Use this form to apply for initial PBS-subsidised treatment with avatrombopag, eltrombopag or romiplostim for severe chronic immune (idiopathic) thrombocytopenic purpura (ITP).
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.
Please note: You don’t need to complete this form if you use the Online PBS Authorities system.
Download and complete the Idiopathic thrombocytopenic purpura - initial authority application form.
This information was printed 3 January 2025 from https://www.servicesaustralia.gov.au/pb097. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/site-notices when using this material.