Narcolepsy Program in Pharmaceutical Benefits Scheme (PBS) 012-18051127
Expand allNarcolepsy restriction and item codes
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PBS Narcolepsy restriction and item codes
FAQs from Service Officers
Table 1: see Table 2 in Processing Complex Authority Required Listings for FAQs about all Complex programs.
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Item |
Description |
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1 |
What diagnostic reports are required to be provided with an initial application? For initial patients without cataplexy, a copy of the polysomnography and Multiple Sleep Latency Test (MSLT) or Electroencephalograph (EEG) test reports must be provided with the authority application. The polysomnography and MSLT may be included in the same report. Escalate to a PA if clarification is required. |
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2 |
Is a second Initial application required for the alternative agent? No. Once a patient has been approved for Initial treatment with either agent, they can change to the alternate agent under the “Continuing or Change of treatment” restriction via telephone or by using the online PBS authority system. |
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3 |
If a patient takes a break in treatment, do they need to requalify under the Initial criteria? No. Even if there are extended breaks in treatment, an approval can be processed under the Continuing restriction, as there are no response requirements. |
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4 |
Can an authority request for modafinil be approved for 120 with 5 repeats if the dose is less than 4 per day? Yes. As this is the PBS-listed quantity and number of repeats, it can be approved regardless of dose. Initial treatment will often be titrated up to the optimal dose, so do not reject a request as being too soon without checking the patient history for any changes in dose. |