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.

  • Legend
  • MPMedical Practitioner
Prescriber code Item code Name, manner of administration and form & strength Max qty
packs
Max qty
units
No. of
repeats
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