PBS Forms

Page last updated: 25 March 2020

Accessibility

The documents on this page may not be accessible. If you need assistance please email the PBS Web team.

Please note, from 1 July 2019 new processes and supporting cost recovery arrangements apply. Please refer to the PBS Process Improvements and Cost Recovery web pages for more information.

This page contains forms that may be required by the Department of Health to list a medicine on the Pharmaceutical Benefits Scheme. Forms relating to processing claims, paying benefits, or PBS stationery order forms can be found on the Services Australia website.

  

Application Form for Pre-submission Services (Pre-submission Meeting Request Form)

This application is to be completed and submitted to the Pre-submission Meetings team. For more information, please refer to the Procedure Guidance and Cost Recovery Administrative Guidelines.

Other forms for pre-submission meetings:

  

Application Form for Submission Services

You can now submit your Intent to Apply for Major and Minor Submissions, and your Minor and Major submissions online via the Health Products Portal (HPP). More information on the HPP including registering, sign in, FAQs, Reference Guides and Terms and Conditions can be found on the Health Products Portal pages.

Part A (Intent to Apply) and Part B (Application to accompany PBAC Submission) of this application form are to be completed and submitted to the Pharmaceutical Benefits Advisory Committee (PBAC) secretariat.

Part C (Application for New Brand of existing pharmaceutical item) of this application form is to be completed and submitted to the Information Management Team. For more information, please refer to the Procedure Guidance and Cost Recovery Administrative Guidelines.

  

Application Form for Pricing Services

Part A (Notice of Intent for Pricing) and Part B (Pricing Application) of this application form are to be completed and submitted to PBS Pricing. For more information, please refer to the Procedure Guidance and Cost Recovery Administrative Guidelines.

  

Application for List Management Services

This application is to be completed and submitted to the department for the following list management services that involve either a price increase or Ministerial Discretion:

  • Ministerial Discretion not to apply a Statutory Price Reduction request
  • Price increase requests
  • Brand Premium requests
  • New item recognised as a new preparation request.

For more information, please refer to the Procedure Guidance and Cost Recovery Administrative Guidelines.

  

Application to list a Drug or Medicinal Preparation as a Pharmaceutical Benefit (PB11)

This application is to be completed and submitted to the Pharmaceutical Benefits Advisory Committee (PBAC) secretariat. For more information, please refer to the PBAC guidelines.

 

Request for Approved Ex-Manufacturer Price (PB11a)

The PB11a is a form that sponsors need to submit to reflect the listing price sought for their product on the Pharmaceutical Benefits Scheme (PBS) or when requesting a price or related alteration for a product already listed on the PBS.

The PB11a form has been updated to reflect the new legislation changes commencing 1 October 2012. All price agreements, new listings, changes to pack sizes and brand premiums must use the new PB11a form for all price agreements from 1 October 2012.

For any questions relating to completion of the PB11a form, please email the Pricing Section, Pharmaceutical Evaluation Branch.

A new PB11a form is required for the purpose of a new price agreement where the Responsible Person changes their details including:

  • the registered company name and ABN
  • Brand names for which they are the Responsible Person
  • Responsible Person

 

Cost Information (PB11b)

Page last updated: 21 January 2020

Submit the PB11b form to the PBAC Secretariat at the time of making a PBAC submission, or to apply for a price increase for a product already listed on the PBS, submit to the Pricing Section.

 

Guarantee of Supply

This form is to be used when a Responsible Person  wishes to advise a failure to supply a brand of an item listed on the PBS, or a belief that a failure to supply is likely to occur.

Please email the completed form to PBS Listings.

 

Responsible Person

This form confirms with the Department of Health those brands of items on the PBS a particular Responsible Person will be supplying.

Please email the completed Responsible Person form to PBS Listings.

  

Australian Medicines Terminology (AMT) descriptions for PBS Listings

Submissions to the PBAC should include the following form, if the submission includes a new medicine that is not currently listed in the Australian Medicines Terminology (AMT).