Severe asthma - adolescent and adult - initial or recommencement after 12 months break authority application form (PB075)

Use this form to apply for initial PBS-subsidised treatment with a biological medicine for patients 12 years or over with uncontrolled severe asthma.

You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology.

You can upload this form in HPOS.

You can also use this form to apply to recommence PBS-subsidised treatment with a biological medicine in a new treatment cycle following a mandatory 12-month break.

'Biological medicine' refers to:

  • benralizumab
  • dupilumab
  • mepolizumab
  • omalizumab.

Download and complete the severe asthma - adolescent and adult - initial or recommencement after 12 months break authority application form.

Page last updated: 1 October 2024.
QC 20906