Browse by Section 100 Item List
HIGHLY SPECIALISED DRUGS PROGRAM (Private Hospital)
For Highly Specialised Drugs prescribed through private hospitals, claiming and approval of authority prescriptions is administered by Department of Human Services. 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 Department of Human Services may be obtained either by posting an Authority Prescription Form to Department of Human Services, or by using Department of Human Services’ 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. Commonwealth subsidy is not available for hospital in-patients.
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.
- MPMedical Practitioner
|Prescriber code||Item code||Name, manner of administration and form & strength||Max qty
|MP||9621J||ABATACEPTabatacept 250 mg injection, 1 vial||1||1||0|
|MP||9680L||ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL cartridges||1||2||0|
|MP||9679K||ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes||1||2||0|
|MP||9678J||ADALIMUMABadalimumab 20 mg/0.4 mL injection, 2 x 0.4 mL syringes||1||2||0|
|MP||10243D||ALEMTUZUMABalemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial||5||5||0|
|MP||10246G||ALEMTUZUMABalemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial||3||3||0|
|MP||9648T||AMBRISENTANambrisentan 5 mg tablet, 30||1||30||0|
|MP||9649W||AMBRISENTANambrisentan 10 mg tablet, 30||1||30||0|
|MP||10263E||ANAKINRAanakinra 100 mg/0.67 mL injection, 28 x 0.67 mL syringes||1||28||5|
|MP||11083H||APOMORPHINEapomorphine hydrochloride 100 mg/20 mL injection, 5 x 20 mL vials||18||90||5|
|MP||10971K||APOMORPHINEapomorphine hydrochloride 50 mg/10 mL injection, 5 x 10 mL syringes||36||180||5|
|MP||9607P||APOMORPHINEapomorphine hydrochloride 20 mg/2 mL injection, 5 x 2 mL ampoules||72||360||5|
|MP||10235Q||APOMORPHINEapomorphine hydrochloride 10 mg/mL injection, 5 x 1 mL ampoules||72||360||5|
|MP||9640J||APOMORPHINEapomorphine hydrochloride 50 mg/5 mL injection, 5 x 5 mL ampoules||36||180||5|
|MP||6100C||AZACITIDINEazacitidine 100 mg injection, 1 vial||14||14||2|
|MP||6138C||AZACITIDINEazacitidine 100 mg injection, 1 vial||14||14||5|
|MP||6221K||AZITHROMYCINazithromycin 600 mg tablet, 8||2||16||5|