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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. 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
- NPNurse Practitioner
Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.
|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||9678J||ADALIMUMABadalimumab 20 mg/0.4 mL injection, 2 x 0.4 mL syringes||1||2||0|
|MP||12368Y||ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices||1||2||5|
|MP||9680L||ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices||1||2||0|
|MP||12349Y||ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe||2||2||5|
|MP||12439Q||ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe||2||2||0|
|MP||12384T||ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes||1||2||5|
|MP||9679K||ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes||1||2||0|
|MP||12335F||ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices||1||2||0|
|MP||12396K||ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes||1||2||0|
|MP||12443X||ADALIMUMABadalimumab 20 mg/0.2 mL injection, 2 x 0.2 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||12180C||AMBRISENTANambrisentan 10 mg tablet, 30||1||30||5|
|MP||9649W||AMBRISENTANambrisentan 10 mg tablet, 30||1||30||5|
|MP||12201E||AMBRISENTANambrisentan 5 mg tablet, 30||1||30||5|
|MP||9648T||AMBRISENTANambrisentan 5 mg tablet, 30||1||30||5|
|MP||10263E||ANAKINRAanakinra 100 mg/0.67 mL injection, 28 x 0.67 mL syringes||1||28||5|
|MP||9640J||APOMORPHINEapomorphine hydrochloride hemihydrate 50 mg/5 mL injection, 5 x 5 mL ampoules||36||180||5|
|MP||11083H||APOMORPHINEapomorphine hydrochloride hemihydrate 100 mg/20 mL injection, 5 x 20 mL vials||18||90||5|
|MP||11688E||APOMORPHINEapomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL cartridges||20||100||5|
|MP||11475Y||APOMORPHINEapomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL pen devices||20||100||5|
|MP||9607P||APOMORPHINEapomorphine hydrochloride hemihydrate 20 mg/2 mL injection, 5 x 2 mL ampoules||72||360||5|
|MP||10971K||APOMORPHINEapomorphine hydrochloride hemihydrate 50 mg/10 mL injection, 5 x 10 mL syringes||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|
|MPNP||6221K||AZITHROMYCINazithromycin 600 mg tablet, 8||2||16||5|