Digital Transformation of Authority Required (Written) PBS listings

Page last updated: 30 June 2022

Commencing 1 July 2022, changes will begin to be made to the Pharmaceutical Benefits Scheme (PBS) listings of medicines that require prescribers to apply to Services Australia in writing or upload documents in Health Professional Online Services (HPOS). These changes will allow prescribers to apply for authority approval to prescribe these medicines using Services Australia's Online PBS Authorities (OPA) System. This same channel is already in use for medicines that have Authority Required (telephone) PBS listings and these changes are intended to reduce the administrative burden for prescribers and allow patients to have faster access to their medicines.

Authority requests will be assessed in the OPA system via HPOS in real time allowing prescribers to obtain immediate authority approval (following confirmation of eligibility), without direct contact with Services Australia. Once approved, patients may leave with the prescription for their medicine at the end of their consultation.

Unfortunately, the PBS listings for all of these medicines cannot be updated at one time. The Department of Health is working to update all of the relevant PBS listings as quickly as possible.

From 1 July 2022 the PBS listings for the following cancer medicines have been updated.

Medicine name, Form, Quantity	PBS item code, Program code	Indication, Treatment phase
azacitidine 100 mg injection, 1 vial	6100C (HS)	Chronic Myelomonocytic Leukaemia (CMML) – Initial treatment
azacitidine 100 mg injection, 1 vial	9597D (HB)	Chronic Myelomonocytic Leukaemia (CMML) – Initial treatment
lenalidomide 10 mg capsule, 21	2796E (HS)	Myelodysplastic Syndrome (MDS) – Initial treatment and Continuing treatment
lenalidomide 10 mg capsule, 21	2802L (HB)	Myelodysplastic Syndrome (MDS) – Initial treatment and Continuing treatment
lenalidomide 5 mg capsule, 21	2798G (HS)	Myelodysplastic Syndrome (MDS) – Initial treatment and Continuing treatment
lenalidomide 5 mg capsule, 21	2799H (HB)	Myelodysplastic Syndrome (MDS) – Initial treatment and Continuing treatment
midostaurin 25 mg capsule, 112	11531X (HS)	Acute Myeloid Leukaemia (AML) – Maintenance therapy – Initial treatment
midostaurin 25 mg capsule, 112	11552B (HB)	Acute Myeloid Leukaemia (AML) – Maintenance therapy – Initial treatment
lapatinib 250 mg tablet, 70	9148L (GE)	Metastatic (Stage IV) HER2 positive breast cancer – Initial treatment
ponatinib 15 mg tablet, 60	10520Q (GE)	Chronic Myeloid Leukaemia (CML) – Initial treatment and First continuing treatment
ponatinib 45 mg tablet, 30	10530F (GE)	Chronic Myeloid Leukaemia (CML) – Initial treatment and First continuing treatment
trastuzumab emtansine (infus.)	11951B (IP)	Early HER2 positive breast cancer – Initial adjuvant treatment
trastuzumab emtansine (infus.)	11956G (IN)	Early HER2 positive breast cancer – Initial adjuvant treatment

The Department of Health will publish further information on the PBS website as groups of medicine are reviewed.

Information for prescribers

What do these changes involve?

The PBS listings for these medicines will be reworded to remove the requirement for doctors/prescribers to submit physical copies of forms, prescriptions and test results and instead keep these in the patient’s medical records.

You will no longer be required to submit paper forms, prescriptions and test results, or upload copies of these to Services Australia for assessment. Instead, you will be able to provide this same information digitally by answering the questions in the OPA system. You may also find that the wording of certain eligibility criteria, prescribing instructions and administrative notes have changed. These changes will simplify the process for requesting authority approval from Services Australia. However, the eligible patient group for each medicine is unchanged.

Can I still apply for Authority to prescribe by post?

You can still submit applications for authority to prescribe via Australia Post or upload documents in HPOS if you choose to do so. Updated versions of Services Australia's application forms will remain available on the Services Australia website.

Information for Pharmacists

You will continue to see authority approval numbers written or printed on prescriptions and may still see some with the red Services Australia ‘Approved’ stamp. The authority approval number prefix will vary depending on the channel used to obtain PBS Authority approval.

Approval obtained by the prescriber using the Online PBS Authority System in HPOS will be prefixed with a ‘H’ i.e. H1234RX and approval obtained using integrated prescribing software will be prefixed with a ‘C’ i.e. C1234RX. Approval given over the telephone or in writing by Services Australia will be prefixed with an ‘M’ i.e. M1234RX.

Authority Approval numbers may also be prefixed with letters that reflect the PBS program they are listed in. Some examples include PUB or PTE for public or private hospital items, CAR for some Complex Authority Required listings, HSD for community access listings and PLC for palliative care listings.

The PBS Online claiming system will check the authority approval and any warning or reject messages must be actioned.