Pulmonary arterial hypertension - initial dual or triple therapy authority application form (PB303)

Use this form to apply for initial PBS-subsidised dual or triple therapy treatment for pulmonary arterial hypertension (PAH).

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.

You can apply for dual or triple therapy PAH treatment with either:

  • one endothelin receptor antagonist (ERA) and one prostanoid
  • one ERA and one phosphodiesterase-5 inhibitor (PDE-5i)
  • one PDE-5i and one prostanoid
  • one ERA, one PDE-5i and one prostanoid.

Download and complete the pulmonary arterial hypertension - initial dual or triple therapy authority application form.

Page last updated: 18 June 2024.
QC 54016