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

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CRSwNP restriction and item codes

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A linked attachment is available for staff only (i.e. under IPS/FOI)PBS CRSwNP restriction and item codes

Contact details

PBS Complex Drugs Programs

Forms

Chronic rhinosinusitis with nasal polyps - mepolizumab - initial authority application form (PB348)

Services Australia website

Chronic rhinosinusitis with nasal polyps

FAQs from Service Officers

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

Item

Description

1

When the prescriber writes the eosinophils as 0.3, how is this keyed in OPA?

The eosinophil count is keyed in OPA as 300. Prescribers may use different units to those written in the restriction. Other examples:

  • 1.1 is keyed as 1100, and
  • 0.15 is keyed as 150

2

If the prescriber provides three baseline scores (bilateral endoscopic nasal polyp score, nasal obstruction visual analogue (VAS) score and overall symptom VAS score), should all three be keyed in OPA?

Only the scores that meet the PBS requirements, as indicated on the form and the OPA question, should be keyed.

The restriction only requires a minimum of two qualifying scores. If a score is keyed that is not meeting, OPA will reject the application.

3

Is there an age restriction?

Yes. Patients must be 18 years or older to qualify for this program.

4

If the prescriber uses an old application form indicating a duration of therapy of prior optimised nasal polyp therapy (intranasal corticosteroid with or without nasal irrigation) but does not give a specific end date, can this be accepted?

Yes. If the duration of intranasal corticosteroid therapy is at least 2 months (unless contraindicated or not tolerated), the PBS requirement is met.

You may need to calculate and key the end date in OPA by adding the treatment duration to the commencement date. For example, if the commencement date is 1/04/2026 (keyed as the From date in OPA) and the duration is 2.5 months, the end date is approximately 15/06/2026. Key this date as the To date in OPA. Escalate to a PA if not sure.