AXSPA restriction and item codes
Do not share this attachment externally. See Freedom of Information - Information Publication Scheme.
PBS AXSPA restriction and item codes
Contact details
PBS Complex Drugs Programs
Forms
Non-radiographic axial spondyloarthritis - initial authority application (PB255)
Services Australia website
Non-radiographic axial spondyloarthritis
External website
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. Loading is optional. Patients may commence on maintenance doses. If a loading dose is not requested, the authority request must still be approved under the loading dose item code with an adjusted quantity and number of repeats to align with the intended treatment period. Refer to code sheet for further details. |
3 | How many prescriptions are required for an initial/change/recommencement application for certolizumab? When there is: - a loading regimen intended - two prescriptions are needed:
- One for the loading, written for a quantity of 6 (of 200mg) and no repeats
- The second one for the balance with 2 doses of 200mg and 2 repeats
- no loading dose requested - one prescription for a quantity of 2 doses of 200mg and up to 4 repeats. However, item codes for loading (12063X for syringe or 12027B for pen) must be used
|
4 | How many prescriptions are required for an initial/change/recommencement application for secukinumab? When there is: - a loading regimen intended - two prescriptions are needed:
- One loading script written for a quantity of 5 (of 150mg) and no repeats
- The second one for the balance with 1 (of 150mg) and 2 repeats
- no loading dose requested - one prescription for a quantity of 1 (of 150mg) and up to 4 repeats using item code for loading 12321L
|
5 | 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
|
6 | 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. |
7 | 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. |
8 | 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. |
Expand all