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Narcolepsy Program in Pharmaceutical Benefits Scheme (PBS) 012-18051127



This document outlines details of PBS-subsidised armodafinil and modafinil for patients with narcolepsy.

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

On this page:

Narcolepsy quick reference

Delayed assessment

Narcolepsy quick reference

Table 1

Restrictions

Authority level and section

PA assessment

Processing system

Prescriber type

Prescriber self-serve

Initial 1

(narcolepsy without cataplexy)

PB104 form

Written

Electronic

S85:

armodafinil
modafinil

No

OPA

Must be treated by a:

  • neurologist
  • qualified sleep medicine practitioner

Yes - delayed assessment

Initial 2

(narcolepsy with cataplexy)

Telephone

Electronic

S85:

armodafinil
modafinil

No

OPA

Must be treated by a:

  • neurologist
  • qualified sleep medicine practitioner

Yes

Continuing

or

Change

Telephone

Electronic

S85:

armodafinil
modafinil

No

OPA

  • medical practitioner

Yes

Delayed assessment

Table 2: this table lists the details of what to check for the delayed assessment and common acronyms.

Delayed assessment checks

Examples

Outcome

Service Officers to assess uploaded documents:

  • Both MSLT and polysomnography attached, or
  • EEG report

Approve

  • Only MSLT or polysomnography attached (not both)

Reject

  • Unrelated documents attached

Reject

If applicable assess free text

Relevant to the question

  • Heart condition
  • Worsened renal failure
  • Nausea and vomiting
  • Elevated or deranged etc. liver function test
  • Gastrointestinal toxicity

Approve

Random text

  • Happy Birthday
  • Patient did not want to take
  • lkasditbn

Reject

Non-descriptive

  • Grade 3 (no detail of toxicity)
  • Toxicity

Reject

Common acronyms

  • LFT - Liver function tests
  • GI toxicity - Gastrointestinal
  • N+V - Nausea and vomiting

Escalate to a Pharmaceutical Advisor by phone if unsure of the acronym used.