Non-radiographic axial spondyloarthritis (AXSPA) Program in Pharmaceutical Benefits Scheme (PBS) 012-18112216

AXSPA restriction and item codes

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$\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.png$ PBS AXSPA restriction and item codes

Contact details

PBS Complex Drugs Programs

Forms

Non-radiographic axial spondyloarthritis - initial authority application (PB255)

Non-radiographic axial spondyloarthritis - bimekizumab - initial grandfather authority application (PB353)

Services Australia website

Non-radiographic axial spondyloarthritis

External websites

PBS schedule for non-radiographic axial spondyloarthritis

FAQs from Service Officers

Table 1: see Table 2 in Processing Complex Authority Required Listings for FAQs about all Complex programs.

Item	Description
1	What are the acceptable reasons for not meeting the criteria if a patients C-reactive protein (CRP) is not elevated on initial application? Acceptable reasons are: Treatment with prednisolone dosed at 7.5 mg or higher daily (or equivalent) Steroid injection within the past month (intramuscular or intravenous methylprednisolone or equivalent) Refer to a Pharmaceutical Advisor (PA) for any other reason.
2	For medications with a loading dose, is the prescriber required to use a loading dose? No. The prescriber is not required to use a loading dose. If a loading dose is requested, it must be approved under the loading dose item code to make sure the correct Q+As are requested with reduced quantity and increased repeats. Refer to code sheet for further details.
3	Can a prescriber use a continuing Ankylosing Spondylitis form to apply for continuing treatment? No. Not all clinical criteria is addressed on the Ankylosing Spondylitis form. Continuing treatment must be requested: using the online PBS authority system, or by phone
4	What tests are required for continuing treatment? A Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is needed for all patients however CRP is only required if it was elevated at baseline.
5	Is there a maximum of drug failures for a patient? Yes. There is a maximum of four failures on PBS subsidy before a break from the program of five years is required.
6	Can a patient return to a drug they have failed? No. As the patient failed a drug they cannot return, however an adverse reaction is not considered a failure.