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Crohn's disease (CD) Program in Pharmaceutical Benefits Scheme (PBS) 012-18051111

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CD restriction and item codes

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Calculator

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Contact details

PBS Complex Drugs Programs

Forms

Crohn's disease adult - initial authority application (PB087)

Crohn’s disease adult - upadacitinib - initial grandfather authority application (PB357)

Crohn's disease adult - change, recommencement or demonstration of response authority application (PB235)

Crohn's disease adult - continuing authority application (PB088)

Crohn's disease paediatric - initial authority application (PB085)

Crohn's disease paediatric - change, recommencement or demonstration of response authority application (PB239)

Crohn’s disease paediatric - continuing authority application (PB161)

Fistulising Crohn's disease - initial, grandfather or recommencement (treatment break greater than 5 years) authority application (PB092)

Fistulising Crohn’s disease - change, recommencement (treatment break less than 5 years) or demonstration of response authority application (PB236)

Fistulising Crohn's disease - continuing authority application (PB093)

Services Australia website

Crohn's disease - adult patient

Crohn's disease - paediatric patient

Crohn's disease - fistulising Crohn’s disease

External website

PBS schedule for Crohn's disease (adult patients)

PBS schedule for Crohn's disease (paediatric patients)

PBS schedule for Fistulising Crohn’s disease

FAQs from Service Officers

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

Item

Description

1

The prescriber did not provide a CDAI at the baseline for an adult CD patient, but the patient is meeting CDAI now. Is this ok?

No, a response can only be assessed against the parameters provided at baseline.

Note: there are 8 possible baseline targets for adult CD indicated on the database:

  • CDAI ≤ 150
  • Normalisation of platelet count
  • ESR ≤ 25mm/hr
  • CRP ≤ 15mg/L
  • Normalisation of lactoferrin or calprotectin level
  • Evidence of mucosal healing on diagnostic imaging
  • Reversal of high faecal output
  • Prevention of surgery/TPN