Eye (CNV DMO PDR RVO) Programs in Pharmaceutical Benefits Scheme (PBS) 012-18032900
This document outlines details of PBS-subsidised aflibercept, brolucizumab, dexamethasone intravitreal implant, faricimab and ranibizumab for patients with eye conditions.
For information on how to process a PBS Authority, see Processing Complex Authority Required Listings.
On this page:
Subfoveal choroidal neovascularisation (CNV) quick reference
Diabetic macular oedema (DMO) quick reference
Proliferative diabetic retinopathy (PDR) and/or DMO quick reference
Retinal vein occlusion (RVO) quick reference
Eye program assessing table for CNV
Subfoveal choroidal neovascularisation (CNV) quick reference
Table 1
|
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
|
Initial
PB072 form
|
Written
Electronic
S85:
aflibercept
brolucizumab
faricimab
ranibizumab
|
No |
OPA |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
Yes |
|
Continuing
|
Streamlined
S85:
aflibercept
faricimab
ranibizumab
|
No |
N/A |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
N/A |
|
Continuing
|
Telephone
Electronic
S85:
brolucizumab
|
No |
OPA |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
Yes |
Diabetic macular oedema (DMO) quick reference
Table 2
|
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
|
Initial |
Telephone
Electronic
S85:
aflibercept
dexamethasone intravitreal implant
faricimab |
No |
OPA |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
Yes |
|
Continuing
|
Streamlined
S85:
aflibercept
dexamethasone intravitreal implant
faricimab |
No |
N/A |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
N/A |
Proliferative diabetic retinopathy (PDR) and/or DMO quick reference
Table 3
|
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
|
Initial |
Telephone
Electronic
S85:
ranibizumab |
No |
OPA |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
Yes |
|
Continuing
|
Streamlined
S85:
ranibizumab |
No |
N/A |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
N/A |
Retinal vein occlusion (RVO) quick reference
Table 4
|
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
|
Initial
PB154 form
|
Written
Electronic
S85:
aflibercept
dexamethasone intravitreal implant
faricimab
ranibizumab
|
No |
OPA |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
Yes |
|
Continuing
|
Streamlined
S85:
aflibercept
dexamethasone intravitreal implant
faricimab
ranibizumab
|
No |
N/A |
Must be treated by an:
- ophthalmologist
- accredited ophthalmology registrar in consultation with an ophthalmologist
|
N/A |
Eye program assessing table for CNV
Table 5
|
Drug |
Condition |
Clinical criteria |
Result |
|
Lucentis (Ranibizumab) |
CNV |
Not stated
|
Reject
|
|
Lucentis (Ranibizumab) |
CNV |
Due to age-related macular degeneration (AMD), pathologic myopia (PM) or causes other than AMD/PM
|
Approve |
|
Lucentis (Ranibizumab) |
Not stated |
Due to AMD, PM or causes other than AMD/PM
|
Reject |
|
All |
Multiple indications and/or criteria specified |
Multiple listed
|
Reject |
|
Eylea (Aflibercept) |
CNV |
Not stated
|
Reject |
|
Eylea (Aflibercept) |
Not stated |
Due to AMD
|
Reject |
|
Eylea (Aflibercept) |
CNV |
Due to AMD or PM
|
Approve |
|
Eylea (Aflibercept 8 mg/0.07 mL) |
CNV |
Not stated
|
Reject |
|
Eylea (Aflibercept 8 mg/0.07 mL) |
Not stated |
Due to AMD
|
Reject |
|
Eylea (Aflibercept 8 mg/0.07 mL) |
CNV |
Due to AMD
|
Approve |
|
Beovu (Brolucizumab) |
CNV |
Due to AMD
|
Approve |
|
Beovu (Brolucizumab) |
CNV |
Not stated
|
Reject |
|
Beovu (Brolucizumab) |
Not stated |
Due to AMD
|
Reject |
|
Vabysmo (Faricimab) |
CNV |
Due to AMD
|
Approve |
|
Vabysmo (Faricimab) |
CNV |
Not stated
|
Reject |
|
Vabysmo (Faricimab) |
Not stated |
Due to AMD
|
Reject |
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