Crohn's disease (CD) Program in Pharmaceutical Benefits Scheme (PBS) 012-18051111
Expand allThis document outlines details of PBS-subsidised biological medicines for patients with CD and fistulising Crohn's disease (FCD).
For information on how to process a PBS Authority, see Processing Complex Authority Required Listings.
On this page:
Applications completed on the database
Current treatment for subsequent continuing applications
CD adult quick reference
Table 1
|
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
|
Initial PB087 form |
Written S85: adalimumab infliximab s.c. upadacitinib ustekinumab vedolizumab s.c. S100: infliximab i.v. ustekinumab i.v. vedolizumab i.v. |
Yes |
OPA Database |
Must be treated by a:
|
No |
|
Extended induction (additional dose at week 10) |
Telephone Electronic S100: vedolizumab i.v. |
No |
OPA |
Must be treated by a:
|
Yes |
|
Extended induction (optional) Weeks 12 to 24 |
Telephone Electronic S85: upadacitinib |
No |
OPA |
Must be treated by a:
|
Yes |
|
Change or recommencement after a break (<5 years) or recommencement after a break (>5 years) PB235 form |
Written S85: adalimumab infliximab s.c. upadacitinib ustekinumab vedolizumab s.c. S100: infliximab i.v. ustekinumab i.v. vedolizumab i.v. |
Yes |
OPA Database |
Must be treated by a:
|
No |
|
First continuing PB088 form |
Written S85: adalimumab infliximab s.c. upadacitinib ustekinumab vedolizumab s.c. S100: infliximab i.v. vedolizumab i.v. |
No |
OPA Database |
Must be treated by a:
|
No |
|
Subsequent continuing: originator brands PB088 form |
Written S85: adalimumab infliximab s.c. upadacitinib ustekinumab vedolizumab s.c. S100: infliximab i.v. vedolizumab i.v. |
No |
OPA Database |
Must be treated by a:
|
No |
|
Subsequent continuing: biosimilar brands |
Streamlined S85: adalimumab S100: infliximab i.v. (Telephone for increased quantities of infliximab i.v. for patients>100kg) |
No |
N/A |
Must be treated by a:
|
N/A |
|
Balance of supply (top-up) |
Telephone Electronic S85: adalimumab infliximab s.c. upadacitinib ustekinumab vedolizumab s.c. S100: infliximab i.v. vedolizumab i.v. |
No |
OPA |
Must be treated by a:
|
Yes |
|
Demonstration of response PB235 form |
Written S85: adalimumab infliximab s.c. upadacitinib ustekinumab vedolizumab s.c. S100: infliximab i.v. ustekinumab i.v. vedolizumab i.v. |
No |
Database |
Must be treated by a:
|
No |
|
Medical break |
Written S85: adalimumab infliximab s.c. upadacitinib ustekinumab vedolizumab s.c. S100: infliximab i.v. ustekinumab i.v. vedolizumab i.v. |
Yes |
Database |
Must be treated by a:
|
No |
FCD quick reference
Table 2
|
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
|
Initial or recommencement after a break (>5 years) PB092 form |
Written S85: adalimumab infliximab s.c. ustekinumab s.c. S100: infliximab i.v. ustekinumab i.v. |
Yes |
OPA Database |
Must be treated by a:
|
No |
|
Change or recommencement after a break (<5 years) PB236 form |
Written S85: adalimumab infliximab s.c. ustekinumab s.c. S100: infliximab i.v. ustekinumab i.v. |
Yes |
OPA Database |
Must be treated by a:
|
No |
|
First continuing PB093 form |
Written S85: adalimumab infliximab s.c. ustekinumab s.c. S100: infliximab i.v. |
No |
OPA Database |
Must be treated by a:
|
No |
|
Subsequent continuing: originator brands PB093 form |
Written S85: adalimumab infliximab s.c. ustekinumab s.c. S100: infliximab i.v. |
No |
OPA Database |
Must be treated by a:
|
No |
|
Subsequent continuing: biosimilar brands |
Streamlined S85: adalimumab S100: infliximab i.v. (Telephone for increased quantities of infliximab i.v. for patients>100kg) |
No |
N/A |
Must be treated by a:
|
N/A |
|
Balance of supply (top-up) |
Telephone Electronic S85: adalimumab Infliximab s.c. ustekinumab s.c. S100: infliximab i.v. ustekinumab i.v. |
No |
OPA |
Must be treated by a:
|
Yes |
|
Demonstration of response PB236 form |
Written S85: adalimumab infliximab s.c. ustekinumab s.c. S100: infliximab i.v. ustekinumab i.v. |
No |
Database |
Must be treated by a:
|
No |
|
Medical break |
Written S85: adalimumab infliximab s.c. ustekinumab s.c. S100: infliximab i.v. ustekinumab i.v. |
Yes |
Database |
Must be treated by a:
|
No |
CD paediatric quick reference
Table 3
|
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
|
Initial PB085 form |
Written S85: adalimumab S100: infliximab i.v. |
Yes |
OPA Database |
Must be treated by a:
|
No |
|
Change or recommencement after a break (< 5 years) or recommencement after a break (>5 years) PB239 form |
Written S85: adalimumab S100: infliximab i.v. |
Yes |
OPA Database |
Must be treated by a:
|
No |
|
First continuing PB161 form |
Written S85: adalimumab S100: infliximab i.v. |
No |
OPA Database |
Must be treated by a:
|
No |
|
Subsequent continuing: originator brands PB161 form |
Written S85: adalimumab S100: infliximab i.v. |
No |
OPA Database |
Must be treated by a:
|
No |
|
Subsequent continuing: biosimilar brands |
Streamlined S85: adalimumab S100: infliximab i.v. (Telephone for increased quantities of infliximab i.v. for patients >100kg) |
No |
N/A |
Must be treated by a:
|
N/A |
|
Balance of supply (top-up) |
Telephone Electronic S85: adalimumab S100: infliximab i.v. |
No |
OPA |
Must be treated by a:
|
Yes |
|
Demonstration of response PB239 form |
Written S85: adalimumab S100: infliximab i.v. |
No |
Database |
Must be treated by a:
|
No |
|
Medical break |
Written S85: adalimumab S100: infliximab i.v. |
Yes |
Database |
Must be treated by a:
|
No |
Applications completed on the database
Table 4
First continuing applications
Table 5
Current treatment for subsequent continuing applications
Table 6
|
Step |
Action |
|
1 |
Check previous assessment date + Read more ... Is the previous next assessment date within 3 months of date of processing?
|
|
2 |
Check if application is subsequent continuing + Read more ... Is the application a subsequent continuing for a drug with a biosimilar brand listing?
|
|
3 |
Check prescriber current treatment + Read more ... Is the current treatment no more than 3 months old from the date of the application form?
|
|
4 |
Check dispensing history + Read more ... Is there a dispensing in the last 3 months?
|
|
5 |
Check letter or note from the prescriber + Read more ... Is there a letter or note from the prescriber about a break in treatment?
|