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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
Prescriber code Item code Name, manner of administration and form & strength Max qty
packs
Max qty
units
No. of
repeats
MP 6490N DARBEPOETIN ALFAdarbepoetin alfa 60 microgram/0.3 mL injection, 0.3 mL pen device 8 8 5
MP 6493R DARBEPOETIN ALFAdarbepoetin alfa 150 microgram/0.3 mL injection, 0.3 mL pen device 8 8 5
MP 6492Q DARBEPOETIN ALFAdarbepoetin alfa 100 microgram/0.5 mL injection, 0.5 mL pen device 8 8 5
MP 6365B DARBEPOETIN ALFAdarbepoetin alfa 150 microgram/0.3 mL injection, 4 x 0.3 mL syringes 2 8 5
MP 6326Y DARBEPOETIN ALFAdarbepoetin alfa 100 microgram/0.5 mL injection, 4 x 0.5 mL syringes 2 8 5
MP 6324W DARBEPOETIN ALFAdarbepoetin alfa 50 microgram/0.5 mL injection, 4 x 0.5 mL syringes 2 8 5
MP 6438W DARBEPOETIN ALFAdarbepoetin alfa 80 microgram/0.4 mL injection, 4 x 0.4 mL syringes 2 8 5
MP 6321Q DARBEPOETIN ALFAdarbepoetin alfa 20 microgram/0.5 mL injection, 4 x 0.5 mL syringes 2 8 5
MP 6325X DARBEPOETIN ALFAdarbepoetin alfa 60 microgram/0.3 mL injection, 4 x 0.3 mL syringes 2 8 5
MP 6322R DARBEPOETIN ALFAdarbepoetin alfa 30 microgram/0.3 mL injection, 4 x 0.3 mL syringes 2 8 5
MP 6491P DARBEPOETIN ALFAdarbepoetin alfa 80 microgram/0.4 mL injection, 0.4 mL pen device 8 8 5
MP 6489M DARBEPOETIN ALFAdarbepoetin alfa 40 microgram/0.4 mL injection, 0.4 mL pen device 8 8 5
MP 6488L DARBEPOETIN ALFAdarbepoetin alfa 20 microgram/0.5 mL injection, 0.5 mL pen device 8 8 5
MP 6323T DARBEPOETIN ALFAdarbepoetin alfa 40 microgram/0.4 mL injection, 4 x 0.4 mL syringes 2 8 5
MP 6320P DARBEPOETIN ALFAdarbepoetin alfa 10 microgram/0.4 mL injection, 4 x 0.4 mL syringes 2 8 5
MP 11496C DEFERASIROXdeferasirox 360 mg tablet, 30 6 180 5
MP 11511W DEFERASIROXdeferasirox 360 mg tablet, 30 6 180 2
MP 11547R DEFERASIROXdeferasirox 360 mg tablet, 30 6 180 2
MP 11510T DEFERASIROXdeferasirox 180 mg tablet, 30 6 180 2
MP 11546Q DEFERASIROXdeferasirox 180 mg tablet, 30 6 180 5
MP 11557G DEFERASIROXdeferasirox 180 mg tablet, 30 6 180 2
MP 11545P DEFERASIROXdeferasirox 90 mg tablet, 30 6 180 5
MP 11548T DEFERASIROXdeferasirox 90 mg tablet, 30 6 180 2
MP 11558H DEFERASIROXdeferasirox 90 mg tablet, 30 6 180 2
MP 6416Q DEFERIPRONEdeferiprone 500 mg tablet, 100 3 300 5
MP 9638G DEFERIPRONEdeferiprone 100 mg/mL oral liquid, 250 mL 5 5 5
MP 11724C DEFERIPRONEdeferiprone 1 g tablet, 50 6 300 5
MP 6270B DESFERRIOXAMINEdesferrioxamine mesilate 2 g injection, 1 vial 60 60 5
MP 6113R DESFERRIOXAMINEdesferrioxamine mesilate 500 mg injection, 10 vials 40 400 5
MP 6120D DORNASE ALFAdornase alfa 2.5 mg/2.5 mL inhalation solution, 30 x 2.5 mL ampoules 2 60 5
MPNP 6249X DOXORUBICIN HYDROCHLORIDE (AS PEGYLATED LIPOSOMAL)doxorubicin hydrochloride (as pegylated liposomal) 20 mg/10 mL injection, 10 mL vial 4 4 5
MP 12313C DUPILUMABdupilumab 200 mg/1.14 mL injection, 2 x 1.14 mL syringes 1 2 8
MP 12316F DUPILUMABdupilumab 200 mg/1.14 mL injection, 2 x 1.14 mL syringes 1 2 5
MP 12294C DUPILUMABdupilumab 300 mg/2 mL injection, 2 x 2 mL syringes 1 2 5
MP 12310X DUPILUMABdupilumab 300 mg/2 mL injection, 2 x 2 mL syringes 1 2 8