Arthritis - psoriatic arthritis

The PBS subsidises biological medicines for adult patients with severe psoriatic arthritis.

Patient eligibility

The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological medicines under the National Health Act 1953, section 85 and section 100 for adult patients with severe psoriatic arthritis.

Where the term biological medicine appears, it refers to:

  • adalimumab
  • bimekizumab
  • certolizumab pegol
  • etanercept
  • golimumab
  • guselkumab
  • infliximab
  • ixekizumab
  • secukinumab
  • tofacitinib
  • upadacitinib
  • ustekinumab.

Patients must be eligible for the PBS and meet the relevant restriction criteria.

The Schedule of Pharmaceutical Benefits on the PBS website outlines the restrictions for prescribing biological medicines.

Section 100 arrangements

Infliximab i.v.

This item is only PBS-subsidised for non-admitted patients, day admitted patients or patients on discharge who are attending either:

  • an approved private hospital
  • a public hospital.

This item isn’t PBS-subsidised for public hospital in-patients. You must include the hospital name and provider number on the authority application form.

Toxicity and severity descriptors

When demonstrating a patient’s intolerance to prior treatment, use the psoriatic arthritis toxicity and severity descriptors with the authority application.

Treatment specifics

To be eligible for PBS-subsidised treatment with biological medicines, patients must be treated by either a:

  • rheumatologist
  • clinical immunologist with expertise in the management of psoriatic arthritis.

Authority applications

Applying for initial treatment

Apply for initial authority approval to prescribe PBS-subsidised biological medicines to treat severe psoriatic arthritis in writing and either:

All written applications must include:

Applying for initial grandfather treatment

For patients who received non-PBS-subsidised bimekizumab treatment before 1 October 2024 for severe psoriatic arthritis, apply for initial grandfather authority approval in writing and either:

All written applications must include:

Applying for change or recommencement of treatment

Apply to change or recommence authority approval to prescribe PBS-subsidised biological medicines to treat severe psoriatic arthritis in writing and either:

All written applications must include:

You can also use this authority application form to submit a demonstration of response to the current PBS-subsidised treatment.

Applying for continuing treatment

Apply for continuing authority approval to prescribe PBS-subsidised biological medicines to treat severe psoriatic arthritis in writing and either:

All written applications must include:

After we approve the first application for continuing treatment, subsequent continuing treatments with PBS-subsidised biosimilar brands of biological medicines are Authority Required (Streamlined). You don’t need authority approval from us for the listed quantity and repeats.

More information

Call the PBS Complex Drugs Programs enquiry line for more information.

Page last updated: 1 October 2024.
QC 31901