Hidradenitis suppurativa (HS) Program in Pharmaceutical Benefits Scheme (PBS) 012-18051119

HS 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 HS restriction and item codes

Contact details

PBS Complex Drugs Programs

Forms

Moderate to severe hidradenitis suppurativa - initial, change or recommencement authority application (PB218)

Moderate to severe hidradenitis suppurativa - continuing authority application (PB219)

Services Australia website

Hidradenitis Suppurativa

External websites

PBS schedule for Hidradenitis suppurativa

FAQs from Service Officers

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

Item	Description
1	How many failures are allowed in one treatment cycle for PBS-subsidised treatment of hidradenitis suppurativa (HS)? Three. There are only two biological medicines PBS listed to treat HS. Patients can fail one biological medicine twice within the same treatment cycle.
2	How many prescriptions or details of the proposed prescriptions are required for the initial/change/recommencement of treatment with adalimumab? Two. They are for: loading - written for a quantity of 6 (of 40 mg) or 3 (of 80 mg) and no repeats, with 160 mg administered at week 0, 80 mg at week 2 and 40 mg weekly starting at week 4 balance of 16 weeks of treatment - with a quantity of 4 (of 40 mg) or 2 (of 80 mg) and 2 repeats
3	How many prescriptions or details of the proposed prescriptions are required for the initial/change/recommencement of treatment with secukinumab? When there is: an induction regimen intended - 2 prescriptions, or details of the proposed prescriptions are needed. A prescription for the: induction - for a quantity of 8 doses of 150 mg and no repeats maintenance - 2 (or 4) doses of 150 mg and 3 repeats no loading dose requested - 1 prescription or details of the proposed prescription for a quantity of 2 (or 4) doses of 150 mg and 3 repeats. Note: see HS code sheet for the correct item code(s), quantity and repeats to be entered in the OPA system.
4	Can increased quantity and/or repeats be authorised for secukinumab? The quantity of secukinumab can be increased from 2 to 4 for all treatment phases (excluding the induction) if the patient is dosed at 300 mg per fortnight. No increase in the maximum number of listed repeats can be authorised. Note: see HS code sheet for details.
5	Can the dynamic Q+A in relation to timeframe be answered in OPA when the wording is different on the PBS application form? Yes. Providing the box has been ticked on the application form, any question in relation to timeframe can be answered correctly in OPA.