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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
Prescriber code Item code Name, manner of administration and form & strength Max qty
packs
Max qty
units
No. of
repeats
MP 10134J MACITENTANmacitentan 10 mg tablet, 30 1 30 5
MP 12135Q MACITENTANmacitentan 10 mg tablet, 30 1 30 5
MP 2008Q MANNITOLmannitol 40 mg powder for inhalation, 280 capsules 4 4 5
MP 12030E MEPOLIZUMABmepolizumab 100 mg/mL injection, 1 mL pen device 1 1 5
MP 12043W MEPOLIZUMABmepolizumab 100 mg/mL injection, 1 mL pen device 1 1 0
MP 12051G MEPOLIZUMABmepolizumab 100 mg/mL injection, 1 mL pen device 1 1 7
MP 12052H MEPOLIZUMABmepolizumab 100 mg/mL injection, 1 mL pen device 1 1 5
MP 11003D MEPOLIZUMABmepolizumab 100 mg injection, 1 vial 1 1 7
MP 11014Q MEPOLIZUMABmepolizumab 100 mg injection, 1 vial 1 1 5
MP 11829N MEPOLIZUMABmepolizumab 100 mg injection, 1 vial 1 1 0
MP 12162D METHOXSALENmethoxsalen 200 microgram/10 mL injection, 12 x 10 mL vials 0.2 2 6
MP 12173Q METHOXSALENmethoxsalen 200 microgram/10 mL injection, 12 x 10 mL vials 0.1 1 5
MP 9576B METHOXY POLYETHYLENE GLYCOL-EPOETIN BETAmethoxy polyethylene glycol-epoetin beta 75 microgram/0.3 mL injection, 0.3 mL syringe 2 2 5
MP 9575Y METHOXY POLYETHYLENE GLYCOL-EPOETIN BETAmethoxy polyethylene glycol-epoetin beta 50 microgram/0.3 mL injection, 0.3 mL syringe 2 2 5
MP 9580F METHOXY POLYETHYLENE GLYCOL-EPOETIN BETAmethoxy polyethylene glycol-epoetin beta 360 microgram/0.6 mL injection, 0.6 mL syringe 2 2 5
MP 9577C METHOXY POLYETHYLENE GLYCOL-EPOETIN BETAmethoxy polyethylene glycol-epoetin beta 100 microgram/0.3 mL injection, 0.3 mL syringe 2 2 5
MP 9574X METHOXY POLYETHYLENE GLYCOL-EPOETIN BETAmethoxy polyethylene glycol-epoetin beta 30 microgram/0.3 mL injection, 0.3 mL syringe 2 2 5
MP 9578D METHOXY POLYETHYLENE GLYCOL-EPOETIN BETAmethoxy polyethylene glycol-epoetin beta 120 microgram/0.3 mL injection, 0.3 mL syringe 2 2 5
MP 9579E METHOXY POLYETHYLENE GLYCOL-EPOETIN BETAmethoxy polyethylene glycol-epoetin beta 200 microgram/0.3 mL injection, 0.3 mL syringe 2 2 5
MP 11506N MIDOSTAURINmidostaurin 25 mg capsule, 56 1 56 2
MP 11518F MIDOSTAURINmidostaurin 25 mg capsule, 112 1 112 2
MP 11531X MIDOSTAURINmidostaurin 25 mg capsule, 112 1 112 2
MP 6364Y MYCOPHENOLATEmycophenolate mofetil 1 g/5 mL powder for oral liquid, 165 mL 2 2 5
MP 6208R MYCOPHENOLATEmycophenolate mofetil 250 mg capsule, 100 6 600 5
MP 6370G MYCOPHENOLATEmycophenolate 360 mg enteric tablet, 120 2 240 5
MP 6209T MYCOPHENOLATEmycophenolate mofetil 500 mg tablet, 50 6 300 5
MP 1837Q MYCOPHENOLATEmycophenolate mofetil 250 mg capsule, 50 12 600 5
MP 6369F MYCOPHENOLATEmycophenolate 180 mg enteric tablet, 120 2 240 5