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Patient eligibility
The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with anifrolumab under the National Health Act 1953, section 100 for patients with SLE.
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 anifrolumab.
Section 100 arrangements
anifrolumab
This item is only PBS-subsidised for non-admitted patients, day admitted patients, or patients on discharge who are attending:
- 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 systemic lupus erythematosus toxicity and severity descriptors with the authority application.
Treatment specifics
To be eligible for PBS-subsidised treatment with anifrolumab, patients must be treated by a specialist physician experienced in the management of SLE.
Authority applications
Applying for initial treatment
Apply for initial authority approval to prescribe PBS-subsidised anifrolumab to treat SLE in writing and either:
- use HPOS Form upload
- mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed systemic lupus erythematosus - anifrolumab - initial authority application form
- relevant attachments.
Applying for grandfather treatment
For patients who received non-PBS-subsidised anifrolumab treatment before 1 July 2024
for SLE, apply for initial grandfather authority approval in writing and either:
- use HPOS Form upload
- mail to PBS Complex Drugs Programs.
All written applications must include:
- details of the proposed prescription or prescriptions
- the completed systemic lupus erythematosus - anifrolumab - initial grandfather authority application form
- relevant attachments.
Applying for continuing or recommencement of treatment
Applications to continue or recommence authority approval to prescribe PBS-subsidised anifrolumab to treat SLE can be made either:
- in real time using the Online PBS Authorities system
- by calling the PBS Complex Drugs Programs enquiry line.
More information
Call the PBS Complex Drugs Programs enquiry line for more information.