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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.

  • Legend
  • MPMedical Practitioner
  • NPNurse Practitioner
  • SO
    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.
    Supply Only
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 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