Acute lymphoblastic leukaemia (ALL) Program in Pharmaceutical Benefits Scheme (PBS) 012-18051101
This document outlines details of PBS-subsidised blinatumomab, dasatinib, imatinib, inotuzumab and ponatinib for patients with acute lymphoblastic leukaemia (ALL).
For information on how to process a PBS Authority, see Processing Complex Authority Required Listings.
On this page:
Blinatumomab, dasatinib, imatinib, inotuzumab and ponatinib applications
Inotuzumab ozogamicin quick reference
Blinatumomab, dasatinib, imatinib, inotuzumab and ponatinib applications
Table 1
Blinatumomab quick reference
Table 2
Restrictions | Authority level and section | PA assessment | Processing system | Prescriber type | Prescriber self-serve |
Initial (Induction) PB210 form | Written Electronic S100: blinatumomab | No | OPA | N/A | Yes - delayed assessment due to DPMQ (cost) |
Continuing (Consolidation) | Telephone Electronic S100: blinatumomab | No | OPA | N/A | Yes |
Induction - Balance of Supply | Telephone Electronic S100: blinatumomab | No | OPA | N/A | Yes |
Dasatinib quick reference
Table 3
Restrictions | Authority level and section | PA assessment | Processing system | Prescriber type | Prescriber self-serve |
Initial (induction/consolidation) - first line PB271 form | Written Electronic S85: dasatinib | Yes | OPA | Must be treated by a:
| Yes - delayed assessment due to pathology report attachment |
Continuing (maintenance of first complete remission) - first line | Telephone Electronic S85: dasatinib | No | OPA | Must be treated by a:
| Yes |
Initial - second line PB077 form | Written Electronic S85: dasatinib | Yes | OPA | Must be treated by a:
| Yes - delayed assessment due to pathology report attachment |
Continuing - second line | Telephone Electronic S85: dasatinib | No | OPA | Must be treated by a:
| Yes |
Change - whilst in first line initial phase (due to toxicity) PB271 form | Written Electronic S85: dasatinib | Yes | OPA | Must be treated by a:
| Yes - delayed assessment due to pathology report attachment |
Change - whilst in first line continuing phase (due to toxicity) | Telephone Electronic S85: dasatinib | No | OPA | Must be treated by a:
| Yes |
Imatinib quick reference
Table 4
Inotuzumab ozogamicin quick reference
Table 5
Restrictions | Authority level and section | PA assessment | Processing system | Prescriber type | Prescriber self-serve |
Initial (induction) PB269 form | Written Electronic S100 EFC: inotuzumab | Yes | OPA | N/A | Yes - delayed assessment due to pathology report attachment and DPMQ (cost) |
Continuing (consolidation) | Telephone Electronic S100 EFC: inotuzumab | No | OPA | N/A | Yes |
Ponatinib quick reference
Table 6:
Restrictions | Authority level and section | PA assessment | Processing system | Prescriber type | Prescriber self-serve |
Initial PB169 form | Written Electronic S85: ponatinib | Yes | OPA | Must be treated by a:
| Yes - delayed assessment due to pathology report attachment |
Continuing | Telephone Electronic S85: ponatinib | No | OPA | Must be treated by a:
| Yes |
Delayed assessment
Delayed assessment due to pathology report attachment.
Table 7: this table lists the details of what Service Officers should check for delayed assessment.