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Paroxysmal nocturnal haemoglobinuria (PNH) C5 inhibitor - eculizumab and ravulizumab quick reference
Paroxysmal nocturnal haemoglobinuria (PNH) - pegcetacoplan quick reference
Paroxysmal nocturnal haemoglobinuria (PNH) C5 inhibitor - eculizumab and ravulizumab quick reference
Table 1
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
Initial 1
induction
PB327 form |
Written
S100:
eculizumab
ravulizumab |
No |
OPA
|
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Initial 2 - switching from LSDP-funded eculizumab -(induction dose)
PB327 form |
Written
S100:
ravulizumab
|
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Return - from PBS-subsidised eculizumab -(induction doses)
PB327 form |
Written
S100:
ravulizumab
|
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Return - from PBS-subsidised pegcetacoplan (induction doses)
PB327 form |
Written
S100:
ravulizumab |
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Initial switching from PBS -subsidised ravulizumab for pregnancy
PB327 form |
Written
S100:
eculizumab
|
No |
OPA
|
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Initial - switching from PBS-subsidised pegcetacoplan for pregnancy (induction doses)
PB327 form |
Written
S100:
eculizumab |
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Return - from PBS-subsidised pegcetacoplan (induction doses)
PB327 form |
Written
S100:
eculizumab |
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Balance of Supply (BOS) transition from non-PBS during induction
PB327 form |
Written
S100:
eculizumab
|
No |
OPA
|
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Grandfather - transition from non-PBS
PB329 form |
Written
S100:
eculizumab
ravulizumab
|
No |
OPA
|
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Grandfather - transition from LSDP-funded eculizumab
PB329 form |
Written
S100:
eculizumab
|
No |
OPA
|
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
First continuing
or
Subsequent continuing
PB328 form |
Written
S100:
eculizumab
ravulizumab
|
No |
OPA
|
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Paroxysmal nocturnal haemoglobinuria (PNH) - pegcetacoplan quick reference
Table 2
Restrictions |
Authority level and section |
PA assessment |
Processing system |
Prescriber type |
Prescriber self-serve |
Initial
PB343 form |
Written
S100:
pegcetacoplan |
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
Return
PB344 form |
Written
S100:
pegcetacoplan |
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |
First continuing
or
Subsequent continuing
PB344 form |
Written
S100:
pegcetacoplan |
No |
OPA |
Must be treated by a:
-
haematologist
-
non-specialist physician in consultation with a haematologist
|
No |