Severe aplastic anaemia

Treatment Phase: Initial treatment - Second line treatment

Clinical criteria:

  • The condition must be severe aplastic anaemia,

AND

  • Patient must not have achieved an adequate response to prior immunosuppressive therapy including anti-thymocyte antibody and ciclosporin; OR

  • Patient must have relapsed following prior immunosuppressive therapy including anti-thymocyte antibody and ciclosporin,

AND

  • Patient must not receive more than 16 weeks of treatment under this restriction.

The authority application must be made via the online PBS Authorities (real time assessment), or in writing via HPOS form upload or mail and must include:

(a) prior immunosuppressive therapy, including dates of treatment.

If the application is submitted through HPOS form upload or mail, it must include:

(i) details of the proposed prescription; and

(ii) a completed authority application form relevant to the indication and treatment phase (the latest version is located on the website specified in the Administrative Advice).

Note

No increase in the maximum quantity or number of units may be authorised.

Note

No increase in the maximum number of repeats may be authorised.

Note

Special Pricing Arrangements apply.

Note

Any queries concerning the arrangements to prescribe may be directed to Services Australia on 1800 700 270 (hours of operation 8 a.m. to 5 p.m. Monday to Friday).

Prescribing information (including Authority Application forms and other relevant documentation as applicable) is available on the Services Australia website at www.servicesaustralia.gov.au

Applications for authorisation under this restriction should be made in real time using the Online PBS Authorities system (see www.servicesaustralia.gov.au/hpos)

Alternatively, applications for authority to prescribe can be submitted online using the form upload facility in Health Professional Online Services (HPOS) at www.servicesaustralia.gov.au/hpos

Or mailed to:

Services Australia

Complex Drugs

Reply Paid 9826

HOBART TAS 7001