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Chronic rhinosinusitis with nasal polyps (CRSwNP) in Pharmaceutical Benefits Scheme (PBS) 012-23031433

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This document outlines details of PBS-subsidised mepolizumab for patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

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

Chronic rhinosinusitis with nasal polyps (CRSwNP) quick reference

Table 1

Restrictions

Authority level and section

PA assessment

Processing system

Prescriber type

Prescriber self-serve

Initial

or

Recommencement after a break (>12 months)

PB348 form

Written

Electronic

S100:

mepolizumab

No

OPA

Must be treated by one of the following:

  • respiratory physician
  • clinical immunologist
  • allergist
  • ear nose and throat specialist
  • general physician with expertise in managing CRSwNP

Yes - immediate or delayed assessment (delayed if any free text option used)

Continuing

Telephone

Electronic

S100:

mepolizumab

No

OPA

Must be treated by one of the following:

  • respiratory physician
  • clinical immunologist
  • allergist
  • ear nose and throat specialist
  • general physician with expertise in managing CRSwNP

Yes

Delayed assessment

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

Delayed assessment due to nasal polyp surgical exception.

Service Officers to assess that free text is:

Example

Outcome

Relevant to the question
  • Cardiovascular
  • Stroke

Approve

Random text
  • Happy Birthday
  • Patient did not want to take
  • Ikasditbn

Reject

Non-descriptive
  • Serious comorbid disease (no details)
  • Risk of surgery unacceptable (no details)

Reject

Common acronyms

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

Escalate to a Pharmaceutical Adviser (PA) by phone if unsure of the acronym used.