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HIGHLY SPECIALISED DRUGS PROGRAM (Private Hospital)
For Highly Specialised Drugs prescribed through private hospitals, claiming and approval of authority prescriptions is administered by Services Australia. Highly Specialised Drugs prescribed in private hospitals are Authority Required items. Medical practitioners must seek approval to prescribe these items as pharmaceutical benefits prior to their dispensing under the PBS. Approval of authority prescriptions by Services Australia may be obtained either by posting an Authority Prescription Form to Services Australia, or by using the Services Australia Authority free-call service (1800 888 333). Prescribers must quote the provider number of the hospital when applying. Maximum quantities and repeats for Highly Specialised Drugs are listed in the Schedule.
Private hospital prescriptions for Highly Specialised Drugs can be dispensed by an approved private hospital dispensary or by a community pharmacy. A patient will be required to pay a contribution for each supply of a highly specialised drug at the same rate as the Pharmaceutical Benefits Scheme.
The remuneration rates for Highly Specialised Drugs prescribed through private hospitals comprise the normal PBS ready-prepared dispensing fee plus a mark-up ascertained as follows:
- 10% for drugs with a price ex-manufacturer of less than $40;
- $4 for drugs with a price ex-manufacturer of between $40 and $100;
- 4% for drugs with a price ex-manufacturer of between $100.01 and $1000;
- $40 for drugs with a price ex-manufacturer of greater than $1000.
Reciprocal Health Care Agreement – Where a patient is entitled to be treated as an eligible person as a visitor from a country with which Australia has entered into a Reciprocal Health Care Agreement, the supply will be limited to the original prescription only. Repeat prescriptions for these patients are not permitted.
- Legend
- MPMedical Practitioner
- NPNurse Practitioner
Prescriber code | Item code | Name, manner of administration and form & strength | Max qty packs |
Max qty units |
No. of repeats |
---|---|---|---|---|---|
MP | 12242H | SELEXIPAGselexipag 200 microgram tablet, 60 | 1 | 60 | 5 |
MP | 12241G | SELEXIPAGselexipag 200 microgram tablet, 140 | 1 | 140 | 2 |
MP | 12260G | SELEXIPAGselexipag 400 microgram tablet, 60 | 1 | 60 | 5 |
MP | 12248P | SELEXIPAGselexipag 600 microgram tablet, 60 | 1 | 60 | 5 |
MP | 12246M | SELEXIPAGselexipag 800 microgram tablet, 60 | 1 | 60 | 5 |
MP | 12253X | SELEXIPAGselexipag 800 microgram tablet, 60 | 1 | 60 | 3 |
MP | 12245L | SELEXIPAGselexipag 1 mg tablet, 60 | 1 | 60 | 5 |
MP | 12257D | SELEXIPAGselexipag 1.2 mg tablet, 60 | 1 | 60 | 5 |
MP | 12251T | SELEXIPAGselexipag 1.4 mg tablet, 60 | 1 | 60 | 5 |
MP | 12264L | SELEXIPAGselexipag 1.6 mg tablet, 60 | 1 | 60 | 5 |
MP | 13099K | SELINEXORselinexor 20 mg tablet, 16 | 1 | 16 | 2 |
MP | 13103P | SELINEXORselinexor 20 mg tablet, 20 | 1 | 20 | 2 |
MP | 13105R | SELINEXORselinexor 20 mg tablet, 32 | 1 | 32 | 2 |
MP | 11838C | SEVELAMERsevelamer carbonate 800 mg tablet, 180 | 2 | 360 | 5 |
MP | 9620H | SEVELAMERsevelamer hydrochloride 800 mg tablet, 180 | 2 | 360 | 5 |
MP | 12138W | SILDENAFILsildenafil 20 mg tablet, 90 | 1 | 90 | 5 |
MP | 9605M | SILDENAFILsildenafil 20 mg tablet, 90 | 1 | 90 | 5 |
MP | 12930M | SILTUXIMABsiltuximab 100 mg injection, 1 vial | 2 | 2 | 4 |
MP | 12934R | SILTUXIMABsiltuximab 400 mg injection, 1 vial | 2 | 2 | 4 |
MP | 6437T | SIROLIMUSsirolimus 1 mg/mL oral liquid, 60 mL | 2 | 2 | 5 |
MP | 9748C | SIROLIMUSsirolimus 500 microgram tablet, 100 | 2 | 200 | 5 |
MP | 6436R | SIROLIMUSsirolimus 1 mg tablet, 100 | 2 | 200 | 5 |
MP | 6457W | SIROLIMUSsirolimus 2 mg tablet, 100 | 2 | 200 | 5 |
MPNP | 11144M | SOFOSBUVIR + VELPATASVIRsofosbuvir 400 mg + velpatasvir 100 mg tablet, 28 | 1 | 28 | 2 |
MPNP | 11659P | SOFOSBUVIR + VELPATASVIR + VOXILAPREVIRsofosbuvir 400 mg + velpatasvir 100 mg + voxilaprevir 100 mg tablet, 28 | 1 | 28 | 2 |
MP | 10230K | SUCROFERRIC OXYHYDROXIDEsucroferric oxyhydroxide 2.5 g (iron 500 mg) chewable tablet, 90 | 2 | 180 | 5 |