imatinib mesylate and has at any time failed to meet the criteria for continuing treatment of chronic myeloid leukaemia in the chronic phase, is not eligible for PBS-subsidised re-treatment

Oral

30

5

Glivec

 

Tablet 400 mg (as mesylate)

 

Chronic myeloid leukaemia (accelerated phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Treatment of patients in the accelerated phase of chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, and who have a primary diagnosis of chronic myeloid leukaemia; and

 where progress to the accelerated phase is defined by the presence of 1 or more of the following:

 (1) percentage of blasts in the peripheral blood or bone marrow greater than or equal to 15% but less than 30%; or

 (2) percentage of blasts plus promyelocytes in the peripheral blood or bone marrow greater than or equal to 30%; or

 (3) peripheral basophils greater than or equal to 20%; or

 (4) progressive splenomegaly to a size greater than or equal to 10 cm below the left costal margin confirmed on 2 occasions at least 4 weeks apart, or a greater than or equal to 50% increase in size below the left costal margin over 4 weeks; or

 (5) karyotypic evolution (chromosomal abnormalities in addition to a single Philadelphia chromosome); and

 where the application for authorisation includes:

 (a) a completed copy of the appropriate Imatinib Mesylate (Glivec) PBS Authority Application for Use in the Treatment of Chronic Myeloid Leukaemia - Supporting Information form, stating which of the above criteria are satisfied by the patient; and

 (b) a copy of the confirming pathology report from an Approved Pathology Authority in the case of criteria (1), (2), (3) and (5) above, or details of the dates of assessments in the case of progressive splenomegaly

Chronic myeloid leukaemia (blast phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Treatment of patients in the blast phase of chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, and who have a primary diagnosis of chronic myeloid leukaemia; and

 where progress to myeloid blast crisis is defined as either:

 (1) percentage of blasts in the peripheral blood or bone marrow greater than or equal to 30%; or

 (2) extramedullary involvement other than spleen and liver; and

 where the application for authorisation includes:

 (a) a completed copy of the appropriate Imatinib Mesylate (Glivec) PBS Authority Application for Use in the Treatment of Chronic Myeloid Leukaemia - Supporting Information form, stating which of the above criteria are satisfied by the patient; and

 (b) a copy of the confirming pathology report from an Approved Pathology Authority in the case of criterion (1) above, or details of the date of assessment in the case of extramedullary involvement

Chronic myeloid leukaemia (accelerated phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment of patients with chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, where the patient has previously received PBS-subsidised treatment with imatinib mesylate of the accelerated phase of chronic myeloid leukaemia

Chronic myeloid leukaemia (blast phase)

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment of patients with chronic myeloid leukaemia expressing the Philadelphia chromosome or the transcript, bcr-abl tyrosine kinase, where the patient has previously received PBS-subsidised treatment with imatinib mesylate of the blast phase of chronic myeloid leukaemia

Oral

30

2

Glivec

 

Tablet 400 mg (as mesylate)

 

Acute lymphoblastic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment in combination with chemotherapy as induction or consolidation of a newly diagnosed patient with acute lymphoblastic leukaemia (ALL) bearing the Philadelphia chromosome or expressing the transcript, BCR-ABL; and

 where the authority application includes:

 (a) a completed copy of the appropriate Acute Lymphoblastic Leukaemia Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a pathology cytogenetic report conducted on peripheral blood or bone marrow supporting the diagnosis of acute lymphoblastic leukaemia to confirm eligibility for treatment, with either cytogenetic evidence of the Philadelphia chromosome, or a qualitative PCR report documenting the presence of the BCR-ABL transcript in either peripheral blood or bone marrow, along with the date of the relevant report; and

 (c) a signed patient acknowledgement

Acute lymphoblastic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment of a patient with acute lymphoblastic leukaemia bearing the Philadelphia chromosome or expressing the transcript BCR-ABL who was previously treated with imatinib mesylate under the Imatinib Compassionate Program and who meets all the PBS criteria; and

 where the authority application includes:

 (a) a completed copy of the appropriate Acute Lymphoblastic Leukaemia Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a pathology cytogenetic report conducted on peripheral blood or bone marrow supporting the diagnosis of acute lymphoblastic leukaemia to confirm eligibility for treatment, with either cytogenetic evidence of the Philadelphia chromosome, or a qualitative PCR report documenting the presence of the BCR-ABL transcript in either peripheral blood or bone marrow, along with the date of the relevant report; and

 (c) a signed patient acknowledgement

Acute lymphoblastic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuing treatment in combination with chemotherapy as maintenance of first complete remission of patients with acute lymphoblastic leukaemia (ALL) bearing the Philadelphia chromosome or expressing the transcript, BCR-ABL;

 imatinib mesylate is available with a lifetime maximum of 24 months for continuing treatment with imatinib mesylate therapy for patients with acute lymphoblastic leukaemia reimbursed through the PBS

Oral

30

2

Glivec

 

Tablet 400 mg (as mesylate)

 

Dermatofibrosarcoma protuberans

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 800 mg per day) of a patient with unresectable, locally recurrent or metastatic dermatofibrosarcoma protuberans, and where:

 (1) the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a signed patient acknowledgement; and

 (2) if the application for authority to prescribe is being sought on the basis of unresectable tumour, written evidence in support of that claim is provided; and

 (3) if the application for authority to prescribe is being sought on the basis of locally recurrent disease, the site of the local recurrence is specified; and

 (4) if the application for authority to prescribe is being sought on the basis of metastatic disease, the site(s) of metastatic disease are provided

Dermatofibrosarcoma protuberans

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 800 mg per day) of a patient with unresectable, locally recurrent or metastatic dermatofibrosarcoma protuberans who has previously been issued with an authority prescription for imatinib and who has demonstrated a response, but whose disease remains unresectable, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a statement that the disease has not progressed on imatinib therapy

Oral

30

2

Glivec

 

Tablet 400 mg (as mesylate)

 

Hypereosinophilic syndrome or chronic eosinophilic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with hypereosinophilic syndrome or chronic eosinophilic leukaemia requiring treatment and confirmed to carry the FIP1L1-PDGFRA fusion gene, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the pathology report confirming the presence of the FIP1L1-PDGFRA fusion gene; and

 (c) a copy of the full blood examination report confirming the presence of hypereosinophilic syndrome or chronic eosinophilic leukaemia; and

 (d) details of organ involvement requiring treatment, including a copy of the radiology, nuclear medicine, respiratory function or anatomical pathology reports as appropriate; and

 (e) a signed patient acknowledgement

Hypereosinophilic syndrome or chronic eosinophilic leukaemia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with hypereosinophilic syndrome or chronic eosinophilic leukaemia who has previously been issued with an authority prescription for imatinib and who has achieved and maintained a complete haematological response, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the full blood examination report which demonstrates a complete haematological response, with a normal eosinophil count; and

 (c) a statement that the disease has not progressed on imatinib therapy

Oral

30

2

Glivec

 

Tablet 400 mg (as mesylate)

 

Myelodysplastic or myeloproliferative disorder

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with a myelodysplastic or myeloproliferative disorder where:

 (1) there is confirmed evidence of a platelet-derived growth factor receptor (PDGFR) gene re-arrangement either by standard karyotyping, or FISH, or PDGFRB fusion gene transcript; and

 (2) the patient has previously failed an adequate trial of 1 or more of the following conventional therapies:

 — cytarabine;

 — etoposide;

 — hydroxyurea; and

 (3) the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the pathology report confirming the platelet-derived growth factor receptor (PDGFR) gene re-arrangement; and

 (c) a copy of the bone marrow biopsy report which demonstrates the presence of a myelodysplastic or myeloproliferative disorder; and

 (d) details of the prior therapy trialled and the response; and

 (e) a signed patient acknowledgement

Myelodysplastic or myeloproliferative disorder

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with a PDGFRB fusion gene-positive myelodysplastic or myeloproliferative disorder who has previously been issued with an authority prescription for imatinib and who has demonstrated a complete haematological response, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the full blood examination report which demonstrates a complete haematological response; and

 (c) a statement that the disease has not progressed on imatinib therapy

Oral

30

2

Glivec

 

Tablet 400 mg (as mesylate)

 

Systemic mastocytosis with eosinophilia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with aggressive systemic mastocytosis with eosinophilia where:

 (1) there is confirmed evidence of the FIP1L1-PDGFRA fusion gene; and

 (2) the patient has previously failed an adequate trial of 1 or more of the following conventional therapies:

 — corticosteroids;

 — hydroxyurea; and

 (3) the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the pathology report confirming the presence of the FIP1L1-PDGFRA fusion gene; and

 (c) a copy of the bone marrow biopsy report and/or other tissue biopsy report confirming the diagnosis of aggressive systemic mastocytosis and a copy of the full blood examination report demonstrating eosinophilia; and

 (d) details of symptomatic organ involvement requiring treatment, including a copy of the radiology, nuclear medicine, respiratory function or anatomical pathology reports as appropriate; and

 (e) details of prior treatment trialled and the response; and

 (f) a signed patient acknowledgement

Systemic mastocytosis with eosinophilia

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing PBS-subsidised treatment (at a dose that does not exceed 400 mg per day) of a patient with aggressive systemic mastocytosis confirmed to carry the FIP1L1-PDGFRA fusion gene, who has previously been issued with an authority prescription for imatinib and who has demonstrated a complete haematological response, and where the application for authorisation includes:

 (a) a completed copy of the appropriate Rare Diseases Imatinib PBS Authority Application - Supporting Information Form; and

 (b) a copy of the full blood examination report which demonstrates a complete haematological response; and

 (c) a statement that the disease has not progressed on imatinib therapy

Oral

30

2

Glivec

Interferon Alfa-2a

Injection 3,000,000 I.U. in 0.5 mL single dose pre-filled syringe

 

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

15

5

Roferon-A

 

Injection 4,500,000 I.U. in 0.5 mL single dose pre-filled syringe

 

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

5

5

Roferon-A

 

Injection 6,000,000 I.U. in 0.5 mL single dose pre-filled syringe

 

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

5

5

Roferon-A

 

Injection 9,000,000 I.U. in 0.5 mL single dose pre-filled syringe

 

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

5

5

Roferon-A

Interferon Alfa-2b

Solution for injection 18,000,000 I.U. in 1.2 mL multi-dose injection pen

 

In compliance with authority procedures set out in subparagraph 11 (d):

Maintenance treatment of multiple myeloma once remission has been achieved with chemotherapy

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

3

5

Intron A Redipen

Ketoconazole

Tablet 200 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral candidiasis in severely immunocompromised persons where topical therapy has failed

Systemic or deep mycoses where other forms of therapy have failed

Oral

30

5

Nizoral

Lansoprazole

Tablet 30 mg (orally disintegrating)

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Oral

28

5

Zoton FasTabs

 

Capsule 30 mg

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Oral

28

5

APO-Lansoprazole

Lanzopran

Zopral

Lercanidipine

Tablet containing lercanidipine hydrochloride 10 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Drug interactions expected to occur with all of the base-priced drugs

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

Oral

28

5

Zanidip

 

Tablet containing lercanidipine hydrochloride 20 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Drug interactions expected to occur with all of the base-priced drugs

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

Oral

28

5

Zanidip

Medroxyprogesterone

Tablet containing medroxyprogesterone acetate 10 mg

 

Endometriosis

Oral

100

2

Provera

Ralovera

Methadone

Tablet containing methadone hydrochloride 10 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Physeptone

 

Injection containing methadone hydrochloride 10 mg in 1 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Injection

10

..

Physeptone

Methotrexate

Tablet 10 mg

 

For patients requiring doses greater than 20 mg per week

Oral

50

2

Methoblastin

Metronidazole

Tablet 400 mg

 

Treatment of anaerobic infections

Oral

21

1

Flagyl

Metrogyl 400

Metronide 400

Milk powder — lactose free formula

Oral powder 900 g (S-26 LF)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Proven chronic lactose intolerance in infants up to the age of 12 months, where the date of birth of the patient is included in the authority application, and where lactose intolerance has been proven by:

 (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

Oral

5

5

S-26 LF

 

Oral powder 900 g (Karicare De-Lact)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Proven chronic lactose intolerance in infants up to the age of 12 months, where the date of birth of the patient is included in the authority application, and where lactose intolerance has been proven by:

 (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

Oral

5

5

Karicare De-Lact

Milk powder — lactose modified

Oral powder 900 g (Digestelact)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Proven chronic lactose intolerance in children aged 1 year and over who are significantly malnourished, where the date of birth of the patient is included in the authority application, and where lactose intolerance has been proven by:

 (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

Oral

3

10

Digestelact

Morphine

Tablet containing morphine sulfate 30 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Anamorph

 

Tablet containing morphine sulfate 5 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

MS Contin

 

Tablet containing morphine sulfate 10 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Momex SR 10

MS Contin

 

Tablet containing morphine sulfate 15 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

MS Contin

 

Tablet containing morphine sulfate 30 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Momex SR 30

MS Contin

 

Tablet containing morphine sulfate 60 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Momex SR 60

MS Contin

 

Tablet containing morphine sulfate 100 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Momex SR 100

MS Contin

 

Capsule containing morphine sulfate 10 mg (containing sustained release pellets)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Kapanol

 

Capsule containing morphine sulfate 20 mg (containing sustained release pellets)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Kapanol

 

Capsule containing morphine sulfate 30 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

MS Mono

 

Capsule containing morphine sulfate 50 mg (containing sustained release pellets)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Kapanol

 

Capsule containing morphine sulfate 60 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

MS Mono

 

Capsule containing morphine sulfate 90 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

MS Mono

 

Capsule containing morphine sulfate 100 mg (containing sustained release pellets)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Kapanol

 

Capsule containing morphine sulfate 120 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

MS Mono

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 20 mg per sachet

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

MS Contin Suspension 20 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 30 mg per sachet

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

MS Contin Suspension 30 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 60 mg per sachet

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

MS Contin Suspension 60 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 100 mg per sachet

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

MS Contin Suspension 100 mg

 

Oral solution containing morphine hydrochloride 2 mg per mL, 200 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

2

..

Ordine 2

 

Oral solution containing morphine hydrochloride 5 mg per mL, 200 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

2

..

Ordine 5

 

Oral solution containing morphine hydrochloride 10 mg per mL, 200 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

2

..

Ordine 10

Naratriptan

Tablet 2.5 mg (as hydrochloride)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where adverse events have occurred with other suitable PBS-listed drugs

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where drug interactions have occurred with other suitable PBS-listed drugs

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where drug interactions are expected to occur with other suitable PBS-listed drugs

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where transfer to another suitable PBS-listed drug would cause patient confusion resulting in problems with compliance

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where transfer to another suitable PBS-listed drug is likely to result in adverse clinical consequences

Oral

4

5

Naramig

Nifedipine

Tablet 20 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Drug interactions expected to occur with all of the base-priced drugs

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

Oral

30

5

Adalat Oros 20mg

Nilotinib

Capsule 200 mg (as hydrochloride monohydrate)

 

In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Continuing treatment, as the sole PBS-subsidised therapy, of a patient who has received initial treatment with nilotinib as a pharmaceutical benefit for chronic myeloid leukaemia, and who has demonstrated either a major cytogenetic response to nilotinib, or less than 1% BCR-ABL level in the blood, within 18 months of the commencement of treatment and at 12 monthly intervals thereafter; and

 where the following conditions apply:

 a major cytogenetic response is defined as less than 35% Philadelphia positive bone marrow cells;

 a bone marrow or peripheral blood BCR-ABL level of less than 1% on the international scale (Blood 108: 28-37, 2006) indicates a response, at least the biological equivalent of a major cytogenetic response;

 response to PBS-subsidised treatment with nilotinib is assessed by:

 (1) cytogenetic analysis indicating the number of Philadelphia positive [t (9;22)] cells in the bone marrow measured by standard karyotyping, or, in the case where standard karyotyping is not informative for technical reasons, cytogenetic analysis performed on the bone marrow by the use of fluorescence in situ hybridisation (FISH) with BCR-ABL specific probe; or

 (2) quantitative PCR indicating the relative level of BCR-ABL transcript in the peripheral blood using the international scale;

 the cytogenetic or peripheral blood quantitative PCR analyses demonstrating response are submitted as follows:

 (i) between 10 and 18 months of the commencement of treatment with nilotinib, at which time patients in whom a major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been demonstrated are eligible for a further 12 months of treatment; and

 (ii) at no greater than 12 month intervals thereafter, to demonstrate that the major cytogenetic response or peripheral blood BCR-ABL level of less than 1% has been sustained;

 the authority application includes:

 (1) a completed copy of the appropriate Chronic Myeloid Leukaemia Dasatinib/Nilotinib Authority Application Form for continuing treatment; and

 (2) demonstration of continued response to treatment as evidenced by:

 (a) a copy of the cytogenetic analysis showing a major cytogenetic response, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; or

 (b) a copy of the quantitative PCR analysis showing a peripheral blood level of BCR-ABL of less than 1% on the international scale, unless the relevant pathology report has been supplied within the previous 12 months (or 18 months if the application is the first application for continuing treatment), in which case only the date of this report needs to be provided; and

 (3) if the cytogenetic analysis submitted with the application was conducted using FISH with BCR-ABL specific probe because standard karyotyping was not informative, a copy of the non-informative standard karyotype analysis;

 a patient who has previously received PBS-subsidised treatment with nilotinib and has at any time failed to meet the criteria for continuing treatment, is not eligible for PBS-subsidised re-treatment

Oral

112

5

Tasigna

Nitrazepam

Tablet 5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Myoclonic epilepsy

Malignant neoplasia (late stage)

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

Oral

50

5

Alodorm

Mogadon

Omeprazole

Tablet 20 mg (as magnesium)

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Zollinger-Ellison syndrome

Oral

30

5

Acimax Tablets

Losec Tablets

Omepral

 

Tablet 20 mg

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Zollinger-Ellison syndrome

Oral

30

5

APO-Omeprazole

Chem mart Omeprazole

GenRx Omeprazole

Meprazol

Omeprazole-GA

Omeprazole Ranbaxy

Omeprazole Winthrop

Ozmep

Terry White Chemists Omeprazole

 

Capsule 20 mg

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Zollinger-Ellison syndrome

Oral

30

5

Probitor

Ondansetron

Tablet 4 mg (as hydrochloride dihydrate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

APO-Ondansetron

Ondansetron-RL

Ondaz

Onsetron 4

Zofran

 

Tablet 8 mg (as hydrochloride dihydrate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

APO-Ondansetron

Ondansetron-RL

Ondaz

Onsetron 8

Zofran

 

Wafer 4 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

Ondansetron-RL Zydis

Ondaz Zydis

Zofran Zydis

 

Wafer 8 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

Ondansetron-RL Zydis

Ondaz Zydis

Zofran Zydis

 

Syrup 4 mg (as hydrochloride dihydrate) per 5 mL, 50 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

1

1

Zofran syrup 50 mL

 

I.V. injection 4 mg (as hydrochloride dihydrate) in 2 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Injection

1

..

Ondansetron-RL

Ondaz

Onsetron

Pfizer Australia Pty Ltd

Zofran

 

I.V. injection 8 mg (as hydrochloride dihydrate) in 4 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Injection

1

..

Ondansetron-RL

Ondaz

Onsetron

Pfizer Australia Pty Ltd

Zofran

Oxazepam

Tablet 15 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Malignant neoplasia (late stage)

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

Oral

50

5

Alepam 15

Serepax

 

Tablet 30 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Malignant neoplasia (late stage)

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

Oral

50

5

Alepam 30

Murelax

Serepax

Oxycodone

Tablet containing oxycodone hydrochloride 5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Endone

 

Capsule containing oxycodone hydrochloride 5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyNorm

 

Capsule containing oxycodone hydrochloride 10 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyNorm

 

Capsule containing oxycodone hydrochloride 20 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyNorm

 

Oral solution containing oxycodone hydrochloride 5 mg per 5 mL, 250 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

2

..

OxyNorm Liquid 5mg/5mL

 

Tablet containing oxycodone hydrochloride 5 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyContin

 

Tablet containing oxycodone hydrochloride 10 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyContin

 

Tablet containing oxycodone hydrochloride 15 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyContin

 

Tablet containing oxycodone hydrochloride 20 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyContin

 

Tablet containing oxycodone hydrochloride 30 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyContin

 

Tablet containing oxycodone hydrochloride 40 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyContin

 

Tablet containing oxycodone hydrochloride 80 mg (controlled release)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

OxyContin

 

Suppository 30 mg (as pectinate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

Rectal

24

..

Proladone

Pancreatic Extract

Capsule (containing enteric coated minimicrospheres) providing not less than 5,000 BP units of lipase activity

 

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

Oral

500

21

Creon 5000

 

Capsule (containing enteric coated minimicrospheres) providing not less than 10,000 BP units of lipase activity

 

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

Oral

500

21

Creon 10,000

 

Capsule (containing enteric coated minimicrospheres) providing not less than 25,000 BP units of lipase activity

 

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

Oral

200

21

Creon 25,000

 

Capsule (containing enteric coated minimicrospheres) providing not less than 40,000 BP units of lipase activity

 

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

Oral

200

21

Creon 40,000

Pancrelipase

Capsule (containing enteric coated microtablets) providing not less than 25,000 BP units of lipase activity

 

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

Oral

200

21

Panzytrat 25000

Pantoprazole

Tablet (enteric coated) 40 mg (as sodium sesquihydrate)

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Zollinger-Ellison syndrome

Oral

30

5

APO-Pantoprazole

Chem mart Pantoprazole

Ozpan

Panto

Pantoloc

Pantoprazole-GA

Pantoprazole Sandoz

Salpraz

Somac

Sozol

Terry White Chemists Pantoprazole

 

Sachet containing granules 40 mg (as sodium sesquihydrate)

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Zollinger-Ellison syndrome

Oral

30

5

Somac

Paracetamol

Tablet 500 mg

 

Chronic arthropathies

Oral

300

4

APO-Paracetamol

Chem mart Paracetamol

Febridol

Generic Health Pty Ltd

Panamax

Paracetamol Sandoz

Paralgin

Pharmacy Choice Paracetamol

Terry White Chemists Paracetamol

Paraffin

Eye ointment, compound, containing white soft paraffin with liquid paraffin, 3.5 g

 

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

Application to the eye

2

11

Duratears

Poly Visc

 

Pack containing 2 tubes eye ointment, compound, containing white soft paraffin with liquid paraffin, 3.5 g

 

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

Application to the eye

1

11

Ircal

Lacri-Lube

Poly Visc

Phenoxymethylpenicillin

Tablet 250 mg phenoxymethylpenicillin (as potassium)

 

Prophylaxis of recurrent streptococcal infections (including rheumatic fever)

Oral

50

5

Abbocillin-VK Filmtab

 

Capsule 250 mg phenoxymethylpenicillin (as potassium)

 

Prophylaxis of recurrent streptococcal infections (including rheumatic fever)

Oral

50

5

Cilicaine VK

Cilopen VK

LPV

Polyethylene glycol 400

Eye drops 2.5 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Blink Intensive Tears

Polyethylene Glycol 400 with Propylene Glycol

Eye drops 4 mg-3 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Systane

Poly-l-lactic acid

Powder for injection 150 mg

 

In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Initial PBS-subsidised treatment, for facial administration only, of severe facial lipoatrophy caused by therapy for HIV infection;

 accreditation following completion of injection administration training with Sanofi-Aventis is required to prescribe poly-l-lactic acid under the PBS;

 patients must be referred from the HIV physician to the accredited injector

Injection

2

4

Sculptra

Polyvinyl Alcohol

Eye drops 14 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Liquifilm Tears

PVA Tears

 

Eye drops 14 mg per mL, 15 mL (contains sodium chlorite/hydrogen peroxide as preservative)

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Vistil

 

Eye drops 30 mg per mL, 15 mL

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Liquifilm Forte

PVA Forte

 

Eye drops 30 mg per mL, 15 mL (contains sodium chlorite/hydrogen peroxide as preservative)

 

For use in patients who have severe dry eye syndrome, including Sjogren's syndrome, and who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Application to the eye

1

11

Vistil Forte

Pramipexole

Tablet containing pramipexole hydrochloride 125 micrograms

 

Treatment of severe primary restless legs syndrome in a patient who manifests all 4 diagnostic criteria listed below and whose baseline International Restless Legs Syndrome Rating Scale (IRLSRS) score is greater than or equal to 21 points prior to initiation of pramipexole, where the date and IRLSRS score are documented in the patient's medical records at the time pramipexole treatment is initiated, and where the diagnostic criteria for restless legs syndrome are:

 (a) an urge to move the legs usually accompanied or caused by unpleasant sensations in the legs; and

 (b) the urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting; and

 (c) the urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues; and

 (d) the urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur during the evening or night

Oral

30

2

Sifrol

 

Tablet containing pramipexole hydrochloride 250 micrograms

 

Parkinson disease

Oral

100

5

Sifrol

Pravastatin

Tablet containing pravastatin sodium 10 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Pravastatin

Chem mart Pravastatin

Cholstat 10

GenRx Pravastatin

Lipostat 10

Liprachol

Pravachol

Pravastatin 10

Pravastatin-GA 10

Pravastatin generichealth

Pravastatin Winthrop

Terry White Chemists Pravastatin

 

Tablet containing pravastatin sodium 20 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Pravastatin

Chem mart Pravastatin

Cholstat 20

GenRx Pravastatin

Lipostat 20

Pravachol

Pravastatin 20

Pravastatin-GA 20

Pravastatin generichealth

Pravastatin Sandoz

Pravastatin Winthrop

Terry White Chemists Pravastatin

Vastoran

 

Tablet containing pravastatin sodium 40 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Pravastatin

Chem mart Pravastatin

Cholstat 40

GenRx Pravastatin

Lipostat 40

Pravachol

Pravastatin 40

Pravastatin-GA 40

Pravastatin generichealth

Pravastatin Sandoz

Pravastatin Winthrop

Terry White Chemists Pravastatin

Vastoran

 

Tablet containing pravastatin sodium 80 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Pravastatin

Chem mart Pravastatin

Lipostat 80

Pravachol

Pravastatin-GA 80

Pravastatin generichealth

Pravastatin Sandoz

Terry White Chemists Pravastatin

Rabeprazole

Tablet containing rabeprazole sodium 20 mg (enteric coated)

 

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Oral

30

5

Pariet

Ranitidine

Tablet, effervescent, 150 mg (as hydrochloride)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Drug interactions expected to occur with all of the base-priced drugs

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

Oral

60

5

Zantac

 

Syrup 150 mg (as hydrochloride) per 10 mL, 300 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Drug interactions expected to occur with all of the base-priced drugs

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

Oral

2

5

Zantac Syrup

Rifampicin

Capsule 150 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Leprosy in adults

Oral

100

..

Rimycin 150

 

Capsule 300 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Leprosy in adults

Oral

100

..

Rimycin 300

Risperidone

Tablet 0.5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

APO-Risperidone

Ozidal

Resdone 0.5

Rispa

Risperdal

Risperidone-GA

Rixadone

 

 

1589

 Schizophrenia

 

 

 

 

 

Tablet 0.5 mg (orally disintegrating)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

56

5

Risperdal Quicklet

 

 

1589

 Schizophrenia

 

 

 

 

 

Tablet 1 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

APO-Risperidone

Ozidal

Resdone 1

Rispa

Risperdal

Risperidone-GA

Risperidone generichealth

Rixadone

 

 

1589

 Schizophrenia

 

 

 

 

 

 

2272

 Adjunctive therapy to mood stabilisers for up to 6 months, of an episode of acute mania associated with bipolar I disorder

 

 

 

 

 

Tablet 1 mg (orally disintegrating)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

56

5

Risperdal Quicklet

 

 

1589

 Schizophrenia

 

 

 

 

 

 

2272

 Adjunctive therapy to mood stabilisers for up to 6 months, of an episode of acute mania associated with bipolar I disorder

 

 

 

 

 

Tablet 2 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

APO-Risperidone

Ozidal

Resdone 2

Rispa

Risperdal

Risperidone-GA

Risperidone generichealth

Rixadone

 

 

1589

 Schizophrenia

 

 

 

 

 

 

2272

 Adjunctive therapy to mood stabilisers for up to 6 months, of an episode of acute mania associated with bipolar I disorder

 

 

 

 

 

Tablet 2 mg (orally disintegrating)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

56

5

Risperdal Quicklet

 

 

1589

 Schizophrenia

 

 

 

 

 

 

2272

 Adjunctive therapy to mood stabilisers for up to 6 months, of an episode of acute mania associated with bipolar I disorder

 

 

 

 

 

Oral solution 1 mg per mL, 100 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

1

5

Risperdal

 

 

1589

 Schizophrenia

 

 

 

 

 

 

2272

 Adjunctive therapy to mood stabilisers for up to 6 months, of an episode of acute mania associated with bipolar I disorder

 

 

 

 

Rituximab

Solution for I.V. infusion 100 mg in 10 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of previously untreated, CD20 positive, diffuse large B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

Treatment of symptomatic patients with previously untreated, CD20 positive, Stage III or IV, follicular, B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

Injection

2

7

Mabthera

 

Solution for I.V. infusion 500 mg in 50 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of previously untreated, CD20 positive, diffuse large B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

Treatment of symptomatic patients with previously untreated, CD20 positive, Stage III or IV, follicular, B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

Injection

1

7

Mabthera

Rivaroxaban

Tablets 10 mg, 10

 

In compliance with authority procedures set out in subparagraph 11 (d):

Prevention of venous thromboembolism in a patient undergoing total hip replacement

Oral

1

1

Xarelto

 

Tablet 10 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Prevention of venous thromboembolism in a patient undergoing total hip replacement

Oral

15

1

Xarelto

Rosuvastatin

Tablet 5 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Crestor

 

Tablet 10 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Crestor

 

Tablet 20 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Crestor

 

Tablet 40 mg (as calcium)

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Crestor

Sertraline

Tablet 50 mg (as hydrochloride)

 

Obsessive-compulsive disorder

Panic disorder where other treatments have failed or are inappropriate

Oral

30

5

Eleva 50

Xydep 50

Zoloft

 

Tablet 100 mg (as hydrochloride)

 

Obsessive-compulsive disorder

Panic disorder where other treatments have failed or are inappropriate

Oral

30

5

Eleva 100

Xydep 100

Zoloft

Simvastatin

Tablet 5 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

Simvabell

Simvahexal

Simvasyn

Zimstat

Zocor

 

Tablet 10 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Simvastatin

Chem mart Simvastatin

GenRx Simvastatin

Lipex 10

Pharmacor Simvastatin 10

Ransim

Simvabell

Simvahexal

Simvar 10

Simvastatin-DP

Simvastatin-GA 10

Simvastatin generichealth

Simvastatin-Spirit 10

Simvastatin Winthrop

Simvasyn

Terry White Chemists Simvastatin

Zimstat

Zocor

 

Tablet 20 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Simvastatin

Chem mart Simvastatin

GenRx Simvastatin

Lipex 20

Pharmacor Simvastatin 20

Ransim

Simvabell

Simvahexal

Simvar 20

Simvastatin-DP

Simvastatin-GA 20

Simvastatin generichealth

Simvastatin-Spirit 20

Simvastatin Winthrop

Simvasyn

Terry White Chemists Simvastatin

Zimstat

Zocor

 

Tablet 40 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Simvastatin

Chem mart Simvastatin

GenRx Simvastatin

Lipex 40

Pharmacor Simvastatin 40

Ransim

Simvabell

Simvahexal

Simvar 40

Simvastatin-DP

Simvastatin-GA 40

Simvastatin generichealth

Simvastatin-Spirit 40

Simvastatin Winthrop

Simvasyn

Terry White Chemists Simvastatin

Zimstat

Zocor

 

Tablet 80 mg

 

For use in accordance with paragraph 14 in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

Oral

30

11

APO-Simvastatin

Chem mart Simvastatin

GenRx Simvastatin

Lipex 80

Pharmacor Simvastatin 80

Ransim

Simvabell

Simvahexal

Simvar 80

Simvastatin-DP

Simvastatin-GA 80

Simvastatin generichealth

Simvastatin-Spirit 80

Simvastatin Winthrop

Simvasyn

Terry White Chemists Simvastatin

Zimstat

Zocor

Sulfasalazine

Tablet 500 mg

 

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

Oral

200

11

Salazopyrin

 

Tablet 500 mg (enteric coated)

 

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

Oral

200

11

Pyralin EN

Salazopyrin-EN

Sunitinib

Capsule 12.5 mg (as malate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment beyond 3 months, as the sole PBS-subsidised therapy, of Stage IV clear cell variant renal cell carcinoma (RCC) in a patient who has previously been issued with an authority prescription for sunitinib and who has stable or responding disease according to RECIST (Response Evaluation Criteria in Solid Tumours) criteria

Initial treatment, as the sole PBS-subsidised therapy, of Stage IV clear cell variant renal cell carcinoma (RCC) in a patient who was receiving treatment with sunitinib prior to 1 May 2009

Oral

28

3

Sutent

 

Capsule 12.5 mg (as malate)

 

In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

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

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

 (2)  a signed patient acknowledgement

In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

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

Oral

28

1

Sutent

 

Capsule 25 mg (as malate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment beyond 3 months, as the sole PBS-subsidised therapy, of Stage IV clear cell variant renal cell carcinoma (RCC) in a patient who has previously been issued with an authority prescription for sunitinib and who has stable or responding disease according to RECIST (Response Evaluation Criteria in Solid Tumours) criteria

Initial treatment, as the sole PBS-subsidised therapy, of Stage IV clear cell variant renal cell carcinoma (RCC) in a patient who was receiving treatment with sunitinib prior to 1 May 2009

Oral

28

3

Sutent

 

Capsule 25 mg (as malate)

 

In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

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

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

 (2)  a signed patient acknowledgement

In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

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

Oral

28

1

Sutent

 

Capsule 50 mg (as malate)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing treatment beyond 3 months, as the sole PBS-subsidised therapy, of Stage IV clear cell variant renal cell carcinoma (RCC) in a patient who has previously been issued with an authority prescription for sunitinib and who has stable or responding disease according to RECIST (Response Evaluation Criteria in Solid Tumours) criteria

Initial treatment, as the sole PBS-subsidised therapy, of Stage IV clear cell variant renal cell carcinoma (RCC) in a patient who was receiving treatment with sunitinib prior to 1 May 2009

Oral

28

3

Sutent

 

Capsule 50 mg (as malate)

 

In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

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

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

 (2)  a signed patient acknowledgement

In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

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

Oral

28

1

Sutent

Temazepam

Tablet 10 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Malignant neoplasia (late stage)

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

Oral

50

5

APO-Temazepam

Normison

Temaze

Temtabs

Temozolomide

Capsule 5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Recurrence of anaplastic astrocytoma following standard therapy

Recurrence of glioblastoma multiforme following standard therapy

Glioblastoma multiforme following radiotherapy

Oral

5

5

Temodal

 

Capsule 20 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Recurrence of anaplastic astrocytoma following standard therapy

Recurrence of glioblastoma multiforme following standard therapy

Glioblastoma multiforme following radiotherapy

Oral

5

5

Temodal

 

Capsule 100 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Recurrence of anaplastic astrocytoma following standard therapy

Recurrence of glioblastoma multiforme following standard therapy

Glioblastoma multiforme following radiotherapy

Oral

5

5

Temodal

 

Capsule 140 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Recurrence of anaplastic astrocytoma following standard therapy

Recurrence of glioblastoma multiforme following standard therapy

Glioblastoma multiforme following radiotherapy

Oral

5

5

Temodal

Terbinafine

Tablet 250 mg (as hydrochloride)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Proximal or extensive (greater than 80% nail involvement) onychomycosis due to dermatophyte infection where topical treatment has failed, where the infection is proven by microscopy or culture and confirmed by an Approved Pathology Authority not more than 12 months prior to the date of the authority application and where the date of the pathology report is included in the authority application

Oral

42

1

GenRx Terbinafine

Lamisil (Novartis Pharmaceuticals Australia Pty Limited)

Sebifin 250

Tamsil

Terbihexal

Terbinafine 250

Terbinafine-DP

Terbinafine-GA

Terbix 250

Zabel

Tramadol

Capsule containing tramadol hydrochloride 50 mg

 

For dosage titration in chronic pain where aspirin or paracetamol alone is inappropriate or has failed

Oral

20

2

Chem mart Tramadol

GA Tramadol 50mg

GenRx Tramadol

Lodam 50

Terry White Chemists Tramadol

Tramal

Tramedo

Zydol

 

Tablet (sustained release) containing tramadol hydrochloride 50 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

Tramal SR 50

 

Tablet (sustained release) containing tramadol hydrochloride 100 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

APO-Tramadol SR

Chem mart Tramadol SR

GA Tramadol SR 100mg

Lodam SR 100

Terry White Chemists Tramadol SR

Tramahexal SR

Tramal SR 100

Tramedo SR 100

Zydol SR 100

 

Tablet (extended release) containing tramadol hydrochloride 100 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Durotram XR

 

Tablet (sustained release) containing tramadol hydrochloride 150 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

APO-Tramadol SR

Chem mart Tramadol SR

GA Tramadol SR 150mg

Lodam SR 150

Terry White Chemists Tramadol SR

Tramahexal SR

Tramal SR 150

Tramedo SR 150

Zydol SR 150

 

Tablet (sustained release) containing tramadol hydrochloride 200 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

APO-Tramadol SR

Chem mart Tramadol SR

GA Tramadol SR 200mg

Lodam SR 200

Terry White Chemists Tramadol SR

Tramahexal SR

Tramal SR 200

Tramedo SR 200

Zydol SR 200

 

Tablet (extended release) containing tramadol hydrochloride 200 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Durotram XR

 

Tablet (extended release) containing tramadol hydrochloride 300 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

20

..

Durotram XR

 

Oral drops containing tramadol hydrochloride 100 mg per mL, 10 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

2

..

Tramal

Ustekinumab

Injection 45 mg in 0.5 mL

 

Chronic plaque psoriasis (whole body) — initial treatment 1

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment as systemic monotherapy (other than methotrexate), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have severe chronic plaque psoriasis where lesions have been present for at least 6 months from the time of initial diagnosis; and

 (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the whole body; and

 (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments:

 (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

 (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or

 (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or

 (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

 unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is indicated by a current Psoriasis Area and Severity Index (PASI) score of greater than 15, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment, and is demonstrated in the patient at the time of the authority application;

 a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 28 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment as systemic monotherapy (other than methotrexate), in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with ustekinumab for a period of less than 28 weeks, and where approval of the application would enable the patient to complete a course of 28 weeks of treatment in total

Chronic plaque psoriasis (whole body) — initial treatment 2

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with ustekinumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis; and

 (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and

 (c) have not failed PBS-subsidised therapy with ustekinumab for the treatment of this condition in the current Treatment Cycle; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who have previously demonstrated a response to PBS-subsidised treatment with ustekinumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised ustekinumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 agent treatment, including dosage, date and duration of treatment;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 28 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with ustekinumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 28 weeks, and where approval of the application would enable the patient to complete a course of 28 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 1

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment as systemic monotherapy (other than methotrexate), commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and

 (b) have not received any prior PBS-subsidised treatment with a biological agent for this condition, or, where the patient has received prior PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more, starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and

 (c) have signed a patient and prescriber acknowledgement indicating they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the restriction for continuing treatment of psoriasis affecting the face, hand or foot; and

 (d) have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 3 of the following 4 treatments:

 (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

 (ii) methotrexate at a dose of at least 10 mg weekly for at least 6 weeks; and/or

 (iii) cyclosporin at a dose of at least 2 mg per kg per day for at least 6 weeks; and/or

 (iv) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

 unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to at least 1 of the 4 treatments, for a minimum of 6 weeks; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 failure to achieve an adequate response is demonstrated in the patient at the time of the authority application and is indicated by chronic plaque psoriasis classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where:

 (i) at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling are rated as severe or very severe, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment; or

 (ii) the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed preferably whilst still on treatment but no longer than 1 month following cessation of the most recent prior treatment;

 a PASI assessment is completed for each prior treatment course, preferably whilst still on treatment but no longer than 1 month following cessation of each course of treatment;

 the most recent PASI assessment is no more than 1 month old at the time of application;

 if treatment with any of the drugs mentioned at (d) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or phototherapy is contraindicated, the authority application includes details of the contraindication;

 if intolerance to treatment with the regimens specified at (d) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area diagrams including the dates of assessment of the patient's condition; and

 (ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and

 (iii) the signed patient and prescriber acknowledgements;

 a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 28 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment as systemic monotherapy (other than methotrexate), in a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with ustekinumab for a period of less than 28 weeks, and where approval of the application would enable the patient to complete a course of 28 weeks of treatment in total

Chronic plaque psoriasis (face, hand, foot) — initial treatment 2

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i):

 Initial treatment, or recommencement of treatment, with ustekinumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who:

 (a) have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

 (b) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle; and

 (c) have not failed PBS-subsidised therapy with ustekinumab for the treatment of this condition in the current Treatment Cycle; and

 where biological agent means adalimumab, etanercept, infliximab or ustekinumab; and

 where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and

 where the following conditions apply:

 patients who have previously demonstrated a response to PBS-subsidised treatment with ustekinumab within this Treatment Cycle are only eligible to recommence therapy with this drug within this same cycle, following a break in therapy, where evidence of a response to their most recent course of PBS-subsidised ustekinumab treatment was submitted to the Medicare Australia CEO within 1 month of cessation of that treatment;

 the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:

 (i) 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 agent treatment, including dosage, date and duration of treatment;

 a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 28 weeks of treatment

 In compliance with authority procedures set out in subsubparagraph 11 (d) (i) or 11 (d) (ii):

 Continuation of initial treatment, or of a course which recommences treatment, with ustekinumab as systemic monotherapy (other than methotrexate), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 28 weeks, and where approval of the application would enable the patient to complete a course of 28 weeks of treatment in total

Injection

1

2

Stelara

Valaciclovir

Tablet 500 mg (as hydrochloride)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Oral

30

5

Valtrex

 

Tablet 500 mg (as hydrochloride)

 

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of patients with herpes zoster within 72 hours of the onset of the rash

Herpes zoster ophthalmicus

Oral

42

..

Valtrex

Vancomycin

Powder for injection 500 mg (500,000 I.U.) (as hydrochloride)

 

Endophthalmitis

Use initiated in a hospital for infections where vancomycin hydrochloride is an appropriate antibiotic

Injection

5

..

Hospira Pty Limited

Vancocin CP

Vancomycin Sandoz

 

Powder for injection 1 g (1,000,000 I.U.) (as hydrochloride)

 

Endophthalmitis

Use initiated in a hospital for infections where vancomycin hydrochloride is an appropriate antibiotic

Injection

3

..

Hospira Pty Limited

Vancomycin Sandoz

Zoledronic acid

Solution for I.V. infusion 5 mg (as monohydrate) in 100 mL

 

In compliance with authority procedures set out in subparagraph 11 (d):

Symptomatic Paget disease of bone, and where PBS-subsidised treatment is limited to 1 dose each year

Injection

1

..

Aclasta

Zolmitriptan

Tablet 2.5 mg

 

In compliance with authority procedures set out in subparagraph 11 (d):

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where adverse events have occurred with other suitable PBS-listed drugs

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where drug interactions have occurred with other suitable PBS-listed drugs

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where drug interactions are expected to occur with other suitable PBS-listed drugs

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where transfer to another suitable PBS-listed drug would cause patient confusion resulting in problems with compliance

Migraine attack in a patient where attacks in the past have usually failed to respond to analgesics, and where transfer to another suitable PBS-listed drug is likely to result in adverse clinical consequences

Oral

4

5

Zomig

 

 

 

 

SCHEDULE 2 - PART 1

Listed Drug

Form

(strength, type, size, etc.)

Manner of adminis-

tration

Maximum quantity

Maximum number of repeats

Brand

Benzydamine

Mouth and throat rinse containing benzydamine hydrochloride 22.5 mg per 15 mL, 500 mL

Oral application

1

..

Difflam

Bisacodyl

Tablet 5 mg

Oral

200

..

Bisalax

 

 

 

 

 

Lax-Tab

 

Suppositories 10 mg, 10

Rectal

3

..

Dulcolax

 

 

 

 

 

Petrus Bisacodyl Suppositories

 

Suppositories 10 mg, 12

Rectal

3

..

Petrus Bisacodyl Suppositories

 

Enemas 10 mg in 5 mL, 25

Rectal

1

..

Bisalax

Carmellose

Mouth spray containing carmellose sodium 10 mg per mL, 25 mL

Oral application

1

..

Aquae

 

Mouth spray containing carmellose sodium 10 mg per mL, 100 mL

Oral application

1

..

Aquae

Clonazepam

Tablet 500 micrograms

Oral

100

..

Paxam 0.5

 

 

 

 

 

Rivotril

 

Tablet 2 mg

Oral

100

..

Paxam 2

 

 

 

 

 

Rivotril

 

Oral liquid 2.5 mg per mL, 10 mL

Oral

2

..

Rivotril

Diazepam

Tablet 2 mg

Oral

50

..

Antenex 2

 

 

 

 

 

Valium

 

 

 

 

 

Valpam 2

 

Tablet 5 mg

Oral

50

..

Antenex 5

 

 

 

 

 

Diazepam-GA

 

 

 

 

 

Ranzepam

 

 

 

 

 

Valium

 

 

 

 

 

Valpam 5

Diclofenac

Tablet (enteric coated) containing diclofenac sodium 25 mg

Oral

100

..

APO-Diclofenac

 

 

 

 

 

Chem mart Diclofenac

 

 

 

 

 

Clonac 25

 

 

 

 

 

Diclofenac-GA

 

 

 

 

 

Diclofenac Sandoz

 

 

 

 

 

Fenac 25

 

 

 

 

 

Terry White Chemists Diclofenac

 

 

 

 

 

Voltaren 25

 

Tablet (enteric coated) containing diclofenac sodium 50 mg

Oral

50

..

APO-Diclofenac

 

 

 

 

 

Chem mart Diclofenac

 

 

 

 

 

Clonac 50

 

 

 

 

 

Diclofenac-GA

 

 

 

 

 

Diclofenac Sandoz

 

 

 

 

 

Fenac

 

 

 

 

 

Terry White Chemists Diclofenac

 

 

 

 

 

Voltaren 50

 

Suppository containing diclofenac sodium 100 mg

Rectal

40

..

Voltaren 100

Fentanyl

Lozenges 200 micrograms (as citrate), 3

Buccal

3

..

Actiq

 

Lozenges 400 micrograms (as citrate), 3

Buccal

3

..

Actiq

 

Lozenges 600 micrograms (as citrate), 3

Buccal

3

..

Actiq

 

Lozenges 800 micrograms (as citrate), 3

Buccal

3

..

Actiq

 

Lozenges 1200 micrograms (as citrate), 3

Buccal

3

..

Actiq

 

Lozenges 1600 micrograms (as citrate), 3

Buccal

3

..

Actiq

Glycerol

Suppositories 700 mg, 12

Rectal

3

..

Petrus Pharmaceuticals Pty Ltd

 

Suppositories 1.4 g, 12

Rectal

3

..

Petrus Pharmaceuticals Pty Ltd

 

Suppositories 2.8 g, 12

Rectal

3

..

Petrus Pharmaceuticals Pty Ltd

Hyoscine

Injection containing hyoscine butylbromide 20 mg in 1 mL

Injection

5

..

Buscopan

Hypromellose

Oral gel 20 mg per g, 100 g

Oral application

1

..

Aquae Gel

Ibuprofen

Tablet 400 mg

Oral

90

..

Brufen

Indomethacin

Capsule 25 mg

Oral

100

..

Arthrexin

 

 

 

 

 

Indocid

 

Suppository 100 mg

Rectal

40

..

Indocid

Lactulose

Solution BP 3.34 g per 5 mL, 500 mL

Oral

1

..

Actilax

 

 

 

 

 

Duphalac

 

 

 

 

 

Genlac

 

 

 

 

 

GenRx Lactulose

 

 

 

 

 

Lac-Dol

 

 

 

 

 

Lactocur

Macrogol 3350

Sachets containing powder for oral solution 6.563 g with electrolytes, 30

Oral

1

..

Movicol-Half

 

Sachets containing powder for oral solution 13.125 g with electrolytes, 30

Oral

1

..

Movicol

Methadone

Oral liquid containing methadone hydrochloride 25 mg per 5 mL, 200 mL

Oral

1

..

Sigma Pharmaceuticals (Australia) Pty Ltd

Methylnaltrexone

Solution for injection containing methylnaltrexone bromide 12 mg in 0.6 mL

Injection

3

..

Relistor

Morphine

Tablet containing morphine sulfate 10 mg

Oral

20

..

Sevredol

 

Tablet containing morphine sulfate 20 mg

Oral

20

..

Sevredol

 

Tablet containing morphine sulfate 200 mg (controlled release)

Oral

20

..

MS Contin

Naproxen

Tablet containing naproxen sodium 550 mg

Oral

50

..

Anaprox 550

 

 

 

 

 

Crysanal

 

Tablet 250 mg

Oral

100

..

Inza 250

 

 

 

 

 

Naprosyn

 

Tablet 500 mg

Oral

50

..

Inza 500

 

 

 

 

 

Naprosyn

 

Tablet 750 mg (sustained release)

Oral

28

..

Naprosyn SR750

 

 

 

 

 

Proxen SR 750

 

Tablet 1 g (sustained release)

Oral

28

..

Naprosyn SR1000

 

 

 

 

 

Proxen SR 1000

 

Oral suspension 125 mg per 5 mL, 474 mL

Oral

1

..

Naprosyn

Nitrazepam

Tablet 5 mg

Oral

50

..

Alodorm

 

 

 

 

 

Mogadon

Oxazepam

Tablet 15 mg

Oral

50

..

Alepam 15

 

 

 

 

 

Serepax

 

Tablet 30 mg

Oral

50

..

Alepam 30

 

 

 

 

 

Murelax

 

 

 

 

 

Serepax

Paracetamol

Tablet 665 mg (modified release)

Oral

192

..

Panadol Osteo

 

Suppositories 500 mg, 24

Rectal

1

..

Panadol

Promethazine

Tablet containing promethazine hydrochloride 10 mg

Oral

50

..

Phenergan

 

Tablet containing promethazine hydrochloride 25 mg

Oral

50

..

Phenergan

 

Oral liquid containing promethazine hydrochloride 5 mg per 5 mL, 100 mL

Oral

1

..

Phenergan

Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate

Enemas 3.125 g-450 mg-45 mg in 5 mL, 12

Rectal

2

..

Microlax

Sterculia with Frangula Bark

Granules 620 mg-80 mg per g, 500 g

Oral

1

..

Normacol Plus

Sulindac

Tablet 100 mg

Oral

100

..

Aclin

 

Tablet 200 mg

Oral

50

..

Aclin 200

Temazepam

Tablet 10 mg

Oral

50

..

APO-Temazepam

 

 

 

 

 

Normison

 

 

 

 

 

Temaze

 

 

 

 

 

Temtabs

SCHEDULE 2 - PART 2

Listed Drug

Form

(strength, type, size, etc.)

Purposes

Manner of adminis-

tration

Maximum quantity

Maximum number of repeats

Brand

Benzydamine

Mouth and throat rinse containing benzydamine hydrochloride 22.5 mg per 15 mL, 500 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where a painful mouth is a problem

Continuing supply for palliative care patients where a painful mouth is a problem, and where consultation with a palliative care specialist or service has occurred

Oral application

1

3

Difflam

Bisacodyl

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

200

3

Bisalax

Lax-Tab

 

Suppositories 10 mg, 10

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

3

3

Dulcolax

Petrus Bisacodyl Suppositories

 

Suppositories 10 mg, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

3

3

Petrus Bisacodyl Suppositories

 

Enemas 10 mg in 5 mL, 25

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

1

3

Bisalax

Carmellose

Mouth spray containing carmellose sodium 10 mg per mL, 25 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where dry mouth is a symptom

Continuing supply for palliative care patients where dry mouth is a symptom, and where consultation with a palliative care specialist or service has occurred

Oral application

1

3

Aquae

 

Mouth spray containing carmellose sodium 10 mg per mL, 100 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where dry mouth is a symptom

Continuing supply for palliative care patients where dry mouth is a symptom, and where consultation with a palliative care specialist or service has occurred

Oral application

1

3

Aquae

Clonazepam

Tablet 500 micrograms

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients for the prevention of epilepsy

Continuing supply for palliative care patients for the prevention of epilepsy, where consultation with a palliative care specialist or service has occurred

Oral

100

3

Paxam 0.5

Rivotril

 

Tablet 2 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients for the prevention of epilepsy

Continuing supply for palliative care patients for the prevention of epilepsy, where consultation with a palliative care specialist or service has occurred

Oral

100

3

Paxam 2

Rivotril

 

Oral liquid 2.5 mg per mL, 10 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients for the prevention of epilepsy

Continuing supply for palliative care patients for the prevention of epilepsy, where consultation with a palliative care specialist or service has occurred

Oral

2

3

Rivotril

Diazepam

Tablet 2 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Antenex 2

Valium

Valpam 2

 

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Antenex 5

Diazepam-GA

Ranzepam

Valium

Valpam 5

Diclofenac

Tablet (enteric coated) containing diclofenac sodium 25 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

100

3

APO-Diclofenac

Chem mart Diclofenac

Clonac 25

Diclofenac-GA

Diclofenac Sandoz

Fenac 25

Terry White Chemists Diclofenac

Voltaren 25

 

Tablet (enteric coated) containing diclofenac sodium 50 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

APO-Diclofenac

Chem mart Diclofenac

Clonac 50

Diclofenac-GA

Diclofenac Sandoz

Fenac

Terry White Chemists Diclofenac

Voltaren 50

 

Suppository containing diclofenac sodium 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

40

3

Voltaren 100

Fentanyl

Lozenges 200 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

First continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Second and subsequent continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects, where consultation with a palliative care specialist or service has occurred

Buccal

20

2

Actiq

 

Lozenges 200 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

Second and subsequent continuing supply, for up to 1 month, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Buccal

20

..

Actiq

 

Lozenges 400 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

First continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Second and subsequent continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects, where consultation with a palliative care specialist or service has occurred

Buccal

20

2

Actiq

 

Lozenges 400 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

Second and subsequent continuing supply, for up to 1 month, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Buccal

20

..

Actiq

 

Lozenges 600 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

First continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Second and subsequent continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects, where consultation with a palliative care specialist or service has occurred

Buccal

20

2

Actiq

 

Lozenges 600 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

Second and subsequent continuing supply, for up to 1 month, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Buccal

20

..

Actiq

 

Lozenges 800 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

First continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Second and subsequent continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects, where consultation with a palliative care specialist or service has occurred

Buccal

20

2

Actiq

 

Lozenges 800 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

Second and subsequent continuing supply, for up to 1 month, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Buccal

20

..

Actiq

 

Lozenges 1200 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

First continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Second and subsequent continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects, where consultation with a palliative care specialist or service has occurred

Buccal

20

2

Actiq

 

Lozenges 1200 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

Second and subsequent continuing supply, for up to 1 month, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Buccal

20

..

Actiq

 

Lozenges 1600 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

First continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Second and subsequent continuing supply, for up to 3 months, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects, where consultation with a palliative care specialist or service has occurred

Buccal

20

2

Actiq

 

Lozenges 1600 micrograms (as citrate), 3

In compliance with authority procedures set out in subparagraph 11 (d):

Second and subsequent continuing supply, for up to 1 month, for breakthrough pain in palliative care patients with cancer who are receiving opioids for their persistent pain and where further escalation in the dose of morphine for breakthrough pain results in intolerable adverse effects

Buccal

20

..

Actiq

Glycerol

Suppositories 700 mg, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

3

3

Petrus Pharmaceuticals Pty Ltd

 

Suppositories 1.4 g, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

3

3

Petrus Pharmaceuticals Pty Ltd

 

Suppositories 2.8 g, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

3

3

Petrus Pharmaceuticals Pty Ltd

Hyoscine

Injection containing hyoscine butylbromide 20 mg in 1 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where colicky pain is a symptom

Continuing supply for palliative care patients where colicky pain is a symptom, and where consultation with a palliative care specialist or service has occurred

Injection

5

3

Buscopan

Hypromellose

Oral gel 20 mg per g, 100 g

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where dry mouth is a symptom

Continuing supply for palliative care patients where dry mouth is a symptom, and where consultation with a palliative care specialist or service has occurred

Oral application

1

3

Aquae Gel

Ibuprofen

Tablet 400 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

90

3

Brufen

Indomethacin

Capsule 25 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

100

3

Arthrexin

Indocid

 

Suppository 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

40

3

Indocid

Lactulose

Solution BP 3.34 g per 5 mL, 500 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

1

3

Actilax

Duphalac

Genlac

GenRx Lactulose

Lac-Dol

Lactocur

Macrogol 3350

Sachets containing powder for oral solution 6.563 g with electrolytes, 30

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

1

3

Movicol-Half

 

Sachets containing powder for oral solution 13.125 g with electrolytes, 30

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

1

3

Movicol

Methadone

Oral liquid containing methadone hydrochloride 25 mg per 5 mL, 200 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics

Continuing supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

Oral

1

2

Sigma Pharmaceuticals (Australia) Pty Ltd

Methylnaltrexone

Solution for injection containing methylnaltrexone bromide 12 mg in 0.6 mL

In compliance with authority procedures set out in subparagraph 11 (d):

First continuing supply, in combination with oral laxatives, for a palliative care patient with opioid-induced constipation who has demonstrated a response to methylnaltrexone

Second and subsequent continuing supply, in combination with oral laxatives, for a palliative care patient with opioid-induced constipation who has demonstrated a response to methylnaltrexone, and where consultation with a palliative care specialist or service has occurred

Injection

7

3

Relistor

 

Solution for injection containing methylnaltrexone bromide 12 mg in 0.6 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Continuing supply, in combination with oral laxatives, for a palliative care patient with opioid-induced constipation who has demonstrated a response to methylnaltrexone

Injection

7

..

Relistor

Morphine

Tablet containing morphine sulfate 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics

Continuing supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

Oral

20

2

Sevredol

 

Tablet containing morphine sulfate 20 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics

Continuing supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

Oral

20

2

Sevredol

 

Tablet containing morphine sulfate 200 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics

Continuing supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

Oral

20

2

MS Contin

Naproxen

Tablet 250 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

100

3

Inza 250

Naprosyn

 

Tablet containing naproxen sodium 550 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Anaprox 550

Crysanal

 

Tablet 500 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Inza 500

Naprosyn

 

Tablet 750 mg (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

28

3

Naprosyn SR750

Proxen SR 750

 

Tablet 1 g (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

28

3

Naprosyn SR1000

Proxen SR 1000

 

Oral suspension 125 mg per 5 mL, 474 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Continuing supply for palliative care patients where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent, and where consultation with a palliative care specialist or service has occurred

Oral

1

3

Naprosyn

Nitrazepam

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where insomnia is a problem

Continuing supply for palliative care patients where insomnia is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Alodorm

Mogadon

Oxazepam

Tablet 15 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Alepam 15

Serepax

 

Tablet 30 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Alepam 30

Murelax

Serepax

Paracetamol

Tablet 665 mg (modified release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated

Continuing supply for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated, and where consultation with a palliative care specialist or service has occurred

Oral

192

3

Panadol Osteo

 

Suppositories 500 mg, 24

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated

Continuing supply for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated, and where consultation with a palliative care specialist or service has occurred

Rectal

1

3

Panadol

Promethazine

Tablet containing promethazine hydrochloride 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where nausea and/or vomiting is a problem

Continuing supply for palliative care patients where nausea and/or vomiting is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Phenergan

 

Tablet containing promethazine hydrochloride 25 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where nausea and/or vomiting is a problem

Continuing supply for palliative care patients where nausea and/or vomiting is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Phenergan

 

Oral liquid containing promethazine hydrochloride 5 mg per 5 mL, 100 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where nausea and/or vomiting is a problem

Continuing supply for palliative care patients where nausea and/or vomiting is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

1

3

Phenergan

Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate

Enemas 3.125 g-450 mg-45 mg in 5 mL, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Rectal

2

3

Microlax

Sterculia with Frangula Bark

Granules 620 mg-80 mg per g, 500 g

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

1

3

Normacol Plus

Sulindac

Tablet 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

100

3

Aclin

 

Tablet 200 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

Aclin 200

Temazepam

Tablet 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where insomnia is a problem

Continuing supply for palliative care patients where insomnia is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

APO-Temazepam

Normison

Temaze

Temtabs

 

SCHEDULE 3 - PART 1

Listed Drug

Form

(strength, type, size, etc.)

Manner of adminis-
tration

Maximum quantity

Maximum number of repeats

Brand

Adrenaline

Injection 1 mg (as acid tartrate) in 1 mL (1 in 1,000)

Injection

5

..

AstraZeneca Pty Ltd

Amoxycillin

Capsule 250 mg (as trihydrate)

Oral

20

..

Alphamox 250

 

 

 

 

 

Amoxil

 

 

 

 

 

Amoxycillin-GA

 

 

 

 

 

Amoxycillin Ranbaxy

 

 

 

 

 

Amoxycillin Sandoz

 

 

 

 

 

APO-Amoxycillin

 

 

 

 

 

Chem mart Amoxycillin

 

 

 

 

 

Cilamox

 

 

 

 

 

GenRx Amoxycillin

 

 

 

 

 

Terry White Chemists Amoxycillin

 

Capsule 500 mg (as trihydrate)

Oral

20

..

Alphamox 500

 

 

 

 

 

Amoxil

 

 

 

 

 

Amoxycillin-DP

 

 

 

 

 

Amoxycillin-GA

 

 

 

 

 

Amoxycillin Ranbaxy

 

 

 

 

 

Amoxycillin Sandoz

 

 

 

 

 

APO-Amoxycillin

 

 

 

 

 

Chem mart Amoxycillin

 

 

 

 

 

Cilamox

 

 

 

 

 

GenRx Amoxycillin

 

 

 

 

 

Terry White Chemists Amoxycillin

 

Sachet containing oral powder 3 g (as trihydrate)

Oral

1

..

Amoxil

 

Powder for paediatric oral drops 100 mg (as trihydrate) per mL, 20 mL

Oral

1

..

Amoxil

 

Powder for oral suspension 125 mg (as trihydrate) per 5 mL, 100 mL

Oral

1

..

Alphamox 125

 

 

 

 

 

Amoxil

 

 

 

 

 

Amoxycillin Sandoz

 

 

 

 

 

Bgramin

 

 

 

 

 

Chem mart Amoxycillin

 

 

 

 

 

GenRx Amoxycillin

 

 

 

 

 

Ranmoxy

 

 

 

 

 

Terry White Chemists Amoxycillin

 

Powder for oral suspension 250 mg (as trihydrate) per 5 mL, 100 mL

Oral

1

..

Alphamox 250

 

 

 

 

 

Amoxil Forte

 

 

 

 

 

Amoxycillin Sandoz

 

 

 

 

 

Bgramin

 

 

 

 

 

Chem mart Amoxycillin

 

 

 

 

 

Cilamox

 

 

 

 

 

GenRx Amoxycillin

 

 

 

 

 

Ranmoxy

 

 

 

 

 

Terry White Chemists Amoxycillin

 

Powder for oral suspension 500 mg (as trihydrate) per 5 mL, 100 mL

Oral

1

..

Maxamox

Amoxycillin with Clavulanic Acid

Tablet containing 500 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate)

Oral

10

..

APO-Amoxycillin/ Clavulanic Acid 500/125

 

 

 

 

 

Augmentin Duo

 

 

 

 

 

Clamoxyl Duo

 

 

 

 

 

Curam Duo 500/125

 

 

 

 

 

GA-Amclav 500/125

 

 

 

 

 

Moxiclav Duo 500/125

 

Tablet containing 875 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate)

Oral

10

..

Augmentin Duo forte

Chem mart Amoxycillin and Clavulanic Acid

Clamoxyl Duo forte

Clavycillin 875/125

Curam Duo Forte 875/125

GA-Amclav Forte 875/125

GenRx Amoxycillin and Clavulanic Acid

Moxiclav Duo Forte 875/125

Terry White Chemists Amoxycillin and Clavulanic Acid

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Powder for oral suspension containing 125 mg amoxycillin (as trihydrate) with 31.25 mg clavulanic acid (as potassium clavulanate) per 5 mL, 75 mL

Oral

1

..

Augmentin

Clamoxyl

 

 

 

 

 

Curam

 

Powder for oral suspension containing 400 mg amoxycillin (as trihydrate) with 57 mg clavulanic acid (as potassium clavulanate) per 5 mL, 60 mL

Oral

1

..

Augmentin Duo 400

Clamoxyl Duo 400

 

 

 

 

 

Curam Duo

Amphotericin

Lozenge 10 mg

Oral

20

..

Fungilin

Ampicillin

Powder for injection 500 mg (as sodium)

Injection

5

..

Austrapen

 

 

 

 

 

Ibimicyn

 

Powder for injection 1 g (as sodium)

Injection

5

..

Aspen Ampicyn

 

 

 

 

 

Austrapen

 

 

 

 

 

Ibimicyn

Aspirin

Tablet, dispersible, 300 mg

Oral

96

..

Solprin

Atropine

Injection containing atropine sulfate 600 micrograms in 1 mL

Injection

10

..

AstraZeneca Pty Ltd

Benzathine benzylpenicillin

Injection 900 mg in 2.3 mL single use pre-filled syringe

Injection

10

..

Bicillin L-A

Benztropine

Injection containing benztropine mesylate 2 mg in 2 mL

Injection

5

..

Cogentin

Benzydamine

Mouth and throat rinse containing benzydamine hydrochloride 22.5 mg per 15 mL, 500 mL

Oral application

1

..

Difflam

Benzylpenicillin

Powder for injection 600 mg (as sodium)

Injection

10

..

BenPen

 

Powder for injection 3 g (as sodium)

Injection

10

..

BenPen

Betamethasone

Injection containing betamethasone acetate 3 mg with betamethasone sodium phosphate 3.9 mg in 1 mL

Injection

5

..

Celestone Chronodose

Carbamazepine

Tablet 100 mg

Oral

200

..

Carbamazepine Sandoz

 

 

 

 

 

Tegretol 100

 

Tablet 200 mg

Oral

200

..

Carbamazepine Sandoz

 

 

 

 

 

Tegretol 200

 

 

 

 

 

Teril

 

Tablet 200 mg (controlled release)

Oral

200

..

Tegretol CR 200

 

Tablet 400 mg (controlled release)

Oral

200

..

Tegretol CR 400

 

Oral suspension 100 mg per 5 mL, 300 mL

Oral

1

..

Tegretol Liquid

Cefaclor

Tablet (sustained release) 375 mg (as monohydrate)

Oral

10

..

Ceclor CD

 

 

 

 

 

Cefaclor-GA

 

 

 

 

 

Chem mart Cefaclor CD

 

 

 

 

 

Douglas Cefaclor-CD

 

 

 

 

 

GenRx Cefaclor CD

 

 

 

 

 

Karlor CD

 

 

 

 

 

Keflor CD

 

 

 

 

 

Ozcef

 

 

 

 

 

Terry White Chemists Cefaclor CD

 

Powder for oral suspension 125 mg (as monohydrate) per 5 mL, 100 mL

Oral

1

..

Aclor 125

 

 

 

 

 

Ceclor

 

 

 

 

 

Cefaclor Sandoz

 

 

 

 

 

Chem mart Cefaclor

 

 

 

 

 

GenRx Cefaclor

 

 

 

 

 

Keflor

 

 

 

 

 

Ozcef

 

 

 

 

 

Terry White Chemists Cefaclor

 

Powder for oral suspension 250 mg (as monohydrate) per 5 mL, 75 mL

Oral

1

..

Aclor 250

 

 

 

 

 

Ceclor

 

 

 

 

 

Cefaclor Sandoz

 

 

 

 

 

Chem mart Cefaclor

 

 

 

 

 

GenRx Cefaclor

 

 

 

 

 

Keflor

 

 

 

 

 

Ozcef

 

 

 

 

 

Terry White Chemists Cefaclor

Cefalotin

Powder for injection 1 g (as sodium)

Injection

10

..

Cefalotin Sandoz

 

 

 

 

 

Hospira Pty Limited

 

 

 

 

 

Keflin Neutral

Cefotaxime

Powder for injection 1 g (as sodium)

Injection

10

..

Cefotaxime Sandoz

 

 

 

 

 

Hospira Pty Limited

 

Powder for injection 2 g (as sodium)

Injection

10

..

Cefotaxime Sandoz

 

 

 

 

 

Hospira Pty Limited

Cefuroxime

Tablet 250 mg (as axetil)

Oral

14

..

Zinnat

Cephalexin

Capsule 250 mg (anhydrous)

Oral

20

..

Cefalexin Sandoz

 

 

 

 

 

Cephabell

 

 

 

 

 

Cephalexin generichealth

 

 

 

 

 

Cephatrust 250

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 250

 

 

 

 

 

Keflex

 

 

 

 

 

Rancef

 

 

 

 

 

Terry White Chemists Cephalexin

 

Capsule 500 mg (anhydrous)

Oral

20

..

Cefalexin Sandoz

 

 

 

 

 

Cephabell

 

 

 

 

 

Cephalexin generichealth

 

 

 

 

 

Cephatrust 500

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 500

 

 

 

 

 

Keflex

 

 

 

 

 

Rancef

 

 

 

 

 

Terry White Chemists Cephalexin

 

Granules for oral suspension 125 mg per 5 mL, 100 mL

Oral

1

..

APO-Cephalexin

 

 

 

 

 

Cefalexin Sandoz

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 125

 

 

 

 

 

Keflex

 

 

 

 

 

Terry White Chemists Cephalexin

 

Granules for oral suspension 250 mg per 5 mL, 100 mL

Oral

1

..

APO-Cephalexin

 

 

 

 

 

Cefalexin Sandoz

 

 

 

 

 

Chem mart Cephalexin

 

 

 

 

 

Cilex

 

 

 

 

 

GenRx Cephalexin

 

 

 

 

 

Ialex

 

 

 

 

 

Ibilex 250

 

 

 

 

 

Keflex

 

 

 

 

 

Terry White Chemists Cephalexin

Chloramphenicol

Eye drops 5 mg per mL, 10 mL

Application to the eye

1

..

Chloromycetin

 

 

 

 

 

Chlorsig

Clindamycin

Capsule 150 mg (as hydrochloride)

Oral

24

..

Cleocin

 

 

 

 

 

Dalacin C

Codeine

Tablet containing codeine phosphate 30 mg

Oral

20

..

Fawns and McAllan Proprietary Limited

Codeine with Paracetamol

Tablet containing codeine phosphate 30 mg with paracetamol 500 mg

Oral

20

..

APO- Paracetamol/Codeine 500/30

 

 

 

 

 

Codalgin Forte

 

 

 

 

 

Codapane Forte

 

 

 

 

 

Comfarol Forte

 

 

 

 

 

Dolaforte

 

 

 

 

 

Panadeine Forte

 

 

 

 

 

Prodeine Forte

Diazepam

Tablet 2 mg

Oral

50

..

Antenex 2

 

 

 

 

 

Valium

 

 

 

 

 

Valpam 2

 

Tablet 5 mg

Oral

50

..

Antenex 5

 

 

 

 

 

Diazepam-GA

 

 

 

 

 

Ranzepam

 

 

 

 

 

Valium

 

 

 

 

 

Valpam 5

 

Injection 10 mg in 2 mL

Injection

5

..

Hospira Pty Limited

Diclofenac

Tablet (enteric coated) containing diclofenac sodium 25 mg

Oral

100

..

APO-Diclofenac

 

 

 

 

 

Chem mart Diclofenac

 

 

 

 

 

Clonac 25

 

 

 

 

 

Diclofenac-GA

 

 

 

 

 

Diclofenac Sandoz

 

 

 

 

 

Fenac 25

 

 

 

 

 

Terry White Chemists Diclofenac

 

 

 

 

 

Voltaren 25

 

Tablet (enteric coated) containing diclofenac sodium 50 mg

Oral

50

..

APO-Diclofenac

 

 

 

 

 

Chem mart Diclofenac

 

 

 

 

 

Clonac 50

 

 

 

 

 

Diclofenac-GA

 

 

 

 

 

Diclofenac Sandoz

 

 

 

 

 

Fenac

 

 

 

 

 

Terry White Chemists Diclofenac

 

 

 

 

 

Voltaren 50

 

Suppository containing diclofenac sodium 100 mg

Rectal

40

..

Voltaren 100

Dicloxacillin

Capsule 250 mg (as sodium)

Oral

24

..

Dicloxsig

 

 

 

 

 

Distaph 250

 

Capsule 500 mg (as sodium)

Oral

24

..

Diclocil

 

 

 

 

 

Dicloxsig

 

 

 

 

 

Distaph 500

Doxycycline

Tablet 100 mg (as monohydrate)

Oral

7

..

Chem mart Doxycycline

 

 

 

 

 

Doxyhexal

 

 

 

 

 

GenRx Doxycycline

 

 

 

 

 

Terry White Chemists Doxycycline

 

Tablet 100 mg (as hydrochloride)

Oral

7

..

Doxsig

 

 

 

 

 

Doxy-100

 

 

 

 

 

Doxylin 100

 

 

 

 

 

Vibramycin

 

Capsule 100 mg (as hydrochloride) (containing enteric coated pellets)

Oral

7

..

DBL Doxycycline

 

 

 

 

 

Doryx

Erythromycin

Tablet 400 mg (as ethyl succinate)

Oral

25

..

E.E.S. 400 Filmtab

 

 

 

 

 

E-Mycin

 

Capsule 250 mg (containing enteric coated pellets)

Oral

25

..

DBL Erythromycin

 

 

 

 

 

Eryc

 

Powder for oral liquid 200 mg (as ethyl succinate) per 5 mL, 100 mL

Oral

1

..

E.E.S. 200

 

 

 

 

 

E-Mycin 200

 

Powder for oral liquid 400 mg (as ethyl succinate) per 5 mL, 100 mL

Oral

1

..

E.E.S. Granules

 

 

 

 

 

E-Mycin 400

 

Powder for I.V. infusion 1 g (as lactobionate)

Injection

5

..

Erythrocin-I.V.

Flucloxacillin

Capsule 250 mg (as sodium)

Oral

24

..

Flopen

 

 

 

 

 

Staphylex 250

 

Capsule 500 mg (as sodium)

Oral

24

..

Flopen

 

 

 

 

 

Staphylex 500

 

Powder for oral liquid 125 mg (as sodium) per 5 mL, 100 mL

Oral

1

..

Aspen Pharmacare Australia Pty Limited

 

Powder for oral liquid 250 mg (as sodium) per 5 mL, 100 mL

Oral

1

..

Aspen Pharmacare Australia Pty Limited

 

Powder for injection 500 mg (as sodium)

Injection

5

..

Flubiclox

 

 

 

 

 

Flucil

 

Powder for injection 1 g (as sodium)

Injection

5

..

Flubiclox

 

 

 

 

 

Flucil

 

 

 

 

 

Hospira Pty Limited

Glucagon

Injection set containing glucagon hydrochloride 1 mg (1 I.U.) and 1 mL solvent in disposable syringe

Injection

1

..

GlucaGen Hypokit

Glucose

I.V. infusion 139 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

..

B. Braun Australia Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

 

I.V. infusion 278 mmol (anhydrous) per L, 1 L

Injection

5

..

B. Braun Australia Pty Ltd

 

 

 

 

 

Baxter Healthcare Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

Glyceryl Trinitrate

Tablets 600 micrograms, 100

Buccal/sublingual

1

..

Anginine Stabilised

 

 

 

 

 

Lycinate

Hydrocortisone

Injection 100 mg (as sodium succinate) with 2 mL solvent

Injection

6

..

Solu-Cortef

 

Injection 250 mg (as sodium succinate) with 2 mL solvent

Injection

6

..

Solu-Cortef

 

Cream containing hydrocortisone acetate 10 mg per g, 30 g

Application

1

..

Cortic-DS 1%

 

 

 

 

 

Sigmacort

 

Cream containing hydrocortisone acetate 10 mg per g, 50 g

Application

1

..

Cortef

 

 

 

 

 

Cortic-DS 1%

 

 

 

 

 

Sigmacort

 

Ointment containing hydrocortisone acetate 10 mg per g, 30 g

Application

1

..

Cortic-DS 1%

 

 

 

 

 

Sigmacort

 

Ointment containing hydrocortisone acetate 10 mg per g, 50 g

Application

1

..

Cortic-DS 1%

 

 

 

 

 

Sigmacort

Hydromorphone

Tablet containing hydromorphone hydrochloride 2 mg

Oral

20

..

Dilaudid

 

Tablet containing hydromorphone hydrochloride 4 mg

Oral

20

..

Dilaudid

 

Tablet containing hydromorphone hydrochloride 8 mg

Oral

20

..

Dilaudid

 

Tablet (modified release) containing hydromorphone hydrochloride 4 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 8 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 16 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 32 mg

Oral

10

..

Jurnista

 

Tablet (modified release) containing hydromorphone hydrochloride 64 mg

Oral

10

..

Jurnista

 

Oral liquid containing hydromorphone hydrochloride 1 mg per mL, 473 mL

Oral

1

..

Dilaudid

 

Injection containing hydromorphone hydrochloride 2 mg in 1 mL

Injection

5

..

Dilaudid

 

Injection containing hydromorphone hydrochloride 10 mg in 1 mL

Injection

5

..

Dilaudid-HP

 

Injection containing hydromorphone hydrochloride 50 mg in 5 mL

Injection

5

..

Dilaudid-HP

Ibuprofen

Tablet 400 mg

Oral

30

..

Brufen

Indomethacin

Capsule 25 mg

Oral

100

..

Arthrexin

 

 

 

 

 

Indocid

 

Suppository 100 mg

Rectal

40

..

Indocid

Ketoprofen

Capsule 200 mg (sustained release)

Oral

28

..

Orudis SR 200

 

 

 

 

 

Oruvail SR

 

Suppository 100 mg

Rectal

40

..

Orudis

Lignocaine

Injection containing lignocaine hydrochloride 100 mg in 5 mL

Injection

5

..

Pfizer Australia Pty Ltd

Lincomycin

Injection 600 mg (as hydrochloride) in 2 mL

Injection

5

..

Lincocin

Methylprednisolone

Injection containing methylprednisolone acetate 40 mg in 1 mL

Injection

5

..

Depo-Medrol

 

 

 

 

 

Depo-Nisolone

Metoclopramide

Tablet containing metoclopramide hydrochloride 10 mg

Oral

25

..

Maxolon

 

 

 

 

 

Pramin

 

Injection containing metoclopramide hydrochloride 10 mg in 2 mL

Injection

10

..

Maxolon

Metronidazole

Tablet 200 mg

Oral

21

..

Flagyl

 

 

 

 

 

Metrogyl 200

 

 

 

 

 

Metronide 200

 

Tablet 400 mg

Oral

5

..

Metrogyl 400

 

Oral suspension containing metronidazole benzoate 320 mg per 5 mL, 100 mL

Oral

1

..

Flagyl S

 

I.V. infusion 500 mg in 100 mL

Injection

5

..

Baxter Healthcare Pty Ltd

 

 

 

 

 

DBL Metronidazole Intravenous Infusion

 

 

 

 

 

Metronidazole Sandoz

 

Suppositories 500 mg, 10

Rectal

1

..

Flagyl

Morphine

Tablet containing morphine sulfate 30 mg

Oral

20

..

Anamorph

 

Tablet containing morphine sulfate 5 mg (controlled release)

Oral

20

..

MS Contin

 

Tablet containing morphine sulfate 10 mg (controlled release)

Oral

20

..

Momex SR 10

 

 

 

 

 

MS Contin

 

Tablet containing morphine sulfate 15 mg (controlled release)

Oral

20

..

MS Contin

 

Tablet containing morphine sulfate 30 mg (controlled release)

Oral

20

..

Momex SR 30

 

 

 

 

 

MS Contin

 

Tablet containing morphine sulfate 60 mg (controlled release)

Oral

20

..

Momex SR 60

 

 

 

 

 

MS Contin

 

Tablet containing morphine sulfate 100 mg (controlled release)

Oral

20

..

Momex SR 100

 

 

 

 

 

MS Contin

 

Capsule containing morphine sulfate 10 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 20 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 30 mg (controlled release)

Oral

10

..

MS Mono

 

Capsule containing morphine sulfate 50 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 60 mg (controlled release)

Oral

10

..

MS Mono

 

Capsule containing morphine sulfate 90 mg (controlled release)

Oral

10

..

MS Mono

 

Capsule containing morphine sulfate 100 mg (containing sustained release pellets)

Oral

20

..

Kapanol

 

Capsule containing morphine sulfate 120 mg (controlled release)

Oral

10

..

MS Mono

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 20 mg per sachet

Oral

20

..

MS Contin Suspension 20 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 30 mg per sachet

Oral

20

..

MS Contin Suspension 30 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 60 mg per sachet

Oral

20

..

MS Contin Suspension 60 mg

 

Sachet containing controlled release granules for oral suspension, containing morphine sulfate 100 mg per sachet

Oral

20

..

MS Contin Suspension 100 mg

 

Oral solution containing morphine hydrochloride 2 mg per mL, 200 mL

Oral

1

..

Ordine 2

 

Oral solution containing morphine hydrochloride 5 mg per mL, 200 mL

Oral

1

..

Ordine 5

 

Oral solution containing morphine hydrochloride 10 mg per mL, 200 mL

Oral

1

..

Ordine 10

 

Injection containing morphine sulfate 10 mg in 1 mL

Injection

5

..

Hospira Pty Limited

 

Injection containing morphine sulfate 15 mg in 1 mL

Injection

5

..

Hospira Pty Limited

 

Injection containing morphine sulfate 30 mg in 1 mL

Injection

5

..

Hospira Pty Limited

Naloxone

Injection containing naloxone hydrochloride 2 mg in 5 mL disposable injection set

Injection

1

..

Naloxone Min-I-Jet

Naproxen

Tablet 250 mg

Oral

100

..

Inza 250

 

 

 

 

 

Naprosyn

 

Tablet containing naproxen sodium 550 mg

Oral

50

..

Anaprox 550

 

 

 

 

 

Crysanal

 

Tablet 500 mg

Oral

50

..

Inza 500

 

 

 

 

 

Naprosyn

 

Tablet 750 mg (sustained release)

Oral

28

..

Naprosyn SR750

 

 

 

 

 

Proxen SR 750

 

Tablet 1 g (sustained release)

Oral

28

..

Naprosyn SR1000

 

 

 

 

 

Proxen SR 1000

Nitrazepam

Tablet 5 mg

Oral

25

..

Alodorm

 

 

 

 

 

Mogadon

Nystatin

Tablet 500,000 units

Oral

50

..

Nilstat

 

Capsule 500,000 units

Oral

50

..

Nilstat

 

Oral suspension 100,000 units per mL, 24 mL

Oral

1

..

Mycostatin

 

 

 

 

 

Nilstat

Oxazepam

Tablet 15 mg

Oral

25

..

Alepam 15

 

 

 

 

 

Serepax

 

Tablet 30 mg

Oral

25

..

Alepam 30

 

 

 

 

 

Murelax

 

 

 

 

 

Serepax

Oxycodone

Tablet containing oxycodone hydrochloride 5 mg

Oral

20

..

Endone

 

Capsule containing oxycodone hydrochloride 5 mg

Oral

20

..

OxyNorm

 

Capsule containing oxycodone hydrochloride 10 mg

Oral

20

..

OxyNorm

 

Capsule containing oxycodone hydrochloride 20 mg

Oral

20

..

OxyNorm

 

Oral solution containing oxycodone hydrochloride 5 mg per 5 mL, 250 mL

Oral

1

..

OxyNorm Liquid 5mg/5mL

 

Tablet containing oxycodone hydrochloride 5 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 10 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 15 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 20 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 30 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 40 mg (controlled release)

Oral

20

..

OxyContin

 

Tablet containing oxycodone hydrochloride 80 mg (controlled release)

Oral

20

..

OxyContin

 

Suppository 30 mg (as pectinate)

Rectal

12

..

Proladone

Paracetamol

Tablet 500 mg

Oral

100

..

APO-Paracetamol

 

 

 

 

 

Chem mart Paracetamol

 

 

 

 

 

Febridol

 

 

 

 

 

Generic Health Pty Ltd

 

 

 

 

 

Panamax

 

 

 

 

 

Paracetamol Sandoz

 

 

 

 

 

Paralgin

 

 

 

 

 

Pharmacy Choice Paracetamol

 

 

 

 

 

Terry White Chemists Paracetamol

 

Oral liquid 120 mg per 5 mL, 100 mL

Oral

1

..

Panamax

 

Oral liquid 240 mg per 5 mL, 200 mL

Oral

1

..

Panamax 240 Elixir

Phenoxymethylpenicillin

Tablet 250 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Abbocillin-VK Filmtab

 

Tablet 500 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Abbocillin-VK Filmtab

 

Capsule 250 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Cilicaine VK

 

 

 

 

 

Cilopen VK

 

 

 

 

 

LPV

 

Capsule 500 mg phenoxymethylpenicillin (as potassium)

Oral

50

..

Cilicaine VK

 

 

 

 

 

Cilopen VK

 

 

 

 

 

LPV

 

Oral suspension 150 mg (as benzathine) per 5 mL, 100 mL

Oral

2

..

Abbocillin-V

 

 

 

 

 

Cilicaine V

Piroxicam

Dispersible tablet 10 mg

Oral

50

..

Mobilis D-10

 

Dispersible tablet 20 mg

Oral

25

..

Feldene-D

 

 

 

 

 

Mobilis D-20

 

Capsule 10 mg

Oral

50

..

Chem mart Piroxicam

 

 

 

 

 

Feldene

 

 

 

 

 

GenRx Piroxicam

 

 

 

 

 

Mobilis 10

 

 

 

 

 

Terry White Chemists Piroxicam

 

Capsule 20 mg

Oral

25

..

Chem mart Piroxicam

 

 

 

 

 

Feldene

 

 

 

 

 

GenRx Piroxicam

 

 

 

 

 

Mobilis 20

 

 

 

 

 

Terry White Chemists Piroxicam

Procaine Penicillin

Injection 1.5 g in disposable syringe

Injection

5

..

Cilicaine

Prochlorperazine

Tablet containing prochlorperazine maleate 5 mg

Oral

25

..

Stemetil

 

 

 

 

 

Stemzine

 

Injection containing prochlorperazine mesylate 12.5 mg in 1 mL

Injection

10

..

Stemetil

 

Suppositories containing prochlorperazine equivalent to 25 mg prochlorperazine maleate, 5

Rectal

1

..

Stemetil

Promethazine

Injection containing promethazine hydrochloride 50 mg in 2 mL

Injection

10

..

Hospira Pty Limited

Roxithromycin

Tablet for oral suspension 50 mg

Oral

10

..

Rulide D

 

Tablet 150 mg

Oral

10

..

APO-Roxithromycin

 

 

 

 

 

Biaxsig

 

 

 

 

 

Chem mart Roxithromycin

 

 

 

 

 

Roxar 150

 

 

 

 

 

Roxide

 

 

 

 

 

Roximycin

 

 

 

 

 

Roxithromycin-GA

 

 

 

 

 

Rulide

 

 

 

 

 

Terry White Chemists Roxithromycin

 

Tablet 300 mg

Oral

5

..

APO-Roxithromycin

 

 

 

 

 

Biaxsig

 

 

 

 

 

Chem mart Roxithromycin

 

 

 

 

 

Roxar 300

 

 

 

 

 

Roxide

 

 

 

 

 

Roximycin

 

 

 

 

 

Roxithromycin-GA

 

 

 

 

 

Rulide

 

 

 

 

 

Terry White Chemists Roxithromycin

Sodium Chloride

Injection 9 mg per mL, 10 mL

Injection/solvent for injectables

5

..

Pfizer Australia Pty Ltd

 

I.V. infusion 77 mmol per 500 mL, 500 mL

Injection

5

..

B. Braun Australia Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

 

I.V. infusion 154 mmol per L, 1 L

Injection

5

..

B. Braun Australia Pty Ltd

 

 

 

 

 

Baxter Healthcare Pty Ltd

 

 

 

 

 

Fresenius Kabi Australia Pty Limited

 

I.V. infusion 513 mmol per L, 1 L

Injection

2

..

Baxter Healthcare Pty Ltd

Sodium Chloride with Glucose

I.V. infusion 31 mmol-222 mmol (anhydrous) per L, 1 L

Injection

5

..

Baxter Healthcare Pty Ltd

 

I.V. infusion 19 mmol-104 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

..

Baxter Healthcare Pty Ltd

 

I.V. infusion 39 mmol-69 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

..

Baxter Healthcare Pty Ltd

Sulindac

Tablet 100 mg

Oral

100

..

Aclin

 

Tablet 200 mg

Oral

50

..

Aclin 200

Temazepam

Tablet 10 mg

Oral

25

..

APO-Temazepam

 

 

 

 

 

Normison

 

 

 

 

 

Temaze

 

 

 

 

 

Temtabs

Ticarcillin with Clavulanic Acid

Powder for injection containing ticarcillin 3 g (as sodium) with 100 mg clavulanic acid (as potassium clavulanate) (with any determined brand of sodium chloride injection as the required solvent)

Injection

10

..

Timentin

Tramadol

Capsule containing tramadol hydrochloride 50 mg

Oral

20

..

Chem mart Tramadol

 

 

 

 

 

GA Tramadol 50mg

 

 

 

 

 

GenRx Tramadol

 

 

 

 

 

Lodam 50

 

 

 

 

 

Terry White Chemists Tramadol

 

 

 

 

 

Tramal

 

 

 

 

 

Tramedo

 

 

 

 

 

Zydol

 

Tablet (sustained release) containing tramadol hydrochloride 50 mg

Oral

20

..

Tramal SR 50

 

Tablet (sustained release) containing tramadol hydrochloride 100 mg

Oral

20

..

APO-Tramadol SR

 

 

 

 

 

Chem mart Tramadol SR

 

 

 

 

 

GA Tramadol SR 100mg

 

 

 

 

 

Lodam SR 100

 

 

 

 

 

Terry White Chemists Tramadol SR

 

 

 

 

 

Tramahexal SR

 

 

 

 

 

Tramal SR 100

 

 

 

 

 

Tramedo SR 100

 

 

 

 

 

Zydol SR 100

 

Tablet (extended release) containing tramadol hydrochloride 100 mg

Oral

10

..

Durotram XR

 

Tablet (sustained release) containing tramadol hydrochloride 150 mg

Oral

20

..

APO-Tramadol SR

 

 

 

 

 

Chem mart Tramadol SR

 

 

 

 

 

GA Tramadol SR 150mg

 

 

 

 

 

Lodam SR 150

 

 

 

 

 

Terry White Chemists Tramadol SR

 

 

 

 

 

Tramahexal SR

 

 

 

 

 

Tramal SR 150

 

 

 

 

 

Tramedo SR 150

 

 

 

 

 

Zydol SR 150

 

Tablet (sustained release) containing tramadol hydrochloride 200 mg

Oral

20

..

APO-Tramadol SR

 

 

 

 

 

Chem mart Tramadol SR

 

 

 

 

 

GA Tramadol SR 200mg

 

 

 

 

 

Lodam SR 200

 

 

 

 

 

Terry White Chemists Tramadol SR

 

 

 

 

 

Tramahexal SR

 

 

 

 

 

Tramal SR 200

 

 

 

 

 

Tramedo SR 200

 

 

 

 

 

Zydol SR 200

 

Tablet (extended release) containing tramadol hydrochloride 200 mg

Oral

10

..

Durotram XR

 

Tablet (extended release) containing tramadol hydrochloride 300 mg

Oral

10

..

Durotram XR

 

Oral drops containing tramadol hydrochloride 100 mg per mL, 10 mL

Oral

1

..

Tramal

 

Injection containing tramadol hydrochloride 100 mg in 2 mL

Injection

5

..

Tramahexal

 

 

 

 

 

Tramal 100

Triamcinolone

Injection containing triamcinolone acetonide 10 mg in 1 mL

Injection

5

..

Kenacort-A10

Trimethoprim with Sulfamethoxazole

Tablet 80 mg-400 mg

Oral

10

..

Resprim

 

Tablet 160 mg-800 mg

Oral

10

..

Bactrim DS

 

 

 

 

 

Resprim Forte

 

 

 

 

 

Septrin Forte

 

Paediatric oral suspension 40 mg-200 mg per 5 mL, 100 mL

Oral

1

..

Bactrim

 

 

 

 

 

Septrin

Vancomycin

Powder for injection 500 mg (500,000 I.U.) (as hydrochloride)

Injection

2

..

Hospira Pty Limited

 

 

 

 

 

Vancocin CP

 

 

 

 

 

Vancomycin Sandoz

 

Powder for injection 1 g (1,000,000 I.U.) (as hydrochloride)

Injection

1

..

Hospira Pty Limited

 

 

 

 

 

Vancomycin Sandoz

 

SCHEDULE 3 - PART 2

Listed Drug

Form

(strength, type, size, etc.)

Purposes

Manner of adminis-
tration

Maximum quantity

Maximum number of repeats

Brand

Ibuprofen

Tablet 400 mg

Chronic arthropathies (including osteoarthritis) with an inflammatory component

Bone pain due to malignant disease

Oral

90

..

Brufen

Metronidazole

Tablet 400 mg

Treatment of anaerobic infections

Oral

21

..

Flagyl

Metrogyl 400

Metronide 400

Paracetamol

Tablet 500 mg

Chronic arthropathies

Oral

300

..

APO-Paracetamol

Chem mart Paracetamol

Febridol

Generic Health Pty Ltd

Panamax

Paracetamol Sandoz

Paralgin

Pharmacy Choice Paracetamol

Terry White Chemists Paracetamol

SCHEDULE 4

Form of Medicinal Preparation

Maximum quantity

Maximum number of repeats

Creams

100 g

1

Dusting Powders

100 g

1

Ear Drops

15 mL

2

Eye Drops containing Cocaine Hydrochloride BP

15 mL

..

Eye Drops, Other

15 mL

5

Eye Lotions

200 mL

2

Inhalations

50 mL

1

Linctuses containing Codeine Phosphate BP

100 mL

..

Linctuses, Other

100 mL

2

Lotions

200 mL

2

Mixtures containing Codeine Phosphate BP

200 mL

..

Mixtures, Other

200 mL

4

Mixtures for Children containing Codeine Phosphate BP

100 mL

..

Mixtures for Children, Other

100 mL

4

Mouth Washes

200 mL

1

Nasal Instillations

15 mL

2

Ointments, Waxes

100 g

1

Paints

25 mL

1

Pastes containing Cocaine Hydrochloride BP

25 g

..

Pastes, Other

100 g

1

Powders for Internal Use

100 g

2

Solutions

200 mL

2

Notes to the Determination — Pharmaceutical benefits (PB 15 of 2010)

Note 1

The Determination — Pharmaceutical benefits (PB 15 of 2010) (in force under sections 85, 85A and 88 of the National Health Act 1953) as shown in this compilation is amended as indicated in the Tables below.

Table of Instruments

Title

Date of FRLI Registration

Date of
commencement

Application, saving or
transitional provisions

PB 15 of 2010

18 Mar 2010 (see F2010L00666)

1 Apr 2010

 

PB 30 of 2010

30 Mar 2010 (see F2010L00773)

31 Mar 2010

PB 35 of 2010

15 Apr 2010 (see F2010L00931)

1 May 2010

PB 45 of 2010

26 May 2010 (see F2010L01374)

1 June 2010

PB 55 of 2010

21 June 2010 (see F2010L01637)

1 July 2010

Table of Amendments

ad. = added or inserted      am. = amended      rep. = repealed      rs. = repealed and substituted

Provision affected

How affected

Schedule 1

 

Part 1

 

Part 1....................

am. PB 30, 35, 45 and 55 of 2010

Part 2

 

Part 2....................

am. PB 35, 45 and 55 of 2010

Schedule 2

 

Part 1

 

Part 1....................

am. PB 35 and 55 of 2010

Part 2

 

Part 2....................

am. PB 35 and 55 of 2010

Schedule 3

 

Part 1

 

Part 1....................

am. PB 35, 45 and 55 of 2010

Part 2

 

Part 2....................

am. PB 55 of 2010

 

Interactions

Authorises

All Versions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.