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Hidradenitis suppurativa (HS) Program in Pharmaceutical Benefits Scheme (PBS) 012-18051119

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This document outlines details of PBS-subsidised biological medicines for patients with moderate to severe hidradenitis suppurativa (HS).

For information on how to process a PBS Authority, see Processing Complex Authority Required Listings.

On this page:

Hidradenitis suppurativa (HS) quick reference

Delayed assessment

Hidradenitis suppurativa (HS) quick reference

Table 1

Restrictions

Authority level and section

PA assessment

Processing system

Prescriber type

Prescriber self-serve

Initial

PB218 form

Written

Electronic

S85:

adalimumab

bimekizumab

secukinumab

No

OPA

Must be treated by a:

  • dermatologist

Yes - immediate or delayed assessment (delayed if any free text option used)

Grandfather

PB364 form

Written

Electronic

S85:

bimekizumab

No

OPA

Must be treated by a:

  • dermatologist

Yes - immediate or delayed assessment (delayed if any free text option used)

Change or

  • recommencement after a break (< 5 years), or
  • recommencement after a break (>5 years)

PB218 form

Written

Electronic

S85:

adalimumab

bimekizumab

secukinumab

No

OPA

Must be treated by a:

  • dermatologist

Yes

Balance of Supply - initial

Telephone

Electronic

S85:

adalimumab

bimekizumab

secukinumab

No

OPA

Must be treated by a:

  • dermatologist

Yes

Continuing

originators

PB219 form

Written

Electronic

S85:

adalimumab

bimekizumab

secukinumab

No

OPA

Must be treated by a:

  • dermatologist

Yes

Subsequent continuing

biosimilars

Streamlined

S85:

adalimumab

No

N/A

Must be treated by a:

  • dermatologist

N/A

Delayed assessment

Delayed assessment due to the free text field of prior antibiotics treatment.

Table 2 lists the details of what to check for the delayed assessment.

Service Officers to assess that free text is:

Example

Outcome

Relevant to the question

Name of the most common antibiotics to treat HS:

  • amoxycillin
  • cephalexin
  • clindamycin
  • doxycycline
  • erythromycin
  • minocycline
  • rifampicin

Approve

Random text
  • Patient did not want to take
  • Happy Birthday
  • lkasdjtbn

Reject

Non-descriptive text
  • Toxicity (with no further details)
  • Grade 3 (with no details)

Reject

Escalate to a Pharmaceutical Adviser (PA) by phone if unsure of the antibiotics used.