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Juvenile arthropathies (JIA and sJIA) Program in Pharmaceutical Benefits Scheme (PBS) 012-18051123

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This document outlines details of PBS-subsidised biologic medicines for patients with juvenile arthropathies (JIA and sJIA).

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

On this page:

Juvenile idiopathic arthritis (JIA) <18 years quick reference

Juvenile idiopathic arthritis (JIA) >18 years quick reference

Systemic juvenile idiopathic arthritis (sJIA) quick reference

Juvenile idiopathic arthritis (JIA) <18 years quick reference

Table 1

Restrictions

Authority level and section

PA assessment

Processing system

Prescriber type

Prescriber self-serve

Initial

Telephone

Electronic

S85:

tocilizumab s.c.

tofacitinib

S100:

adalimumab

etanercept

tocilizumab i.v.

No

OPA

Must be treated by a:

  • paediatric rheumatologist, or under the supervision of paediatric rheumatology treatment centre

Yes

Grandfather

Telephone

Electronic

S85:

tofacitinib

No

OPA

Must be treated by a:

  • paediatric rheumatologist, or under the supervision of paediatric rheumatology treatment centre

Yes

Continuing

Streamlined

S85:

tocilizumab s.c.

tofacitinib

S100:

adalimumab

etanercept

tocilizumab i.v.

(Telephone for increased quantities of tocilizumab i.v. if required – check dosage calculator)

No

N/A

Must be treated by a:

  • rheumatologist, or under the supervision of paediatric rheumatology treatment centre

 

N/A

Change

or

recommencement

Telephone

Electronic

S85:

tocilizumab s.c.

tofacitinib

S100:

adalimumab

etanercept

tocilizumab i.v.

No

OPA

Must be treated by a:

  • paediatric rheumatologist, or under the supervision of paediatric rheumatology treatment centre

 

Yes

Balance of supply:

for initial only

Telephone

Electronic

S85:

tocilizumab s.c.

tofacitinib

S100:

adalimumab

etanercept

tocilizumab i.v.

No

OPA

Must be treated by a:

  • paediatric rheumatologist, or under the supervision of paediatric rheumatology treatment centre

 

Yes

Juvenile idiopathic arthritis (JIA) >18 years quick reference

Table 2

Restrictions

Authority level and section

PA assessment

Processing system

Prescriber type

Prescriber self-serve

Initial

PB062 form

Written

S85:

adalimumab

etanercept

tocilizumab s.c.

S100:

tocilizumab i.v.

Yes

OPA

Database

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

No

First Continuing

PB063 form

Written

S85:

adalimumab

etanercept

tocilizumab s.c.

S100:

tocilizumab i.v.

No

OPA

Database

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

No

Subsequent continuing

PB063 form

Written

S85:

adalimumab

etanercept

tocilizumab s.c.

S100:

tocilizumab i.v.

No

OPA

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

No

Subsequent continuing:

biosimilar

Streamlined

S85:

adalimumab

No

N/A

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

N/A

Change

or

recommencement

PB282 form

Written

S85:

adalimumab

etanercept

tocilizumab s.c.

S100:

tocilizumab i.v.

Yes

OPA

Database

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

No

Balance of supply

Telephone

Electronic

S85:

adalimumab

etanercept

tocilizumab s.c.

S100:

tocilizumab i.v.

No

OPA

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

Yes

Demonstration of response

PB282 form

Written

S85:

adalimumab

etanercept

tocilizumab s.c.

S100:

tocilizumab i.v.

No

OPA

Database

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

No

Medical break

PB282 form

Written

S85:

adalimumab

etanercept

tocilizumab s.c.

S100:

tocilizumab i.v.

Yes

OPA

Database

Must be treated by a:

  • rheumatologist
  • clinical immunologist with expertise in the management of rheumatoid arthritis

No

Systemic juvenile idiopathic arthritis (sJIA) quick reference

Table 3

Restrictions

Authority level and section

PA assessment

Processing system

Prescriber type

Prescriber self-serve

Initial

Telephone

Electronic

S85:

tocilizumab s.c.

S100:

tocilizumab i.v.

No

OPA

Must be treated by a:

  • rheumatologist, or under the supervision of paediatric rheumatology treatment centre

 

Yes

Continuing

Streamlined

S85:

tocilizumab s.c.

S100:

tocilizumab i.v.

(Telephone for increased quantities of tocilizumab i.v. if required – check dosage calculator)

No

N/A

Must be treated by a:

  • rheumatologist, or under the supervision of paediatric rheumatology treatment centre

 

N/A

Recommencement

Telephone

Electronic

S85:

tocilizumab s.c.

S100:

tocilizumab i.v.

No

OPA

Must be treated by a:

  • rheumatologist, or under the supervision of paediatric rheumatology treatment centre

 

Yes

Balance of supply:

for initial only

Telephone

Electronic

S85:

tocilizumab s.c.

S100:

tocilizumab i.v.

No

OPA

Must be treated by a:

  • rheumatologist, or under the supervision of paediatric rheumatology treatment centre

Yes