PB 93 of 2012

National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2012
(No. 8)1

National Health Act 1953

I, FELICITY McNEILL, First Assistant Secretary, Pharmaceutical Benefits Division, Department of Health and Ageing, delegate of the Minister for Health, make this Instrument under sections 84AF, 84AK, 85, 85A, 88 and 101 of the National Health Act 1953.

Dated 26 November 2012

 

 

 

 

 

 

 

 

 

 

 

FELICITY McNEILL

First Assistant Secretary

Pharmaceutical Benefits Division

Department of Health and Ageing

 


1 Name of Instrument

 (1) This Instrument is the National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2012 (No. 8).

 (2) This Instrument may also be cited as PB 93 of 2012.

2 Commencement

This Instrument commences on 1 December 2012.

3 Amendment of National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012)

 Schedule 1 amends the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012).

 

Schedule 1 Amendments

 

[1]                Section 4, Definitions

(a) omit full stop from the definition of Team Care Arrangements and substitute a semicolon

(b) insert after definition of Team Care Arrangements and before Note:

TGA means Therapeutic Goods Administration;

WHO means World Health Organisation.

[2]                Schedule 1, entry for Aciclovir in the form Tablet 200 mg [GenRx Aciclovir; Max Quantity 50; Number of Repeats 0]

omit from the column headed “Pack Quantity”: 25 substitute: 50

[3]                Schedule 1, after entry for Adrenaline in the form I.M. injection 300 micrograms in 0.3 mL single dose syringe auto-injector (Anapen)

insert:

Aflibercept

Solution for intravitreal injection 4 mg in 100 microlitres (40 mg per mL)

Injection

Eylea

BN

MP

C4153 C4154

 

1

2

1

 

 

[4]                Schedule 1, entry for Alendronic Acid in the form Tablet 70 mg (as alendronate sodium)

(a)        omit from the column headed “Circumstances” (all instances):

C2646

C3070

C3933

 

substitute:

C4122

C4123

C4133

 

(b)        insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Alendronate Pfizer

FZ

MP NP

C4122 C4123 C4133

 

4

5

4

 

 

[5]                Schedule 1, entry for Alendronic acid with colecalciferol in the form Tablet 70 mg (as alendronate sodium) with 70 micrograms colecalciferol

omit from the column headed “Circumstances”:

C2646

C3070

C3933

 

substitute:

C4070

C4087

C4110

 

[6]                Schedule 1, entry for Alendronic acid with colecalciferol in the form Tablet 70 mg (as alendronate sodium) with 140 micrograms colecalciferol

omit from the column headed “Circumstances” (twice occurring):

C2646

C3070

C3933

 

substitute:

C4122

C4123

C4133

 

[7]                Schedule 1, entry for Alendronic acid with colecalciferol and calcium

omit from the column headed “Circumstances” (twice occurring):

C2646

C3070

C3933

 

substitute:

C4122

C4123

C4133

 

[8]                Schedule 1, entry for Amlodipine with valsartan in the form Tablet 5 mg (as besylate)-80 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Valsartan/ Amlodipine Sandoz 80/5

NM

MP NP

C3307

 

28

5

28

 

 

[9]                Schedule 1, entry for Amlodipine with valsartan and hydrochlorothiazide in the form Tablet 5 mg (as besylate)-160 mg-12.5 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Valsartan/ Amlodipine/HCT Sandoz 160/5/12.5

NM

MP NP

C3539

 

28

5

28

 

 

[10]            Schedule 1, entry for Amoxycillin in the form Capsule 250 mg (as trihydrate)

(a) omit:

 

 

 

GenRx Amoxycillin

GX

PDP

 

 

20

0

20

 

 

(b) omit:

 

 

 

GenRx Amoxycillin

GX

MP NP MW

 

 

20

1

20

 

 

[11]            Schedule 1, entry for Amoxycillin in the form Capsule 500 mg (as trihydrate)

(a) omit:

 

 

 

GenRx Amoxycillin

GX

PDP

 

 

20

0

20

 

 

(b) omit:

 

 

 

GenRx Amoxycillin

GX

MP NP MW

 

 

20

1

20

 

 

[12]            Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 125 mg amoxycillin
(as trihydrate) with 31.25 mg clavulanic acid (as potassium clavulanate) per 5 mL, 75 mL [Max Quantity 1; Number of Repeats 0]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

GA-Amclav 125/31.25

GM

PDP

C1836 C1837

 

1

0

1

 

 

[13]            Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 125 mg amoxycillin
(as trihydrate) with 31.25 mg clavulanic acid (as potassium clavulanate) per 5 mL, 75 mL [Max Quantity 1; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

GA-Amclav 125/31.25

GM

MP NP

C1836 C1837

 

1

1

1

 

 

[14]            Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 400 mg amoxycillin
(as trihydrate) with 57 mg clavulanic acid (as potassium clavulanate) per 5 mL, 60 mL [Max Quantity 1; Number of Repeats 0]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

GA-Amclav Forte 400/57

GM

PDP

C1836 C1837

 

1

0

1

 

 

[15]            Schedule 1, entry for Amoxycillin with Clavulanic Acid in the form Powder for oral suspension containing 400 mg amoxycillin
(as trihydrate) with 57 mg clavulanic acid (as potassium clavulanate) per 5 mL, 60 mL [Max Quantity 1; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

GA-Amclav Forte 400/57

GM

MP NP

C1836 C1837

 

1

1

1

 

 

[16]            Schedule 1, entry for Anastrozole

(a) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Pharmacy Choice Anastrozole

RI

MP NP

C2213

 

30

5

30

 

 

(b) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

STADA Anastrozole

TD

MP NP

C2213

 

30

5

30

 

 

[17]            Schedule 1, entry for Apomorphine in the form Injection containing apomorphine hydrochloride 20 mg in 2 mL

(a) omit from the column headed “Max Quantity”: 5 substitute: 360

(b) omit from the column headed “Number of Repeats”: 0 substitute: 5

[18]            Schedule 1, entry for Apomorphine in the form Injection containing apomorphine hydrochloride 50 mg in 5 mL

(a) omit from the column headed “Max Quantity”: 5 substitute: 180

(b) omit from the column headed “Number of Repeats”: 0 substitute: 5

[19]            Schedule 1, entry for Apomorphine in the form Solution for subcutaneous infusion containing apomorphine hydrochloride 50 mg in 10 mL pre-filled syringe

(a) omit from the column headed “Max Quantity”: 5 substitute: 180

(b) omit from the column headed “Number of Repeats”: 0 substitute: 5

[20]            Schedule 1, entry for Atenolol in the form Tablet 50 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Tenolten 50

DO

MP NP

 

 

30

5

30

 

 

[21]            Schedule 1, after entry for Atenolol in the form Tablet 50 mg [Terry White Chemists Atenolol]

insert in the columns in the order indicated:

 

Oral solution 50 mg in 10 mL, 300 mL

Oral

Atenolol-AFT

AE

MP NP

C4076

 

1

5

1

 

 

[22]            Schedule 1, entry for Auranofin in the form Capsule 3 mg

omit from the column headed “Responsible person”: BZ substitute: GH

[23]            Schedule 1, entry for Betamethasone

omit:

 

Ointment 200 micrograms (as valerate) per g, 100 g

Application

Antroquoril

FR

MP NP

C1422

 

2

0

1

 

 

 

 

 

Celestone-M

MK

MP NP

C1422

 

2

0

1

 

 

[24]            Schedule 1, entry for Bortezomib in the form Powder for injection 1 mg

omit all codes from the column headed “Circumstances” and substitute:

 

C4082

C4103

C4127

C4141

C4163

 

[25]            Schedule 1, entry for Bortezomib in the form Powder for injection 3.5 mg

omit all codes from the column headed “Circumstances” and substitute:

 

C4079

C4080

C4081

C4126

C4161

C4162

[26]            Schedule 1, entry for Cabazitaxel

omit all codes from the column headed “Circumstances” and substitute:

 

C4073

C4138

[27]            Schedule 1, entry for Carbomer with Triglyceride Lipids

omit from the column headed “Form”:

Eye gel 2 mg-10 mg per g, 10 g, single dose units 0.6 g, 30

substitute:

Eye gel 2 mg-10 mg per g, single dose units 0.6 g, 30

[28]            Schedule 1, entry for Carvedilol in the form Tablet 3.125 mg

omit:

 

 

 

GenRx Carvedilol

GX

MP NP

C1735 C3234

 

30

0

30

 

 

[29]            Schedule 1, entry for Carvedilol in the form Tablet 6.25 mg

omit:

 

 

 

GenRx Carvedilol

GX

MP NP

C1735 C3234

 

60

5

60

 

 

[30]            Schedule 1, entry for Carvedilol in the form Tablet 12.5 mg

omit:

 

 

 

GenRx Carvedilol

GX

MP NP

C1735 C3234

 

60

5

60

 

 

[31]            Schedule 1, entry for Cefaclor in the form Powder for oral suspension 125 mg (as monohydrate) per 5 mL, 100 mL

(a) omit:

 

 

 

Cefaclor Sandoz

SZ

PDP

 

 

1

0

1

 

 

(b) omit:

 

 

 

Cefaclor Sandoz

SZ

MP

 

 

1

1

1

 

 

[32]            Schedule 1, entry for Cefaclor in the form Powder for oral suspension 250 mg (as monohydrate) per 5 mL, 75 mL

(a) omit:

 

 

 

Cefaclor Sandoz

SZ

PDP

 

 

1

0

1

 

 

(b) omit:

 

 

 

Cefaclor Sandoz

SZ

MP

 

 

1

1

1

 

 

[33]            Schedule 1, entry for Cefepime in the form Powder for injection 2 g (as hydrochloride)

omit:

 

 

 

Maxipime

BQ

MP NP

C1427

 

10

0

1

 

 

[34]            Schedule 1, entry for Cephalexin in the form Granules for oral suspension 125 mg per 5 mL, 100 mL

(a) omit:

 

 

 

GenRx Cephalexin

GX

PDP

 

 

1

0

1

 

 

(b) omit:

 

 

 

GenRx Cephalexin

GX

MP NP

 

 

1

1

1

 

 

[35]            Schedule 1, entry for Cephalexin in the form Granules for oral suspension 250 mg per 5 mL, 100 mL

(a) omit:

 

 

 

GenRx Cephalexin

GX

PDP

 

 

1

0

1

 

 

(b) omit:

 

 

 

GenRx Cephalexin

GX

MP NP

 

 

1

1

1

 

 

[36]            Schedule 1, entry for Citalopram in each of the forms: Tablet 20 mg (as hydrobromide); and Tablet 40 mg (as hydrobromide)

omit:

 

 

 

GenRx Citalopram

GX

MP NP

C1211

 

28

5

28

 

 

[37]            Schedule 1, entry for Clarithromycin in the form Tablet 250 mg

omit:

 

 

 

GenRx Clarithromycin

GX

MP NP

 

 

14

1

14

 

 

[38]            Schedule 1, entry for Clopidogrel with aspirin in the form Tablet 75 mg (as hydrogen sulfate)-100 mg

(a) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

APO-Clopidogrel/ Aspirin 75/100

TX

MP NP

C1722 C3219 C3880

 

30

5

30

 

 

(b) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Chem mart Clopidogrel/ Aspirin 75/100

CH

MP NP

C1722 C3219 C3880

 

30

5

30

 

 

(c) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Terry White Chemists  Clopidogrel/ Aspirin 75/100

TW

MP NP

C1722 C3219 C3880

 

30

5

30

 

 

[39]            Schedule 1, entry for Clozapine in each of the forms: Tablet 25 mg; Tablet 50 mg; Tablet 100 mg; and Tablet 200 mg

omit from the column headed “Max Quantity” (all instances):  100 substitute: 200

[40]            Schedule 1, entry for Cyproterone in the form Tablet containing cyproterone acetate 50 mg [Max Quantity 20; Number of Repeats 5]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Cyproterone-PS

FZ

MP

C1014 C1230 C1404

P1230

20

5

20

 

 

[41]            Schedule 1, entry for Cyproterone in the form Tablet containing cyproterone acetate 50 mg [Max Quantity 100; Number of Repeats 5]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Cyproterone-PS

FZ

MP

C1014 C1230 C1404

P1014 P1404

100

5

50

 

 

[42]            Schedule 1, entry for Cyproterone in the form Tablet containing cyproterone acetate 100 mg

(a) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Cyproterone-PS 100

FZ

MP

C1014 C1404

 

50

5

50

 

 

(b) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Cyproterone Sandoz

HX

MP

C1014 C1404

 

50

5

50

 

 

 


[43]            Schedule 1, entry for Denosumab in the form Injection 60 mg in 1 mL pre-filled syringe

omit from the column headed “Circumstances”:

C3987  C4054

insert in numerical order:

C4094  C4145

[44]            Schedule 1, entry for Denosumab in the form Injection 120 mg in 1.7 mL

omit from the column headed “Circumstances”:

C1035  C4051

insert in numerical order:

C4150  C4158

[45]            Schedule 1, entry for Docetaxel

substitute:

Docetaxel

Solution concentrate for I.V. infusion 140 mg in 7 mL

Injection

Oncotaxel 140

TA

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

Solution concentrate for I.V. infusion 160 mg in 16 mL

Injection

DBL Docetaxel Concentrated Injection

HH

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

Powder for I.V. infusion 20 mg with solvent

Injection

Docetaxel SUN

ZF

MP

C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

Powder for I.V. infusion 80 mg with solvent

Injection

Docetaxel SUN

ZF

MP

C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

Solution concentrate for I.V. infusion 20 mg in 1 mL

Injection

Oncotaxel 20

TA

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

See Note 3

See Note 3

See Note 3

1

 

D(100)

 

 

 

Taxotere

SW

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

See Note 3

See Note 3

See Note 3

1

 

D(100)

 

Solution concentrate for I.V. infusion 20 mg in 2 mL

Injection

DBL Docetaxel Concentrated Injection

HH

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

See Note 3

See Note 3

See Note 3

1

 

D(100)

 

 

 

Docetaxel Ebewe

HX

MP

C3888 C3916 C4078 C4140 C4155 C4160

See Note 3

See Note 3

See Note 3

1

 

D(100)

 

 

 

Docetaxel Sandoz

SZ

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

See Note 3

See Note 3

See Note 3

1

 

D(100)

 

Solution concentrate for I.V. infusion 80 mg in 4 mL

Injection

Oncotaxel 80

TA

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

 

 

Taxotere

SW

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

Solution concentrate for I.V. infusion 80 mg in 8 mL

Injection

DBL Docetaxel Concentrated Injection

HH

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

 

 

Docetaxel Ebewe

HX

MP

C3888 C3916 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

 

 

Docetaxel Sandoz

SZ

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

Injection set containing 1 single use vial concentrate for I.V. infusion 80 mg (anhydrous) in 2 mL with solvent

Injection

Taxotere

SW

MP

C3888 C3892 C3916 C3956 C4078 C4140 C4155 C4160

 

See Note 3

See Note 3

1

 

D(100)

 

[46]            Schedule 1, entry for Etanercept

substitute:

 

Etanercept

Injection 50 mg in 1 mL single use auto-injector, 4

Injection

Enbrel

PF

MP
See Note 1

See Note 3

See Note 3

See Note 3

See Note 3

1

 

C(100)

 

 

 

 

 

MP
See Note 1

C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151

P3273 P3275 P3489 P3510 P3524 P3708 P3770 P3772 P3774 P3776 P3778 P3779 P4088 P4114 P4115 P4116 P4125 P4136 P4137 P4151

1

3

1

 

 

 

 

 

 

 

MP
See Note 1

C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151

P3771 P3773 P3775 P3777 P3780 P3781

1

5

1

 

 

 

Injections 50 mg in 1 mL single use pre-filled syringes, 4

Injection

Enbrel

PF

MP
See Note 1

See Note 3

See Note 3

See Note 3

See Note 3

1

 

C(100)

 

 

 

 

 

MP
See Note 1

C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151

P3273 P3275 P3489 P3510 P3524 P3708 P3770 P3772 P3774 P3776 P3778 P3779 P4088 P4114 P4115 P4116 P4125 P4136 P4137 P4151

1

3

1

 

 

 

 

 

 

 

 

C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151

P3771 P3773 P3775 P3777 P3780 P3781

1

5

1

 

 

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

Injection

Enbrel

PF

MP
See Note 1

See Note 3

See Note 3

See Note 3

See Note 3

1

 

C(100)

 

 

 

 

 

MP
See Note 1

C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151

P3273 P3275 P3489 P3510 P3524 P3708 P3770 P3772 P3774 P3776 P3778 P3779 P4088 P4114 P4115 P4116 P4125 P4136 P4137 P4151

2

3

1

 

 

 

 

 

 

 

MP
See Note 1

C3273 C3275 C3489 C3510 C3524 C3708 C3770 C3771 C3772 C3773 C3774 C3775 C3776 C3777 C3778 C3779 C3780 C3781 C4088 C4114 C4115 C4116 C4125 C4136 C4137 C4151

P3771 P3773 P3775 P3777 P3780 P3781

2

5

1

 

 

[47]            Schedule 1, entry for Ezetimibe with Simvastatin in each of the forms: Tablet 10 mg-10 mg; and Tablet 10 mg-20 mg

omit all codes from the column headed “Circumstances” and substitute:

 

C4068

C4069

C4085

C4086

C4096

C4097

C4120

C4121

C4147

 

[48]            Schedule 1, entry for Ezetimibe with Simvastatin in each of the forms: Tablet 10 mg-40 mg; and Tablet 10 mg-80 mg

omit all codes from the column headed “Circumstances” and substitute:

 

C4068

C4069

C4085

C4086

C4096

C4097

C4120

C4121

[49]            Schedule 1, entry for Famciclovir in the form Tablet 125 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Famciclovir-GA

GM

MP NP

C3624

 

40

1

40

 

 

[50]            Schedule 1, entry for Famciclovir in the form Tablet 250 mg [Max Quantity 20; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Famciclovir-GA

GM

MP NP

C3622 C3623 C3624

P3624

20

1

20

 

 

[51]            Schedule 1, entry for Famciclovir in the form Tablet 250 mg [Max Quantity 21; Number of Repeats 0]

(a) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Famciclovir-GA

GM

MP NP

C3622 C3623 C3624

P3622

21

0

21

 

 

(b) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Famciclovir generichealth 250

GQ

MP NP

C3622 C3623

P3622

21

0

21

 

 

[52]            Schedule 1, entry for Famciclovir in the form Tablet 250 mg [Max Quantity 56; Number of Repeats 5]

(a) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Famciclovir-GA

GM

MP NP

C3622 C3623 C3624

P3623

56

5

56

 

 

(b) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Famciclovir generichealth 250

GQ

MP NP

C3622 C3623

P3623

56

5

56

 

 

[53]            Schedule 1, entry for Famciclovir in the form Tablet 500 mg [Max Quantity 56; Number of Repeats 5]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Famciclovir-GA

GM

MP NP

C3626 C3627 C3628 C3629

P3626 P3627 P3628 P3629

56

5

56

 

 

[54]            Schedule 1, entry for Gemfibrozil in the form Tablet 600 mg [Max Quantity 60; Number of Repeats 5]

(a) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Gemfibrozil-GA

GM

MP

C1540 C3047

P1540

60

5

60

 

 

 

 

 

 

 

NP

C1540

 

60

5

60

 

 

(b) omit:

 

 

 

Lipazil 600 mg

GM

MP

C1540 C3047

P1540

60

5

60

 

 

 

 

 

 

 

NP

C1540

 

60

5

60

 

 

[55]            Schedule 1, entry for Gemfibrozil in the form Tablet 600 mg [Max Quantity 60; Number of Repeats 11]

(a) insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Gemfibrozil-GA

GM

MP

C1540 C3047

P3047

60

11

60

 

 

(b) omit:

 

 

 

Lipazil 600 mg

GM

MP

C1540 C3047

P3047

60

11

60

 

 

[56]            Schedule 1, entry for Glucose Indicator―Blood

(a) insert in the columns indicated after “Test strips, 50 (Glucocard 01 Sensor)”:

 

Test strips, 50 (GlucoDr)

For external use

GlucoDr

OZ

MP NP

 

 

2

5

1

 

 

 

 

 

 

 

MP

 

P3035

2

11

1

 

 

(b) omit:

 

Test strips, 50 (GlucoOz)

For external use

GlucoOz

OZ

MP NP

 

 

2

5

1

 

 

 

 

 

 

 

MP

 

P3035

2

11

1

 

 

[57]            Schedule 1, entry for Granisetron

substitute:

Granisetron

Tablet 2 mg (as hydrochloride)

Oral

Kytril

RO

MP NP
See Note 1

C4102 C4118 See Note 2

P4118
See Note 2

2
See Note 2

0
See Note 2

1

 

 

 

 

 

 

 

MP NP
See Note 1

C4102 C4118 See Note 2

P4102
See Note 2

5
See Note 2

1
See Note 2

5

 

 

 

Concentrated injection 3 mg (as hydrochloride) in 3 mL

Injection

Granisetron Kabi

PK

MP NP
See Note 1

C4077 C4092
See Note 2

 

1
See Note 2

0
See Note 2

1

 

 

 

 

 

Kytril

RO

MP NP
See Note 1

C4077 C4092
See Note 2

 

1
See Note 2

0
See Note 2

1

 

 

[58]            Schedule 1, after entry for Human menopausal gonadotrophin

insert:

Hyaluronic Acid

Eye drops containing sodium hyaluronate 1 mg per mL, 10 mL

Application to the eye

Hylo-Fresh

AE

MP NP

C4105

 

1

5

1

 

 

 

 

 

 

 

AO

C4130

 

1

5

1

 

 

 

Eye drops containing sodium hyaluronate 2 mg per mL, 10 mL

Application to the eye

Hylo-Forte

AE

MP NP

C4105

 

1

5

1

 

 

 

 

 

 

 

AO

C4130

 

1

5

1

 

 

[59]            Schedule 1, entry for Hydroxocobalamin

substitute:

Hydroxocobalamin

Injection 1 mg (as acetate) in 1 mL

Injection

Vita-B12

GH

MP NP

C4111 C4134 C4135

 

3

0

3

 

 

 

Injection 1 mg (as chloride) in 1 mL

Injection

Hydroxo-B12

AS

MP NP

C4111 C4134 C4135

 

3

0

3

 

 

 

 

 

Neo-B12

HH

MP NP

C4111 C4134 C4135

 

3

0

3

 

 

[60]            Schedule 1, entry for Imiquimod

(a)        omit from the column headed “Pack Size” for the brand “Aldara”: 30 substitute: 1

(b)        insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

APO-Imiquimod

TX

MP

C2816

 

1

1

1

 

 

[61]            Schedule 1, entry for Lamivudine in each of the forms: Tablet 150 mg; and Tablet 300 mg

omit from the column headed “Brand”: Alphapharm Lamivudine substitute: Lamivudine Alphapharm

[62]            Schedule 1, entry for Lamotrigine in the form Tablet 25 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Reedos 25

DO

MP NP

C1426

 

56

5

56

 

 

[63]            Schedule 1, entry for Lamotrigine in the form Tablet 50 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Reedos 50

DO

MP NP

C1426

 

56

5

56

 

 

[64]            Schedule 1, entry for Lamotrigine in the form Tablet 100 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Reedos 100

DO

MP NP

C1426

 

56

5

56

 

 

[65]            Schedule 1, entry for Lamotrigine in the form Tablet 200 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Reedos 200

DO

MP NP

C1426

 

56

5

56

 

 

[66]            Schedule 1, entry for Leflunomide in each of the forms: Tablet 10 mg; and Tablet 20 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Leflunomide-GA

GM

MP

C2644

 

30

5

30

 

 

[67]            Schedule 1, entry for Letrozole

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

STADA Letrozole

TD

MP NP

C1608 C2691 C2692

 

30

5

30

 

 

[68]            Schedule 1, entry for Lisinopril in each of the forms: Tablet 5 mg; Tablet 10 mg; and Tablet 20 mg

omit:

 

 

 

GenRx Lisinopril

GX

MP NP

 

 

30

5

30

 

 

[69]            Schedule 1, entry for Loperamide

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Gastrex

CR

MP NP

 

 

12

0

12

 

 

[70]            Schedule 1, entry for Meloxicam in each of the forms: Tablet 7.5 mg; and Tablet 15 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

APO-Meloxicam

TX

MP NP

C1547 C1848

 

30

3

30

 

 

[71]            Schedule 1, entry for Mirtazapine in the form Tablet 15 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

APO-Mirtazapine

TX

MP NP

C1211

 

30

5

30

 

 

[72]            Schedule 1, entry for Mycophenolic Acid

omit:

Mycophenolic Acid

Tablet (enteric coated) containing mycophenolate sodium equivalent to 180 mg mycophenolic acid

Oral

Myfortic

NV

MP

C1763

 

120

3

120

 

 

 

 

 

 

 

MP
See Note 1

C1650 C3355

 

240

5

120

 

C(100)

 

Tablet (enteric coated) containing mycophenolate sodium equivalent to 360 mg mycophenolic acid

Oral

Myfortic

NV

MP

C1763

 

120

3

120

 

 

 

 

 

 

 

MP
See Note 1

C1650 C3355

 

240

5

120

 

C(100)

substitute:

Mycophenolic Acid

Tablet (enteric coated) containing mycophenolate sodium equivalent to 180 mg mycophenolic acid

Oral

Myfortic

NV

MP

C1763 C4131

P1763

120

3

120

 

 

 

 

 

 

 

MP

C1763 C4131

P4131

120

5

120

 

 

 

 

 

 

 

MP
See Note 1

C4084 C4095 C4108 C4146

 

240

5

120

 

C(100)

 

Tablet (enteric coated) containing mycophenolate sodium equivalent to 360 mg mycophenolic acid

Oral

Myfortic

NV

MP

C1763 C4131

P1763

120

3

120

 

 

 

 

 

 

 

MP

C1763 C4131

P4131

120

5

120

 

 

 

 

 

 

 

MP
See Note 1

C4084 C4095 C4108 C4146

 

240

5

120

 

C(100)

[73]            Schedule 1, entry for Naloxone

insert as first item in the columns in the order indicated:

 

Injection containing naloxone hydrochloride 400 micrograms in 1 mL pre-filled syringe

Injection

Naloxone minijet

UC

MP NP PDP

 

 

5

0

1

 

 

 

 

 

 

 

MP NP

 

 

10

0

1

 

 

[74]            Schedule 1, after entry for Naproxen in the form Tablet 1 g (sustained release) [Proxen SR 1000] [Max Quantity 28; Number of Repeats 3]

insert in the columns in the order indicated:

 

Oral suspension 125 mg per mL, 474 mL

Oral

Phebra Naproxen Suspension

PL

MP NP

C4124 C4128 C4129 C4159

P4129

1

0

1

 

 

 

 

 

 

 

 

C4124 C4128 C4129 C4159

P4124 P4128 P4159

1

3

1

 

 

[75]            Schedule 1, omit entry for Neomycin with Bacitracin

[76]            Schedule 1, entry for Nevirapine in the form Tablet 200 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Nevirapine Alphapharm

AF

MP
See Note 1

C3586 C3587 C3588 C3589

 

120

5

60

 

D(100)

[77]            Schedule 1, entry for Octreotide in each of the forms: Injection 50 micrograms (as acetate) in 1 mL; Injection 100 micrograms (as acetate) in 1 mL; and Injection 500 micrograms (as acetate) in 1 mL

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Octreotide (SUN)

ZF

MP
See Note 1

C2622 C2623 C3407 C3408

 

90

11

5

 

D(100)

[78]            Schedule 1, entry for Olanzapine in each of the forms: Wafer 15 mg; and Wafer 20 mg

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Zypine ODT

AF

MP NP

C1589 C2044

 

28

5

28

 

 

[79]            Schedule 1, entry for Olmesartan with amlodipine in each of the forms: Tablet containing olmesartan medoxomil 20 mg with amlodipine
5 mg (as besylate); Tablet containing olmesartan medoxomil 40 mg with amlodipine 5 mg (as besylate); and Tablet containing olmesartan medoxomil 40 mg with amlodipine 10 mg (as besylate)

omit from the column headed “Authorised Prescriber”: MP substitute: MP NP

[80]            Schedule 1, entry for Omeprazole

substitute:

Omeprazole

Tablet 20 mg (as magnesium)

Oral

Acimax Tablets

AL

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Losec Tablets

AP

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omepral

PM

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omeprazole Sandoz

SZ

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Acimax Tablets

AL

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Losec Tablets

AP

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omepral

PM

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omeprazole Sandoz

SZ

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

Tablet 20 mg

Oral

APO-Omeprazole

TX

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Chem mart Omeprazole

CH

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Meprazol

SZ

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omeprazole-GA

GM

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omeprazole generichealth

GQ

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omeprazole-PS

FZ

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omeprazole RBX

RA

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omeprazole Winthrop

WA

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Ozmep

ZP

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Terry White Chemists Omeprazole

TW

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

APO-Omeprazole

TX

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Chem mart Omeprazole

CH

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Meprazol

SZ

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omeprazole-GA

GM

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omeprazole generichealth

GQ

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omeprazole-PS

FZ

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omeprazole RBX

RA

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omeprazole Winthrop

WA

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Ozmep

ZP

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Terry White Chemists Omeprazole

TW

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

Capsule 20 mg

Oral

APO-Omeprazole

TX

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Maxor

AF

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omeprazole Sandoz

HX

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Omepro-GA

GM

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Pemzo

QA

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Pharmacor Omeprazole 20

CR

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

Probitor

SZ

MP NP

C4074 C4075 C4089 C4152

P4074

30

1

30

 

 

 

 

 

APO-Omeprazole

TX

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Maxor

AF

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omeprazole Sandoz

HX

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Omepro-GA

GM

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Pemzo

QA

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Pharmacor Omeprazole 20

CR

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

 

 

Probitor

SZ

MP NP

C4074 C4075 C4089 C4152

P4075 P4089 P4152

30

5

30

 

 

 

Tablet 10 mg (as magnesium)

Oral

Losec Tablets

AP

MP NP

C1337 C1476 C1533

 

30

5

30

 

 

[81]              Schedule 1, after entry for Paraffin in the form Eye ointment, compound, containing white soft paraffin with liquid paraffin, 3.5 g
[Poly Visc] [Max Quantity 2; Number of Repeats 11]

insert in the columns in the order indicated:

 

Eye ointment, compound, containing liquid paraffin, light liquid paraffin, wool fat, white soft paraffin and retinyl palmitate, 5 g

Application to the eye

VitA-POS

AE

MP NP AO

 

 

2

5

1

 

 

 

 

 

 

 

MP

 

P4072

2

11

1

 

 

[82]            Schedule 1, entry for Pazopanib

substitute:

Pazopanib

Tablet 200 mg (as hydrochloride)

Oral

Votrient

GK

MP

C4067 C4109 C4112 C4148

P4112

30

5

30

 

 

 

 

 

 

 

 

C4067 C4109 C4112 C4148

P4148

90

2

90

 

 

 

 

 

 

 

 

C4067 C4109 C4112 C4148

P4067 P4109

90

5

90

 

 

 

Tablet 400 mg (as hydrochloride)

Oral

Votrient

GK

MP

C4067 C4109 C4112 C4148

P4112

30

5

30

 

 

 

 

 

 

 

 

C4067 C4109 C4112 C4148

P4148

60

2

60

 

 

 

 

 

 

 

 

C4067 C4109 C4112 C4148

P4067 P4109

60

5

60

 

 

[83]            Schedule 1, entry for Pravastatin in the form Tablet containing pravastatin sodium 10 mg

(a) omit:

 

 

 

GenRx Pravastatin

GX

MP

C1540 C3047

P1540

30

5

30

 

 

 

 

 

 

 

NP

C1540

 

30

5

30

 

 

(b) omit:

 

 

 

GenRx Pravastatin

GX

MP

C1540 C3047

P3047

30

11

30

 

 

[84]            Schedule 1, entry for Pravastatin in the form Tablet containing pravastatin sodium 20 mg

(a) omit:

 

 

 

GenRx Pravastatin

GX

MP

C1540 C3047

P1540

30

5

30

 

 

 

 

 

 

 

NP

C1540

 

30

5

30

 

 

(b) omit:

 

 

 

GenRx Pravastatin

GX

MP

C1540 C3047

P3047

30

11

30

 

 

[85]            Schedule 1, entry for Pravastatin in the form Tablet containing pravastatin sodium 40 mg

(a) omit:

 

 

 

GenRx Pravastatin

GX

MP

C1540 C3047

P1540

30

5

30

 

 

 

 

 

 

 

NP

C1540

 

30

5

30

 

 

(b) omit:

 

 

 

GenRx Pravastatin

GX

MP

C1540 C3047

P3047

30

11

30

 

 

[86]            Schedule 1, entry for Rabeprazole

substitute:

Rabeprazole

Tablet containing rabeprazole sodium 10 mg (enteric coated)

Oral

APO-Rabeprazole

TX

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Chem mart Rabeprazole

CH

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Pariet

JC

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Parzole 10

ZP

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Prabez

AF

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Rabeprazole-GA

GM

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Rabeprazole generichealth

GQ

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Rabeprazole Pfizer

FZ

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Rabeprazole Sandoz

SZ

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Rabzole

JS

MP NP

C1337 C1533

 

28

5

28

 

 

 

 

 

Terry White Chemists Rabeprazole

TW

MP NP

C1337 C1533

 

28

5

28

 

 

 

Tablet containing rabeprazole sodium 20 mg (enteric coated)

Oral

APO-Rabeprazole

TX

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Chem mart Rabeprazole

CH

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Pariet

JC

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Parzole 20

ZP

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Prabez

AF

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Rabeprazole-GA

GM

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Rabeprazole generichealth

GQ

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Rabeprazole Pfizer

FZ

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Rabeprazole Sandoz

SZ

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Rabzole

JS

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

Terry White Chemists Rabeprazole

TW

MP NP

C1177 C1337 C1533

P1177

30

2

30

 

 

 

 

 

APO-Rabeprazole

TX

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Chem mart Rabeprazole

CH

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Pariet

JC

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Parzole 20

ZP

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Prabez

AF

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Rabeprazole-GA

GM

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Rabeprazole generichealth

GQ

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Rabeprazole Pfizer

FZ

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Rabeprazole Sandoz

SZ

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Rabzole

JS

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

 

 

 

Terry White Chemists Rabeprazole

TW

MP NP

C1177 C1337 C1533

P1337 P1533

30

5

30

 

 

[87]            Schedule 1, entry for Raloxifene

omit from the column headed “Circumstances”: C2647 substitute: C4071

[88]            Schedule 1, entry for Ranitidine in the form Tablet 300 mg (as hydrochloride)

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Ranoxyl

GM

MP NP

 

 

30

5

30

 

 

[89]            Schedule 1, entry for Riluzole

substitute:

Riluzole

Tablet 50 mg

Oral

APO-Riluzole

TX

MP NP

C1762 C2718

 

56

5

56

 

 

 

 

 

Rilutek

SW

MP NP

C1762 C2718

 

56

5

56

 

 

 

 

 

Riluzole Sandoz

SZ

MP NP

C1762 C2718

 

56

5

56

 

 

[90]            Schedule 1, entry for Risedronic Acid in each of the forms: Tablet containing risedronate sodium 5 mg; Tablet containing risedronate sodium 35 mg; Tablet (enteric coated) containing risedronate sodium 35 mg; and Tablet containing risedronate sodium 150 mg

omit from the column headed “Circumstances” (all instances):

C2645

C2646

C3070

 

substitute:

C4117

C4122

C4123

 

[91]            Schedule 1, entry for Risedronic Acid and Calcium

substitute”:

Risedronic Acid and Calcium

Pack containing 4 tablets risedronate sodium 35 mg and 24 tablets calcium 500 mg (as carbonate)

Oral

Acris Combi

AF

MP NP

C4117 C4122 C4123

 

1

5

1

 

 

 

 

 

Actonel Combi

SW

MP NP

C4117 C4122 C4123

 

1

5

1

 

 

 

Pack containing 4 enteric coated tablets risedronate sodium 35 mg and 24 tablets calcium 500 mg (as carbonate)

Oral

Actonel EC Combi

SW

MP NP

C4117 C4122 C4123

 

1

5

1

 

 

 

 

 

Risedronate Winthrop  EC Combi

WA

MP NP

C4117 C4122 C4123

 

1

5

1

 

 

[92]            Schedule 1, entry for Risedronic acid and calcium with colecalciferol

omit from the column headed “Circumstances” (all instances):

C2645

C2646

C3070

 

substitute:

C4117

C4122

C4123

 

[93]            Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [APO-Risperidone; Max Quantiy 60; Number of Repeats 2]

omit from the column headed “Pack Quantity”:  60 substitute: 20

[94]            Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [Risperdal; Max Quantiy 60; Number of Repeats 2]

omit from the column headed “Pack Quantity”:  60 substitute: 20

[95]            Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [APO-Risperidone; Max Quantiy 60; Number of Repeats 5]

omit from the column headed “Pack Quantity”:  60 substitute: 20

[96]            Schedule 1, entry for Risperidone in the form Tablet 0.5 mg [Risperdal; Max Quantiy 60; Number of Repeats 5]

omit from the column headed “Pack Quantity”:  60 substitute: 20

[97]            Schedule 1, after entry for Rivaroxaban in the form Tablet 10 mg [Max Quantity 30; Number of Repeats 0]

insert in the columns in the order indicated:

 

Tablet 15 mg

Oral

Xarelto

BN

MP NP

C4098

 

42

0

42

 

 

 

Tablet 20 mg

Oral

Xarelto

BN

MP NP

C4099 C4132

 

28

5

28

 

 

[98]            Schedule 1, entry for Simvastatin in the form Tablet 20 mg

(a) omit:

 

 

 

GenRx Simvastatin

GX

MP

C1540 C3047

P1540

30

5

30

 

 

 

 

 

 

 

NP

C1540

 

30

5

30

 

 

(b) omit:

 

 

 

GenRx Simvastatin

GX

MP

C1540 C3047

P3047

30

11

30

 

 

[99]            Schedule 1, entry for Simvastatin in the form Tablet 40 mg

(a) omit:

 

 

 

GenRx Simvastatin

GX

MP

C1540 C3047

P1540

30

5

30

 

 

 

 

 

 

 

NP

C1540

 

30

5

30

 

 

(b) omit:

 

 

 

GenRx Simvastatin

GX

MP

C1540 C3047

P3047

30

11

30

 

 


[100]         Schedule 1, entry for Simvastatin in the form Tablet 80 mg

(a) omit:

 

 

 

GenRx Simvastatin

GX

MP

C1540 C3047

P1540

30

5

30

 

 

 

 

 

 

 

NP

C1540

 

30

5

30

 

 

(b) omit:

 

 

 

GenRx Simvastatin

GX

MP

C1540 C3047

P3047

30

11

30

 

 

[101]         Schedule 1, entry for Strontium

omit from the column headed “Circumstances”:

C2647

C2758

substitute:

C4071

C4107

[102]         Schedule 1, entry for Sumatriptan in the form Tablet 50 mg (as succinate)

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Sumatriptan RBX

RA

MP NP

C3233

 

4

5

4

 

 

[103]         Schedule 1, entry for Sunitinib

substitute:

 

Sunitinib

Capsule 12.5 mg (as malate)

Oral

Sutent

PF

MP

C3206 C3207 C4106 C4119

P3206 P3207 P4119

28

1

28

 

 

 

 

 

 

 

MP

C3206 C3207 C4106 C4119

P4106

28

3

28

 

 

 

Capsule 25 mg (as malate)

Oral

Sutent

PF

MP

C3206 C3207 C4106 C4119

P3206 P3207 P4119

28

1

28

 

 

 

 

 

 

 

MP

C3206 C3207 C4106 C4119

P4106

28

3

28

 

 

 

Capsule 50 mg (as malate)

Oral

Sutent

PF

MP

C3206 C3207 C4106 C4119

P3206 P3207 P4119

28

1

28

 

 

 

 

 

 

 

MP

C3206 C3207 C4106 C4119

P4106

28

3

28

 

 

[104]         Schedule 1, entry for Terbinafine in the form Tablet 250 mg (as hydrochloride) [Max Quantity 42; Number of Repeats 0]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Pharmacy Choice Terbinafine

RI

MP NP

C2191 C2865 C3244

P2865 P3244

42

0

42

 

 

[105]         Schedule 1, entry for Terbinafine in the form Tablet 250 mg (as hydrochloride) [Max Quantity 42; Number of Repeats 1]

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

Pharmacy Choice Terbinafine

RI

MP NP

C2191 C2865 C3244

P2191

42

1

42

 

 

[106]         Schedule 1, entry for Teriparatide

omit from the column headed “Circumstances”:

C4031

C4032

substitute:

C4101

C4113

[107]         Schedule 1, entry for Venlafaxine in each of the forms: Capsule (modified release) 75 mg (as hydrochloride); and Capsule (modified release) 150 mg (as hydrochloride)

insert in the columns in the order indicated, and in alphabetical order for the column headed “Brand”:

 

 

 

STADA Venlafaxine SR

TD

MP NP

C1211

 

28

5

28

 

 

[108]         Schedule 1, entry for Zoledronic acid in the form Solution for I.V. infusion 5 mg (as monohydrate) in 100 mL

omit from the column headed “Circumstances”:

C3290

C3945

C3946

C3947

substitute:

C3290

C4100

C4149

C4157


[109]         Schedule 3

omit:

HA

Hamilton Pharmaceutical Pty Ltd

 93 008 204 635

[110]         Schedule 3, after details relevant to Responsible person code JJ

insert:

JS

Janssen-Cilag Pty Ltd

 47 000 129 975

[111]         Schedule 3, after details relevant to Responsible person code RD

insert:

RI

Dr Reddy's Laboratories (Australia) Pty Ltd

 16 120 092 408

[112]         Schedule 4, Part 1, after entry for Adrenaline

insert:

Aflibercept

C4153

 

 

Subfoveal choroidal neovascularisation (CNV)

Initial treatment

Must be treated by a ophthalmologist;

The condition must be due to age-related macular degeneration (AMD);

The condition must be diagnosed by fluorescein angiography;

The treatment must be the sole PBS-subsidised therapy for this condition

Authority approval for initial treatment of each eye must be sought

The first authority application for each eye must be made in writing or by telephone

A written application must include:

(a) a completed authority prescription form;

(b) a completed Subfoveal Choroidal Neovascularisation (CNV) PBS Supporting Information Form; and

(c) a copy of the fluorescein angiogram

A telephone application must be made following submission by facsimile of a copy of a completed Subfoveal Choroidal Neovascularisation (CNV) - PBS Supporting Information Form and a copy of the fluorescein angiogram. The original documentation must be submitted to the Chief Executive Medicare by post after the application has been authorised

Where a fluorescein angiogram cannot be performed due to a contraindication as listed in the TGA-approved product information, details of the contraindication must be provided. A copy of the report of an alternative method of diagnosis must be included in the application, for example, optical coherence tomography (OCT) or red free photography

Compliance with Written or Telephone Authority Required procedures

 

 

C4154

 

 

Subfoveal choroidal neovascularisation (CNV)

Continuing treatment

Must be treated by a ophthalmologist;

The condition must be due to age-related macular degeneration (AMD);

The treatment must be the sole PBS-subsidised therapy for this condition;

Patient must have previously been granted an authority prescription for the same eye

Compliance with Written or Telephone Authority Required procedures

 

[113]         Schedule 4, Part 1, entry for Alendronic Acid

substitute:

Alendronic Acid

C3256

 

 

Symptomatic Paget disease of bone

Compliance with Authority Required procedures - Streamlined Authority Code 3256

 

C4122

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122

 

C4123

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4123

 

C4133

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4133

[114]         Schedule 4, Part 1, entry for Alendronic acid with colecalciferol

substitute:

Alendronic acid with colecalciferol

C4070

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4070

 

C4087

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4087

 

C4110

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4110

 

C4122

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122

 

C4123

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4123

 

C4133

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4133

[115]         Schedule 4, Part 1, entry for Alendronic acid with colecalciferol and calcium

substitute:

Alendronic acid with colecalciferol and calcium

C4122

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122

 

C4123

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4123

 

C4133

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4133

[116]         Schedule 4, Part 1, after entry for Atazanavir

insert:

Atenolol

C4076

 

 

For a patient who is unable to take a solid dose form of atenolol
 

 

[117]         Schedule 4, Part 1, entry for Bevacizumab [Circumstances Code C3894]

omit from the column headed “Circumstances and Purposes”:  performace substitute: performance

[118]         Schedule 4, Part 1, entry for Bortezomib

substitute:

Bortezomib

C4079

 

 

Multiple myeloma

Retreatment of Progressive disease - Initial PBS-subsidised treatment

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must have progressive disease;

Patient must have previously been treated with PBS-subsidised bortezomib;

Patient must have experienced at least a partial response to the most recent course of PBS-subsidised bortezomib therapy;

Patient must not be receiving concomitant PBS-subsidised lenalidomide;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

Progressive disease is defined as at least 1 of the following:

(a) at least a 25% increase and an absolute increase of at least 5 g per L in serum M protein (monoclonal protein); or

(b) at least a 25% increase in 24-hour urinary light chain M protein excretion, and an absolute increase of at least 200 mg per 24 hours; or

(c) in oligo-secretory and non-secretory myeloma patients only, at least a 50% increase of the difference between involved free light chain and uninvolved free light chain; or

(d) at least a 25% relative increase and at least a 10% absolute increase in plasma cells in a bone marrow aspirate or on biopsy; or

(e) an increase in the size or number of lytic bone lesions (not including compression fractures); or

(f) at least a 25% increase in the size of an existing or the development of a new soft tissue plasmacytoma (determined by clinical examination or diagnostic imaging); or

(g) development of hypercalcaemia (corrected serum calcium greater than 2.65 mmol per L not attributable to any other cause)

Oligo-secretory and non-secretory patients are defined as having active disease with less than 10 g per L serum M protein

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or

(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or

(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application - Supporting Information Form which includes details of the basis of the current diagnosis of progressive disease and nomination of which disease activity parameters will be used to assess response; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response to the most recent course of PBS-subsidised bortezomib, if not previously provided; and

(4) a signed patient acknowledgment

To enable confirmation of eligibility for treatment current diagnostic reports of at least one of the following must be provided:

(a) the level of serum monoclonal protein; or

(b) Bence-Jones proteinuria - the results of 24-hour urinary light chain M protein excretion; or

(c) the serum level of free kappa and lambda light chains; or

(d) bone marrow aspirate or trephine; or

(e) if present, the size and location of lytic bone lesions (not including compression fractures); or

(f) if present, the size and location of all soft tissue plasmacytomas by clinical or radiographic examination i.e. MRI or CT-scan; or

(g) if present, the level of hypercalcaemia, corrected for albumin concentration

As these parameters will be used to determine response, results for either (a) or (b) or (c) should be provided for all patients. Where the patient has oligo-secretory or non-secretory multiple myeloma, either (c) or (d) or if relevant (e), (f) or (g) should be provided

Where the prescriber plans to assess response in patients with oligo-secretory or non-secretory multiple myeloma with free light chain assays, evidence of the oligo-secretory or non-secretory nature of the multiple myeloma (current serum M protein less than 10 g per L) must be provided

Compliance with Written Authority Required procedures

 

C4080

 

 

Multiple myeloma

Retreatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must have previously received 8 treatment cycles of bortezomib in the current treatment course;

Patient must have demonstrated at the completion of cycle 8 at least a partial response to bortezomib;

Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;

Patient must not have a gap of more than 10 months between the initial application and an application following completion of 8 treatment cycles;

Patient must not receive more than 3 cycles of bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or

(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or

(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 9, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

Compliance with Written Authority Required procedures

 

C4081

 

 

Multiple myeloma

Treatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must have previously received 8 treatment cycles of bortezomib for progressive disease;

Patient must have demonstrated at the completion of cycle 8 at least a partial response to bortezomib;

Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;

Patient must not have a gap of more than 10 months between the initial application and an application following completion of 8 treatment cycles;

Patient must not receive more than 3 cycles of bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels.
If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or

(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or

(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 9, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

Compliance with Written Authority Required procedures

 

C4082

 

 

Symptomatic multiple myeloma

Continuing PBS-subsidised treatment

Patient must have received an initial authority prescription for bortezomib for newly diagnosed symptomatic multiple myeloma and be ineligible for high dose chemotherapy;

Patient must not have demonstrated progressive disease at the time of application;

Patient must not have achieved a best confirmed response to bortezomib at the time of application;

Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;

The treatment must be in combination with a corticosteroid and melphalan or cyclophosphamide;

Patient must not receive more than 5 cycles of treatment with bortezomib under this restriction

Continuing PBS-subsidised supply will not be approved if there is a gap of more than 6 months between the initial application and this application

Compliance with Written or Telephone Authority Required procedures

 

C4103

 

 

Symptomatic multiple myeloma

Patient must be newly diagnosed;

Patient must be eligible for high dose chemotherapy and autologous stem cell transplantation;

Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;

The treatment must be in combination with chemotherapy;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma; and

(3) a signed patient acknowledgement

Compliance with Written Authority Required procedures

 

C4126

 

 

Multiple myeloma

Treatment of Progressive disease - Initial PBS-subsidised treatment

The condition must be confirmed by a histological diagnosis;

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must have progressive disease after at least one prior therapy;

Patient must have undergone or be ineligible for a primary stem cell transplant;

Patient must have experienced treatment failure after a trial of at least four (4) weeks of thalidomide at a dose of at least 100 mg daily or have failed to achieve at least a minimal response after eight (8) or more weeks of thalidomide-based therapy for progressive disease;

Patient must not be receiving concomitant PBS-subsidised lenalidomide;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

Progressive disease is defined as at least 1 of the following:

(a) at least a 25% increase and an absolute increase of at least 5 g per L in serum M protein (monoclonal protein); or

(b) at least a 25% increase in 24-hour urinary light chain M protein excretion, and an absolute increase of at least 200 mg per 24 hours; or

(c) in oligo-secretory and non-secretory myeloma patients only, at least a 50% increase of the difference between involved free light chain and uninvolved free light chain; or

(d) at least a 25% relative increase and at least a 10% absolute increase in plasma cells in a bone marrow aspirate or on biopsy; or

(e) an increase in the size or number of lytic bone lesions (not including compression fractures); or

(f) at least a 25% increase in the size of an existing or the development of a new soft tissue plasmacytoma (determined by clinical examination or diagnostic imaging); or

(g) development of hypercalcaemia (corrected serum calcium greater than 2.65 mmol per L not attributable to any other cause)

Oligo-secretory and non-secretory patients are defined as having active disease with less than 10 g per L serum M protein

Thalidomide treatment failure is defined as:

(1) confirmed disease progression during thalidomide treatment or within 6 months of discontinuing thalidomide treatment; or

(2) severe intolerance or toxicity unresponsive to clinically appropriate dose adjustment

Severe intolerance due to thalidomide is defined as unacceptable somnolence or sedation interfering with activities of daily living

Toxicity from thalidomide is defined as peripheral neuropathy (Grade 2 or greater, interfering with function), drug-related seizures, serious Grade 3 or 4 drug-related dermatological reactions, such as Stevens-Johnson Syndrome, or other Grade 3 or 4 toxicity

Failure to achieve at least a minimal response after 8 or more weeks of thalidomide-based therapy for progressive disease is defined as:

(1) less than a 25% reduction in serum or urine M protein; or

(2) in oligo-secretory and non-secretory myeloma patients only, less than a 25% reduction in the difference between involved and uninvolved serum free light chain levels

If the dosing requirement for thalidomide cannot be met, the application must state the reasons why this criterion cannot be satisfied

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application - Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma, prior treatments including name(s) of drug(s) and date of most recent treatment cycle and record of prior stem cell transplant or ineligibility for prior stem cell transplant; details of thalidomide treatment failure; details of the basis of the diagnosis of progressive disease or failure to respond; and nomination of which disease activity parameters will be used to assess response; and

(3) duration of thalidomide and daily dose prescribed; and

(4) a signed patient acknowledgment

To enable confirmation of eligibility for treatment, current diagnostic reports of at least one of the following must be provided:

(a) the level of serum monoclonal protein; or

(b) Bence-Jones proteinuria - the results of 24-hour urinary light chain M protein excretion; or

(c) the serum level of free kappa and lambda light chains; or

(d) bone marrow aspirate or trephine; or

(e) if present, the size and location of lytic bone lesions (not including compression fractures); or

(f) if present, the size and location of all soft tissue plasmacytomas by clinical or radiographic examination i.e. MRI or CT-scan; or

(g) if present, the level of hypercalcaemia, corrected for albumin concentration

As these parameters will be used to determine response, results for either (a) or (b) or (c) should be provided for all patients. Where the patient has oligo-secretory or non-secretory multiple myeloma, either (c) or (d) or if relevant (e), (f) or (g) should be provided

Where the prescriber plans to assess response in patients with oligo-secretory or non-secretory multiple myeloma with free light chain assays, evidence of the oligo-secretory or non-secretory nature of the multiple myeloma (current serum M protein less than 10 g per L) must be provided

Compliance with Written Authority Required procedures

 

C4127

 

 

Symptomatic multiple myeloma

Initial PBS-subsidised treatment

Patient must be newly diagnosed;

Patient must have severe acute renal failure;

Patient must require dialysis; OR

Patient must be at high risk of requiring dialysis in the opinion of a nephrologist;

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma, the name of the nephrologist who has reviewed the patient and the date of review, a copy of the current pathology reports reporting Glomerular Filtration Rate from an Approved Pathology Authority, and nomination of the disease activity parameter(s) that will be used to assess response; and

(3) a signed patient acknowledgement

Disease activity parameters include current diagnostic reports of at least one of the following:

(a) the level of serum monoclonal protein; or

(b) Bence-Jones proteinuria - the results of 24-hour urinary light chain M protein excretion; or

(c) in oligo-secretory and non-secretory myeloma patients only, the serum level of free kappa and lambda light chains; or

(d) bone marrow aspirate or trephine; or

(e) if present, the size and location of lytic bone lesions (not including compression fractures); or

(f) if present, the size and location of all soft tissue plasmacytomas by clinical or radiographic examination i.e. Magnetic Resonance Imaging (MRI) or computed tomography (CT) scan; or

(g) if present, the level of hypercalcaemia, corrected for albumin concentration

As these parameters will be used to determine response, results for either (a) or (b) or (c) should be provided for all patients

Where the patient has oligo-secretory or non-secretory multiple myeloma, either (c) or (d) or if relevant (e), (f) or (g) should be provided

Where the prescriber plans to assess response in patients with oligo-secretory or non-secretory multiple myeloma with free light chain assays, evidence of the oligo-secretory or non-secretory nature of the multiple myeloma (current serum M protein less than 10 g per L) must be provided

Compliance with Written Authority Required procedures

 

C4141

 

 

Symptomatic multiple myeloma

Continuing PBS-subsidised treatment

Patient must have received an initial authority prescription for bortezomib for newly diagnosed symptomatic multiple myeloma and have severe acute renal failure;

Patient must have demonstrated at least a partial response at the completion of cycle 4 at the time of application;

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;

Patient must not receive more than 5 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form, which includes a copy of the current pathology reports reporting Glomerular Filtration Rate from an Approved Pathology authority; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are not being used to monitor disease activity, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or

(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or

(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Continuing PBS-subsidised supply will not be approved if there is a gap of more than 6 months between the initial application and this application

Compliance with Written or Telephone Authority Required procedures

 

C4161

 

 

Multiple myeloma

Retreatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must have previously received 4 treatment cycles of bortezomib in the current treatment course;

Patient must have demonstrated at the completion of cycle 4 at least a partial response to bortezomib;

Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;

Patient must not have a gap of more than 6 months between the initial application and subsequent applications;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or

(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or

(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 5, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

Compliance with Written Authority Required procedures

 

C4162

 

 

Multiple myeloma

Treatment of Progressive disease - Continuing PBS-subsidised treatment

The treatment must be as monotherapy; OR

The treatment must be in combination with a corticosteroid and/or cyclophosphamide;

Patient must have previously received 4 treatment cycles of bortezomib for progressive disease;

Patient must have demonstrated at the completion of cycle 4 at least a partial response to bortezomib;

Patient must not have received 2 treatment cycles after first achieving a confirmed complete response;

Patient must not have a gap of more than 6 months between the initial application and subsequent applications;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information form; and

(3) diagnostic reports demonstrating the patient has achieved at least a partial response

If serum M protein is measurable, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 50% reduction in the level of serum M protein (monoclonal protein)

If urine Bence-Jones protein levels are being used to monitor disease activity, partial response (PR) compared with baseline (prior to treatment with bortezomib) is defined as at least a 90% reduction in 24-hour urinary light chain M protein excretion or to less than 200 mg per 24 hours

If serum M protein is unmeasurable as in non-secretory/oligo-secretory multiple myeloma, partial response compared with baseline is defined as at least a 50% reduction in the difference between involved and uninvolved serum free light chain (FLC) levels

If serum M protein and urine Bence-Jones protein and serum FLC are unmeasurable/unavailable, partial response compared with baseline is defined as:

(a) at least a 50% reduction in bone marrow plasma cells; or

(b) no increase in size or number of lytic bone lesions (development of compression fracture does not exclude response); or

(c) at least a 50% reduction in the size of soft tissue plasmacytoma (by clinical or applicable radiographic examination, i.e. MRI or CT-Scan); or

(d) normalisation of corrected serum calcium to less than or equal to 2.65 mmol per L

Diagnostic reports must be no more than one month old at the time of application

Where a response assessment is not submitted prior to cycle 5, patients will be deemed to have failed to respond to treatment with bortezomib

Confirmation of complete response requires 2 determinations a minimum of 6 weeks apart

Compliance with Written Authority Required procedures

 

C4163

 

 

Symptomatic multiple myeloma

Initial PBS-subsidised treatment

Patient must be newly diagnosed;

Patient must be ineligible for high dose chemotherapy;

Patient must not be receiving PBS-subsidised thalidomide or lenalidomide;

The treatment must be in combination with a corticosteroid and melphalan or cyclophosphamide;

Patient must not receive more than 4 cycles of treatment with bortezomib under this restriction

The authority application must be made in writing and must include:

(1) a completed authority prescription form; and

(2) a completed Multiple Myeloma bortezomib Authority Application Supporting Information Form, which includes details of the histological diagnosis of multiple myeloma and ineligibility for high dose chemotherapy; and

(3) a signed patient acknowledgement

Compliance with Written Authority Required procedures

[119]         Schedule 4, Part 1, entry for Cabazitaxel

substitute:

 

C4073

 

 

Where the patient is receiving treatment in the community setting or at/from a Private Hospital

Castration resistant metastatic carcinoma of the prostate

The treatment must be in combination with prednisone or prednisolone;

Patient must have failed treatment with docetaxel due to resistance or intolerance;

Patient must have a WHO performance status of 2 or less

Compliance with Authority Required procedures

 

C4138

 

 

Where the patient is receiving treatment at/from a Public Hospital

Castration resistant metastatic carcinoma of the prostate

The treatment must be in combination with prednisone or prednisolone;

Patient must have failed treatment with docetaxel due to resistance or intolerance;

Patient must have a WHO performance status of 2 or less

Compliance with Authority Required procedures - Streamlined Authority Code 4138

[120]         Schedule 4, Part 1, entry for Denosumab

substitute:

Denosumab

C4094

 

 

Osteoporosis

Patient must be female;

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -2.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4094

 

C4145

 

 

Established post-menopausal osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4145

 

C4150

 

 

Bone metastases

The condition must be due to castration-resistant prostate cancer

Compliance with Authority Required procedures - Streamlined Authority Code 4150

 

C4158

 

 

Bone metastases

The condition must be due to breast cancer

Compliance with Authority Required procedures - Streamlined Authority Code 4158

[121]         Schedule 4, Part 1, entry for Docetaxel

substitute:

Docetaxel

C3888

 

 

Neoadjuvant treatment of a patient with a World Health Organisation performance status of 1 or less, with inoperable Stage III, IVa or IVb squamous cell carcinoma of the oral cavity, larynx, oropharynx or hypopharynx, in combination with cisplatin and fluorouracil

Compliance with Authority Required procedures - Streamlined Authority Code 3888

 

C3892

 

 

Adjuvant treatment of operable breast cancer in combination with cyclophosphamide

Compliance with Authority Required procedures - Streamlined Authority Code 3892

 

C3916

 

 

Adjuvant treatment of node-positive breast cancer in combination with an anthracycline and cyclophosphamide

Compliance with Authority Required procedures - Streamlined Authority Code 3916

 

C3956

 

 

Treatment of HER2 positive breast cancer in combination with trastuzumab

Compliance with Authority Required procedures - Streamlined Authority Code 3956

 

C4078

 

 

Locally advanced or metastatic non-small cell lung cancer

 

Compliance with Authority Required procedures - Streamlined Authority Code 4078

 

 

C4140

 

 

Advanced metastatic ovarian cancer

Patient must have failed prior therapy which included a platinum compound

Compliance with Authority Required procedures - Streamlined Authority Code 4140

 

 

C4155

 

 

Androgen independent (castration resistant) metastatic carcinoma of the prostate

Patient must have a Karnofsky performance status score of at least 60%;

The treatment must be used as first-line chemotherapy;

The treatment must be administered in three weekly cycles;

Patient must not receive more than 10 cycles of treatment with docetaxel under this restriction

Compliance with Authority Required procedures - Streamlined Authority Code 4155
 

 

C4160

 

 

Metastatic breast cancer

Compliance with Authority Required procedures - Streamlined Authority Code 4160

 

[122]         Schedule 4, Part 1, entry for Etanercept

(a)        omit:

 

C4057

P4057

 

Chronic plaque psoriasis (Whole body) [Initial treatment — No prior biological agent]

Initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who:

(a) has severe chronic plaque psoriasis where lesions have been present for at least 6 months from the time of initial diagnosis; and

(b) has not received any prior PBS-subsidised treatment with etanercept for this condition; and

(c) whose parent or authorised guardian has signed a patient acknowledgement; and

(d) has failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 2 of the following 3 treatments:

(i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

(ii) methotrexate at a dose of at least 10 mg or 10 mg per square metre weekly (whichever is lowest) for at least 6 weeks; and/or

(iii) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks

If treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or where phototherapy is contraindicated, please provide details at the time of application

If intolerance to treatment with phototherapy, methotrexate or acitretin develops during the relevant period of use, which is of a severity to necessitate permanent treatment withdrawal, please provide details of the degree of this toxicity at the time of application

The following initiation criterion indicates failure to achieve an adequate response and must be demonstrated in all patients at the time of the application:

(a) A current Psoriasis Area and Severity Index (PASI) score of greater than 15, as assessed, preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment

(b) A PASI assessment must be completed for each prior treatment course, preferably whilst still on treatment, but no longer than 1 month following cessation of each course of treatment

(c) The most recent PASI assessment must be no more than 1 month old at the time of application

Applications for authorisation must be made in writing and must include:

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:

(i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition; and

(ii) details of previous phototherapy and systemic drug therapy [dosage (where applicable), date of commencement and duration of therapy]; and

(iii) the parent or authorised guardian signed patient and prescriber acknowledgements

A maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment

A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this initial course of treatment.  Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept

An adequate response to treatment is defined as:

Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, when compared with the pre-etanercept treatment baseline value

Compliance with Written Authority Required procedures

 

 

 

 

Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has severe chronic plaque psoriasis and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course

Compliance with Written or Telephone Authority Required procedures

 

C4058

P4058

 

Chronic plaque psoriasis (Whole body) [Re-Treatment — Received prior etanercept under PBS]

Treatment as systemic monotherapy (other than methotrexate) by a dermatologist for a patient under 18 years who has:

(a) a documented history of severe chronic plaque psoriasis; and

(b) received prior PBS-subsidised treatment with etanercept for this condition; and

(c) not failed PBS-subsidised therapy with etanercept for the treatment of this condition more than once in the current Treatment Cycle

Applications for authorisation must be made in writing and must include:

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:

(i) the completed current Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition; and

(ii) details of prior etanercept treatment, including date

A total maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment

A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this course of treatment. Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept

Compliance with Written Authority Required procedures

 

 

 

 

Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has a documented history of severe chronic plaque psoriasis, who has previously received PBS-subsidised treatment with etanercept for this condition, and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course

Compliance with Written or Telephone Authority Required procedures

 

C4059

P4059

 

Chronic plaque psoriasis (Face, hand, foot) [Initial treatment — No prior biological agent]

Initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who:

(a) has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot where the plaque or plaques have been present for at least 6 months from the time of initial diagnosis; and

(b) has not received any prior PBS-subsidised treatment with etanercept for this condition; and

(c) whose parent or authorised guardian has signed a patient acknowledgement; and

(d) has failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 2 of the following 3 treatments:

(i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or

(ii) methotrexate at a dose of at least 10 mg or 10 mg per square metre weekly (whichever is lowest) for at least 6 weeks; and/or

(iii) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks

If treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or where phototherapy is contraindicated, please provide details at the time of application

If intolerance to treatment with phototherapy, methotrexate or acitretin develops during the relevant period of use, which is of a severity to necessitate permanent treatment withdrawal, please provide details of the degree of this toxicity at the time of application

The following initiation criterion indicates failure to achieve an adequate response and must be demonstrated in all patients at the time of the application:

(a) Chronic plaque psoriasis classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot where:

(i) at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling are rated as severe or very severe, as assessed, preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment; or

(ii) the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed, preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment

(b) A PASI assessment must be completed for each prior treatment course, preferably whilst still on treatment, but no longer than 1 month following cessation of each course of treatment

(c) The most recent PASI assessment must be no more than 1 month old at the time of application

Applications for authorisation must be made in writing and must include:

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:

(i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area diagrams including the dates of assessment of the patient's condition; and

(ii) details of previous phototherapy and systemic drug therapy [dosage (where applicable), date of commencement and duration of therapy]; and

(iii) the parent or authorised guardian signed patient and prescriber acknowledgements

A maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment

A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated.  This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this initial course of treatment.  Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept

An adequate response to treatment is defined as:

A Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, when compared with the pre-etanercept treatment baseline value

Compliance with Written Authority Required procedures

 

 

 

 

Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course

Compliance with Written or Telephone Authority Required procedures

 

C4060

P4060

 

Chronic plaque psoriasis (Face, hand, foot) [Re-Treatment — Received prior etanercept under PBS]

Treatment as systemic monotherapy (other than methotrexate) by a dermatologist for a patient under 18 years who has:

(a) a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and

(b) received prior PBS-subsidised treatment with etanercept for this condition; and

(c) not failed PBS-subsidised therapy with etanercept for the treatment of this condition more than once in the current Treatment Cycle

Applications for authorisation must be made in writing and must include:

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:

(i) the completed current Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area diagrams including the dates of assessment of the patient's condition; and

(ii) details of prior etanercept treatment, including date

A total maximum of 24 weeks of treatment with etanercept will be authorised under this restriction. A maximum of 16 weeks treatment with etanercept will be authorised for the primary application. The balance of treatment, a further 8 weeks treatment, will be authorised if the submitted PASI assessment shows an adequate demonstrated response to treatment

A PASI assessment of the patient's response to the initial 16 week course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment under this restriction, must be submitted to the Chief Executive Medicare no later than 1 month from the date of completion of this course of treatment. Where a response assessment is not undertaken and submitted to the Chief Executive Medicare within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept

Compliance with Written Authority Required procedures

 

 

 

 

Continuation of initial treatment as systemic monotherapy (other than methotrexate) by a dermatologist of a patient under 18 years who has a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, who has previously received PBS-subsidised treatment with etanercept for this condition, and who, although qualifying for an initial 16 week course of treatment with etanercept under the criteria specified above, has previously been issued with an authority prescription for less than 16 weeks of etanercept treatment, and where approval of the application would enable the patient to complete the initial 16 week treatment course

Compliance with Written or Telephone Authority Required procedures

(b)        insert in numerical order following existing text:

 

C4088

P4088

 

Severe chronic plaque psoriasis

Initial treatment or Re-treatment (Whole body) - completion of course

Must be treated by a dermatologist;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;

Patient must have received 16 weeks treatment under the Initial treatment (whole body) restriction for severe chronic plaque psoriasis; OR

Patient must have received 16 weeks treatment under the Re-treatment (whole body) restriction for severe chronic plaque psoriasis;

Patient must have demonstrated an adequate response to treatment;

Patient must not receive more than 8 weeks of treatment with etanercept under this restriction

An adequate response to treatment is defined as:

A Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, when compared with the pre-etanercept treatment baseline value

The authority application must be made in writing and must include:

(a) a completed authority prescription form; and

(b) the completed current Psoriasis Area and Severity Index (PASI) calculation sheet including the date of assessment of the patient's condition

The same body area assessed at the baseline PASI assessment must be assessed for demonstration of response to treatment for the purposes of gaining approval for the remainder of 24 weeks treatment

A PASI assessment of the patient's response to the initial course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment, must be submitted no later than 1 month from the date of completion of this initial course of treatment. Where a response assessment is not undertaken and submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept

 

Compliance with Written Authority Required procedures

 

 

C4114

P4114

 

Severe chronic plaque psoriasis

Initial treatment or Re-treatment (Whole body) - balance of first supply

Must be treated by a dermatologist;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;

Patient must have received insufficient therapy under the Initial treatment (whole body) restriction for severe chronic plaque psoriasis to complete 16 weeks treatment; OR

Patient must have received insufficient therapy under the Re-treatment (whole body) restriction for severe chronic plaque psoriasis to complete 16 weeks treatment;

The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions

Compliance with Written or Telephone Authority Required procedures

 

 

C4115

P4115

 

Severe chronic plaque psoriasis

Initial treatment (Face, hand, foot)

Must be treated by a dermatologist;

Patient must be under 18 years of age and a parent or authorised guardian must have signed a patient acknowledgement;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;
Patient must have the plaque or plaques of the face, or palm of hand or sole of foot present for at least 6 months from the time of initial diagnosis;

Patient must not have received any prior PBS-subsidised treatment with etanercept for this condition; OR

Patient must not have received any PBS-subsidised treatment with etanercept for this condition for at least 12 months;

Patient must have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 2 of the following 3 treatments: (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or (ii) methotrexate at a dose of at least 10 mg or 10 mg per square metre weekly (whichever is lowest) for at least 6 weeks; and/or (iii)acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

Patient must not receive more than 16 weeks of treatment with etanercept under this restriction

Where treatment with any of the above-mentioned drugs was contraindicated according to the relevant TGA-approved Product Information, or where phototherapy was contraindicated, details must be provided at the time of application

Where intolerance to phototherapy, methotrexate and/or acitretin developed during the relevant period of use, which was of a severity to necessitate permanent treatment withdrawal, details of the degree of this toxicity must be provided at the time of application

The following criterion indicates failure to achieve an adequate response to prior treatment and must be demonstrated in a patient at the time of the application:

(a) Chronic plaque psoriasis classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot where:

(i) at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling are rated as severe or very severe, as assessed, preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment; or

(ii) the skin area affected is 30% or more of the face, palm of a hand or sole of a foot, as assessed, preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment;

(b) A PASI assessment must be completed for each prior treatment course, preferably whilst still on treatment, but no longer than 1 month following cessation of each course of treatment

(c) The most recent PASI assessment must be no more than 1 month old at the time of application

The authority application must be made in writing and must include:

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:

(i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets, and face, hand, foot area diagrams including the dates of assessment of the patient's condition

(ii) details of previous phototherapy and systemic drug therapy [dosage (where applicable), date of commencement and duration of therapy]; and

(iii) the parent or authorised guardian signed patient and prescriber acknowledgements

Where a patient has had a 12 month treatment break, the length of the break is measured from the date the most recent treatment was stopped to the date of the application to re-commence treatment

Compliance with Written Authority Required procedures

 

 

C4116

P4116

 

Severe chronic plaque psoriasis

Initial treatment or Re-treatment (Face, hand, foot) - completion of course

Must be treated by a dermatologist;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;

Patient must have received 16 weeks treatment under the Initial treatment (Face, hand, foot) restriction for severe chronic plaque psoriasis; OR

Patient must have received 16 weeks treatment under the Re-treatment (Face, hand, foot) restriction for severe chronic plaque psoriasis;

Patient must have demonstrated an adequate response to treatment;

Patient must not receive more than 8 weeks of treatment with etanercept under this restriction

An adequate response to treatment is defined as the plaque or plaques assessed prior to biological treatment showing:

(i) a reduction in the PASI symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, as compared to the pre-biological treatment baseline values; or

(ii) a reduction by 75% or more in the skin area affected, or sustained at this level, as compared to the pre-biological treatment baseline value

The authority application must be made in writing and must include:

(a) a completed authority prescription form; and

(b) the completed current Psoriasis Area and Severity Index (PASI) calculation sheet including the date of assessment of the patient's condition

The same body area assessed at the baseline PASI assessment must be assessed for demonstration of response to treatment for the purposes of gaining approval for the remainder of 24 weeks treatment

A PASI assessment of the patient's response to the initial course of treatment must be made after at least 12 weeks of treatment so that there is adequate time for a response to be demonstrated. This assessment, which will be used to determine eligibility for a further 8 weeks of treatment, must be submitted no later than 1 month from the date of completion of this initial course of treatment. Where a response assessment is not undertaken and submitted within these timeframes, the patient will be deemed to have failed to respond to treatment with etanercept

Compliance with Written Authority Required procedures

 

 

C4125

P4125

 

Severe chronic plaque psoriasis

Re-treatment (Whole body)

Must be treated by a dermatologist;

Patient must be under 18 years of age;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;

Patient must have a documented history of severe chronic plaque psoriasis of the whole body;

Patient must have received prior PBS-subsidised treatment with etanercept for this condition in the past 12 months;

Patient must have demonstrated a response to etanercept and experienced a disease flare; OR

Patient must not have failed more than once to achieve an adequate response with etanercept;

Patient must not receive more than 16 weeks of treatment with etanercept under this restriction

A patient is eligible for re-treatment due to disease flare if there is a 50% or greater change in the patients PASI score or the patient has a current PASI score of greater than 15, compared to the most recent response assessment following cessation of the most recent 24 weeks of PBS-subsidised etanercept

The authority application must be made in writing and must include:

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information which includes the following:

(i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition; and

(ii) details of prior etanercept treatment, including date ceased

Where a patient has had a treatment break the length of the break is measured from the date the most recent treatment was stopped to the date of the application for further treatment

Compliance with Written Authority Required procedures

 

 

C4136

P4136

 

Severe chronic plaque psoriasis

Initial treatment of Re-treatment (Face, hand, foot) - balance of first supply

Must be treated by a dermatologist;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;

Patient must have received insufficient therapy under the Initial treatment (Face, hand, foot) restriction for severe chronic plaque psoriasis to complete 16 weeks treatment; OR

Patient must have received insufficient therapy under the Re-treatment (Face, hand, foot) restriction for severe chronic plaque psoriasis to complete 16 weeks treatment;

The treatment must provide no more than the balance of up to 16 weeks treatment available under the above restrictions

Compliance with Written or Telephone Authority Required procedures

 

 

C4137

P4137

 

Severe chronic plaque psoriasis

Re-treatment (Face, hand, foot)

Must be treated by a dermatologist;

Patient must be under 18 years of age;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;

Patient must have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot;

Patient must have received prior PBS-subsidised treatment with etanercept for this condition in the past 12 months

Patient must have demonstrated a response to etanercept and experienced a disease flare; OR

Patient must not have failed more than once to achieve an adequate response with etanercept;

Patient must not receive more than 16 weeks of treatment with etanercept under this restriction

A patient is eligible for re-treatment due to disease flare if:

(i) all subscores are rated moderate to severe or 2 of the 3 subscores are rated severe to very severe; or

(ii) the skin area affected is a 50% or greater change or the area affected is 30% or more of the face, palm of a hand or sole of a foot, compared to the most recent response assessment following cessation of the most recent 24 weeks of PBS-subsidised etanercept

The authority application must be made in writing and must include :

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information which includes the following:

(i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets and face, hand, foot area digrams including the dates of assessment of the patient's condition; and

(ii) details of prior etanercept treatment, including date ceased

Where a patient has had a treatment break the length of the break is measured from the date the most recent treatment was stopped to the date of the application for further treatment

Compliance with Written Authority Required procedures

 

 

C4151

P4151

 

Severe chronic plaque psoriasis

Initial treatment (whole body)

Must be treated by a dermatologist;

Patient must be under 18 years of age and a parent or authorised guardian must have signed a patient acknowledgement;

The treatment must be as systemic monotherapy; OR

The treatment must be in combination with methotrexate;

Patient must have lesions present for at least 6 months from the time of initial diagnosis;

Patient must not have received any prior PBS-subsidised treatment with etanercept for this condition; OR

Patient must not have received any PBS-subsidised treatment with etanercept for this condition for at least 12 months;

Patient must have failed to achieve an adequate response, as demonstrated by a Psoriasis Area and Severity Index (PASI) assessment, to at least 2 of the following 3 treatments: (i) phototherapy (UVB or PUVA) for 3 treatments per week for at least 6 weeks; and/or (ii) methotrexate at a dose of at least 10 mg or 10 mg per square metre weekly (whichever is lowest) for at least 6 weeks; and/or (iii) acitretin at a dose of at least 0.4 mg per kg per day for at least 6 weeks;

Patient must not receive more than 16 weeks of treatment with etanercept under this restriction

Where treatment with any of the above-mentioned drugs was contraindicated according to the relevant TGA-approved Product Information, or where phototherapy was contraindicated, details must be provided at the time of application

Where intolerance to phototherapy, methotrexate and/or acitretin developed during the relevant period of use, which was of a severity to necessitate permanent treatment withdrawal, details of the degree of this toxicity must be provided at the time of application

The following criterion indicates failure to achieve an adequate response to prior treatment and must be demonstrated in a patient at the time of the application:

(a) A current Psoriasis Area and Severity Index (PASI) score of greater than 15, as assessed, preferably whilst still on treatment, but no longer than 1 month following cessation of the most recent prior treatment

(b) A PASI assessment must be completed for each prior treatment course, preferably whilst still on treatment, but no longer than 1 month following cessation of each course of treatment

(c) The most recent PASI assessment must be no more than 1 month old at the time of application

The authority application must be made in writing and must include:

(a) a completed authority prescription form; and

(b) a completed Severe Chronic Plaque Psoriasis in Patients Less Than 18 Years PBS Authority Application - Supporting Information Form which includes the following:

(i) the completed current and previous Psoriasis Area and Severity Index (PASI) calculation sheets including the dates of assessment of the patient's condition and

(ii) details of previous phototherapy and systemic drug therapy [dosage (where applicable), date of commencement and duration of therapy]; and

(iii) the parent or authorised guardian signed patient and prescriber acknowledgements

Where a patient has had a 12 month treatment break, the length of the break is measured from the date the most recent treatment was stopped to the date of the application to re-commence treatment

Compliance with Written Authority Required procedures

 

[123]         Schedule 4, Part 1, entry for Ezetimibe with Simvastatin

substitute:

Ezetimibe with Simvastatin

C4068

 

 

Hypercholesterolaemia

The treatment must be in conjunction with dietary therapy and exercise;

Patient must have cholesterol levels that are inadequately controlled with an HMG CoA reductase inhibitor (statin);

Patient must have coronary heart disease

Inadequate control with a statin is defined as follows:

(1) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs includes an initial cholesterol threshold for PBS-subsidy (i.e. a patient not in a very high risk category), a cholesterol level in excess of that threshold after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated; or

(2) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs allows PBS-subsidised treatment with a statin at any cholesterol level (i.e. a very high risk category patient), a cholesterol level in excess of 4 mmol per L after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4068

 

C4069

 

 

Hypercholesterolaemia

The treatment must be in conjunction with dietary therapy and exercise;

Patient must have cholesterol levels that are inadequately controlled with an HMG CoA reductase inhibitor (statin);

Patient must have heterozygous familial hypercholesterolaemia

Inadequate control with a statin is defined as follows:

(1) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs includes an initial cholesterol threshold for PBS-subsidy (i.e. a patient not in a very high risk category), a cholesterol level in excess of that threshold after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated; or

(2) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs allows PBS-subsidised treatment with a statin at any cholesterol level (i.e. a very high risk category patient), a cholesterol level in excess of 4 mmol per L after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4069

 

C4085

 

 

Hypercholesterolaemia

The treatment must be in conjunction with dietary therapy and exercise;

Patient must have cholesterol levels that are inadequately controlled with an HMG CoA reductase inhibitor (statin);

Patient must have diabetes mellitus

Inadequate control with a statin is defined as follows:

(1) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs includes an initial cholesterol threshold for PBS-subsidy (i.e. a patient not in a very high risk category), a cholesterol level in excess of that threshold after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated; or

(2) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs allows PBS-subsidised treatment with a statin at any cholesterol level (i.e. a very high risk category patient), a cholesterol level in excess of 4 mmol per L after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4085

 

C4086

 

 

Hypercholesterolaemia

The treatment must be in conjunction with dietary therapy and exercise;

Patient must have cholesterol levels that are inadequately controlled with an HMG CoA reductase inhibitor (statin);

Patient must have peripheral vascular disease

Inadequate control with a statin is defined as follows:

(1) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs includes an initial cholesterol threshold for PBS-subsidy (i.e. a patient not in a very high risk category), a cholesterol level in excess of that threshold after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated; or

(2) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs allows PBS-subsidised treatment with a statin at any cholesterol level (i.e. a very high risk category patient), a cholesterol level in excess of 4 mmol per L after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4086

 

C4096

 

 

Hypercholesterolaemia

The treatment must be in conjunction with dietary therapy and exercise;

Patient must have cholesterol levels that are inadequately controlled with an HMG CoA reductase inhibitor (statin);

Patient must have symptomatic cerebrovascular disease

Inadequate control with a statin is defined as follows:

(1) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs includes an initial cholesterol threshold for PBS-subsidy (i.e. a patient not in a very high risk category), a cholesterol level in excess of that threshold after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated; or

(2) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs allows PBS-subsidised treatment with a statin at any cholesterol level (i.e. a very high risk category patient), a cholesterol level in excess of 4 mmol per L after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4096

 

C4097

 

 

Hypercholesterolaemia

Patient must have homozygous familial hypercholesterolaemia;

Patient must be eligible for PBS-subsidised lipid-lowering medication (according to the criteria set out in the General Statement for Lipid-Lowering Drugs)

Compliance with Authority Required procedures - Streamlined Authority Code 4097

 

C4120

 

 

Hypercholesterolaemia

The treatment must be in conjunction with dietary therapy and exercise;

Patient must have cholesterol levels that are inadequately controlled with an HMG CoA reductase inhibitor (statin);

Patient must have a family history of coronary heart disease;

Inadequate control with a statin is defined as follows:

(1) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs includes an initial cholesterol threshold for PBS-subsidy (i.e. a patient not in a very high risk category), a cholesterol level in excess of that threshold after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated; or

(2) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs allows PBS-subsidised treatment with a statin at any cholesterol level (i.e. a very high risk category patient), a cholesterol level in excess of 4 mmol per L after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4120

 

C4121

 

 

Hypercholesterolaemia

The treatment must be in conjunction with dietary therapy and exercise;

Patient must have cholesterol levels that are inadequately controlled with an HMG CoA reductase inhibitor (statin);

Patient must have hypertension

Inadequate control with a statin is defined as follows:

(1) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs includes an initial cholesterol threshold for PBS-subsidy (i.e. a patient not in a very high risk category), a cholesterol level in excess of that threshold after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated; or

(2) where the patient falls into a category for which the General Statement for Lipid-Lowering Drugs allows PBS-subsidised treatment with a statin at any cholesterol level (i.e. a very high risk category patient), a cholesterol level in excess of 4 mmol per L after at least 3 months of treatment at a maximum tolerated dose of a statin, in conjunction with dietary therapy and exercise. The dose and duration of statin treatment and the cholesterol level which shows inadequate control must be documented in the patient's medical records when ezetimibe is initiated. The cholesterol level which shows inadequate control must be no more than 2 months old when ezetimibe is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4121

 

C4147

 

 

Hypercholesterolaemia

Patient must be eligible for PBS-subsidised lipid-lowering medication (according to the criteria set out in the General Statement for Lipid-Lowering Drugs);

Patient must have developed a clinically important product-related adverse event during treatment with an HMG CoA reductase inhibitor (statin) necessitating a reduction in the statin dose

A clinically important product-related adverse event is defined as follows:

(i) Severe myalgia (muscle symptoms without creatine kinase elevation) which is proven to be temporally associated with statin treatment; or

(ii) Myositis (clinically important creatine kinase elevation, with or without muscle symptoms) demonstrated by results twice the upper limit of normal on a single reading or a rising pattern on consecutive measurements and which is unexplained by other causes; or

(iii) Unexplained, persistent elevations of serum transaminases (greater than 3 times the upper limit of normal) during treatment with a statin

Compliance with Authority Required procedures - Streamlined Authority Code 4147

[124]         Schedule 4, Part 1, entry for Granisetron

substitute:

Granisetron

C4077

P4077

 

Nausea and vomiting

The condition must be associated with cytotoxic chemotherapy being used to treat malignancy which occurs within 48 hours of chemotherapy administration

 

 

C4092

P4092

 

Nausea and vomiting

The condition must be associated with radiotherapy being used to treat malignancy

Compliance with Authority Required procedures - Streamlined Authority Code 4092

 

 

C4102

P4102

 

Nausea and vomiting

The condition must be associated with radiotherapy being used to treat malignancy.
 

Compliance with Authority Required procedures - Streamlined Authority Code 4102

 

C4118

P4118

 

Nausea and vomiting

The condition must be associated with cytotoxic chemotherapy being used to treat malignancy which occurs within 48 hours of chemotherapy administration

 

[125]         Schedule 4, Part 1, after entry for High fat formula with vitamins, minerals and trace elements and low in protein and carbohydrate

insert:

Hyaluronic Acid

C4105

 

 

Severe dry eye syndrome

Patient must be sensitive to preservatives in multi-dose eye drops.
 

Compliance with Authority Required procedures - Streamlined Authority Code 4105

 

C4130

 

 

Severe dry eye syndrome

Patient must be sensitive to preservatives in multi-dose eye drops.
 

Compliance with Authority Required procedures
 

[126]         Schedule 4, Part 1, entry for Hydroxocobalamin

substitute:

Hydroxocobalamin

C4111

 

 

Pernicious anaemia

 

 

C4134

 

 

Proven vitamin B12 deficiencies other than pernicious anaemia

 

 

C4135

 

 

Anaemias associated with vitamin B12 deficiency

Patient must have had a gastrectomy;

The treatment must be for prophylaxis

 

[127]         Schedule 4, Part 1, entry for Mycophenolic Acid

insert in numerical order following existing text:

 

C4084

 

 

Prophylaxis of renal allograft rejection

Management

The treatment must be under the supervision and direction of a transplant unit

Compliance with Authority Required procedures - Streamlined Authority Code 4084
 

 

C4095

 

 

WHO Class III, IV or V lupus nephritis

Management

The condition must be proven by biopsy;

Must be treated by a nephrologist or in consultation with a nephrologist

The name of the consulting nephrologist must be included in the patient medical records

Compliance with Authority Required procedures - Streamlined Authority Code 4095

 

 

C4108

 

 

Prophylaxis of renal allograft rejection

Management

The treatment must be under the supervision and direction of a transplant unit

 

Compliance with Written or Telephone Authority Required procedures
 

 

C4131

P4131

 

WHO Class III, IV or V lupus nephritis

Maintenance

The condition must be proven by biopsy;

Patient must have received initiation treatment;

The treatment must be under the supervision and direction of a nephrologist reviewing the patient

The name of the nephrologist reviewing treatment and the date of the latest review, which must be within the last 12 months, must be included in the authority application

 

Compliance with Written or Telephone Authority Required procedures
 

 

C4146

 

 

WHO Class III, IV or V lupus nephritis

Management

The condition must be proven by biopsy;

Must be treated by a nephrologist or in consultation with a nephrologist

The name of the consulting nephrologist must be included in the patient medical records

Compliance with Written or Telephone Authority Required procedures
 

[128]         Schedule 4, Part 1, entry for Naproxen

(a)        omit:

 

C3647

P3647

 

Initial supply, for up to 4 months, for a palliative care patient where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Compliance with Authority Required procedures - Streamlined Authority Code 3647

 

C3648

P3648

 

Continuing supply for a palliative care patient where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Compliance with Authority Required procedures - Streamlined Authority Code 3648

(b)        insert in numerical order following existing text:

 

C4124

P4124

 

Bone pain

The condition must be due to malignant disease;

Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent

 

Compliance with Authority Required procedures - Streamlined Authority Code 4124

 

C4128

P4128

 

Severe pain

Initial treatment

Patient must be undergoing palliative care;

Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent;

Patient must not receive more than 4 months treatment under this restriction

 

Compliance with Authority Required procedures - Streamlined Authority Code 4128

 

C4129

P4129

 

Severe pain

Continuing treatment

Patient must be undergoing palliative care;

Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Compliance with Authority Required procedures - Streamlined Authority Code 4129

 

C4159

P4159

 

Chronic arthropathies (including osteoarthritis)

The condition must have an inflammatory component;

Patient must be unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Compliance with Authority Required procedures - Streamlined Authority Code 4159

[129]         Schedule 4, Part 1, entry for Omeprazole

substitute:

Omeprazole

C1337

 

 

Scleroderma oesophagus

 

 

C1476

 

 

Zollinger-Ellison syndrome

 

 

C1533

 

 

Gastro-oesophageal reflux disease

 

 

C4074

P4074

 

Peptic ulcer

Initial treatment

 

 

C4075

P4075

 

Zollinger-Ellison syndrome

 

 

C4089

P4089

 

Gastro-oesophageal reflux disease

 

 

C4152

P4152

 

Scleroderma oesophagus

 

[130]         Schedule 4, Part 1, entry for Paraffin

insert in numerical order following existing text:

 

 

P4072

 

For use in patients who are receiving treatment under a GP Management Plan or Team Care Arrangements where Medicare benefits were or are payable for the preparation of the Plan or coordination of the Arrangements

 

 

[131]         Schedule 4, Part 1, entry for Pazopanib

substitute:

Pazopanib

C4067

P4067

 

Stage IV clear cell variant renal cell carcinoma (RCC)

Initial treatment

Patient must have been receiving treatment with pazopanib prior to 1 October 2012;

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures
 

 

C4109

P4109

 

Stage IV clear cell variant renal cell carcinoma (RCC)

Continuing treatment beyond 3 months

Patient must have previously been issued with an authority prescription for pazopanib;

Patient must have stable or responding disease according to the Response Evaluation Criteria In Solid Tumours (RECIST);

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures
 

 

C4112

P4112

 

Stage IV clear cell variant renal cell carcinoma (RCC)

Continuing treatment beyond 3 months

Patient must have previously been issued with an authority prescription for pazopanib;

Patient must have stable or responding disease according to the Response Evaluation Criteria In Solid Tumours (RECIST);

Patient must require dose adjustment;

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures
 

 

C4148

P4148

 

Stage IV clear cell variant renal cell carcinoma (RCC)

Initial treatment

Patient must meet the Memorial Sloan Kettering Cancer Centre (MSKCC) low to intermediate risk group criteria;

Patient must have a WHO performance status of 2 or less;

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Patients who have progressive disease on sunitinib are not eligible to receive PBS-subsidised pazopanib

Compliance with Authority Required procedures
 

[132]         Schedule 4, Part 1, entry for Raloxifene

substitute:

Raloxifene

C4071

 

 

Established post-menopausal osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4071

 

[133]         Schedule 4, Part 1, entry for Risedronic Acid

substitute:

Risedronic Acid

C3256

 

 

Symptomatic Paget disease of bone

 

Compliance with Authority Required procedures - Streamlined Authority Code 3256
 

 

C4117

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4117

 

 

C4122

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122
 

 

C4123

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4123

 

[134]         Schedule 4, Part 1, entry for Risedronic Acid and Calcium

substitute:

Risedronic Acid and Calcium

C4117

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4117

 

 

C4122

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122

 

 

C4123

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4123

 

[135]         Schedule 4, Part 1, entry for Risedronic acid and calcium with colecalciferol

substitute:

Risedronic acid and calcium with colecalciferol

C4117

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4117

 

 

C4122

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4122

 

 

C4123

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4123

 

[136]         Schedule 4, Part 1, entry for Rivaroxaban

insert in numerical order following existing text:

 

C4098

 

 

 

Deep vein thrombosis

Initial treatment

Patient must have confirmed acute symptomatic deep vein thrombosis;

Patient must not have symptomatic pulmonary embolism

Compliance with Authority Required procedures - Streamlined Authority Code 4098
 

 

C4099

 

 

Deep vein thrombosis

Continuing treatment

Patient must have confirmed acute symptomatic deep vein thrombosis;

Patient must not have symptomatic pulmonary embolism

Compliance with Authority Required procedures - Streamlined Authority Code 4099
 

 

C4132

 

 

Prevention of recurrent venous thromboembolism

Continuing treatment

Patient must have a history of venous thromboembolism

 

Compliance with Authority Required procedures - Streamlined Authority Code 4132
 

[137]         Schedule 4, Part 1, entry for Strontium

substitute:

Strontium

C4071

 

 

Established post-menopausal osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4071

 

 

C4107

 

 

Osteoporosis

Patient must be female;

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4107

 

[138]         Schedule 4, Part 1, entry for Sunitinib

substitute:

Sunitinib

C3206

P3206

 

Initial PBS-subsidised treatment as monotherapy of a patient with World Health Organisation performance status of 2 or less with a metastatic or unresectable malignant gastrointestinal stromal tumour after failure of imatinib mesylate treatment due to resistance or intolerance, and where the application for authorisation includes:

(1) a completed copy of the appropriate Sunitinib Malate (Sutent) PBS Authority Application for Use in the Treatment of Gastrointestinal Stromal Tumour - Supporting Information Form; and

(2) a signed patient acknowledgement

 

Compliance with Written Authority Required procedures

 

C3207

P3207

 

Continuing PBS-subsidised treatment as monotherapy of a patient with World Health Organisation performance status of 2 or less with a metastatic or unresectable malignant gastrointestinal stromal tumour who has previously been issued with an authority prescription for sunitinib and who does not have progressive disease on sunitinib
 

Compliance with Written or Telephone Authority Required procedures
 

 

C4106

P4106

 

Stage IV clear cell variant renal cell carcinoma (RCC)

Continuing treatment beyond 3 months

Patient must have previously been issued with an authority prescription for sunitinib;

Patient must have stable or responding disease according to the Response Evaluation Criteria In Solid Tumours (RECIST);

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Compliance with Authority Required procedures
 

 

C4119

P4119

 

Stage IV clear cell variant renal cell carcinoma (RCC)

Initial treatment

Patient must meet the Memorial Sloan Kettering Cancer Centre (MSKCC) low to intermediate risk group criteria;

Patient must have a WHO performance status of 2 or less;

The treatment must be the sole PBS-subsidised tyrosine kinase inhibitor therapy for this condition

Patients who have developed progressive disease on pazopanib are not eligible to receive PBS-subsidised sunitinib

Compliance with Authority Required procedures
 

[139]         Schedule 4, Part 1, entry for Teriparatide

substitute:

Teriparatide

C4101

 

 

Severe established osteoporosis

Initial treatment

Must be treated by a specialist; OR

Must be treated by a consultant physician;

Patient must be at very high risk of fracture;

Patient must have a bone mineral density (BMD) T-score of -3.0 or less;

Patient must have had 2 or more fractures due to minimal trauma;

Patient must have experienced at least 1 symptomatic new fracture after at least 12 months continuous therapy with an anti-resorptive agent at adequate doses;

The treatment must be the sole PBS-subsidised agent;

The treatment must not exceed a lifetime maximum of 18 months therapy

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

If treatment with anti-resorptive therapy is contraindicated according to the relevant TGA-approved Product Information, details of the contraindication must be provided at the time of application

If an intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use of one anti-resorptive agent, alternate anti-resorptive agents must be trialled so that the patient achieves the minimum requirement of 12 months continuous therapy. Details must be provided at the time of application

Anti-resorptive therapies for osteoporosis and their adequate doses which will be accepted for the purposes of administering this restriction are alendronate sodium 10 mg per day or 70 mg once weekly, risedronate sodium 5 mg per day or 35 mg once weekly or 150 mg once monthly, raloxifene hydrochloride 60 mg per day (women only), denosumab 60 mg once every 6 months, strontium ranelate 2 g per day and zoledronic acid 5 mg per annum

Details of prior anti-resorptive therapy, fracture history including the date(s), site(s), the symptoms associated with the fracture(s) which developed after at least 12 months continuous anti-resorptive therapy and the score of the qualifying BMD measurement must be provided at the time of application

 

Compliance with Authority Required procedures

 

 

4113

 

 

Severe established osteoporosis

Continuing treatment

Patient must have previously been issued with an authority prescription for this drug;

The treatment must not exceed a lifetime maximum of 18 months therapy

Compliance with Authority Required procedures
 

[140]         Schedule 4, Part 1, entry for Zoledronic acid

(a)        omit:

 

C3945

 

 

Treatment as the sole PBS-subsidised anti-resorptive agent for corticosteroid-induced osteoporosis in a patient currently on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy with a bone mineral density T-score of -1.5 or less, and where the duration and dose of corticosteroid therapy, and the date, site (femoral neck or lumbar spine) and score of the qualifying bone mineral density measurement, are documented in the patient's medical records when treatment is initiated, and where PBS-subsidised treatment is limited to 1 dose per patient each year

Compliance with Authority Required procedures - Streamlined Authority Code 3945

 

C3946

 

 

Treatment as the sole PBS-subsidised anti-resorptive agent for established osteoporosis in a patient with fracture due to minimal trauma, where the fracture has been demonstrated radiologically and the year of plain x-ray or computed tomography scan or magnetic resonance imaging scan is documented in the patient's medical records when treatment is initiated, provided that if the fracture is a vertebral fracture, there is a 20% or greater reduction in height of the anterior or mid portion of the affected vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body, and where PBS-subsidised treatment is limited to 1 dose per patient per year

Compliance with Authority Required procedures - Streamlined Authority Code 3946
 

 

C3947

 

 

Treatment as the sole PBS-subsidised anti-resorptive agent for osteoporosis in a patient aged 70 years of age or older with a bone mineral density T-score of -3.0 or less, where the date, site (femoral neck or lumbar spine) and score of the qualifying bone mineral density measurement are documented in the patient's medical records when treatment is initiated, and where PBS-subsidised treatment is limited to 1 dose per patient each year

Compliance with Authority Required procedures - Streamlined Authority Code 3947

(b)        insert in numerical order following existing text:

 

C4100

 

 

Corticosteroid-induced osteoporosis

Patient must currently be on long-term (at least 3 months), high-dose (at least 7.5 mg per day prednisolone or equivalent) corticosteroid therapy;

Patient must have a Bone Mineral Density (BMD) T-score of -1.5 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition;

Patient must not receive more than one PBS-subsidised treatment per year

The duration and dose of corticosteroid therapy together with the date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4100

 

 

C4149

 

 

Osteoporosis

Patient must be aged 70 years or older;

Patient must have a Bone Mineral Density (BMD) T-score of -3.0 or less;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition;

Patient must not receive more than one PBS-subsidised treatment per year

The date, site (femoral neck or lumbar spine) and score of the qualifying BMD measurement must be documented in the patient's medical records when treatment is initiated

Compliance with Authority Required procedures - Streamlined Authority Code 4149

 

 

C4157

 

 

Established osteoporosis

Patient must have fracture due to minimal trauma;

Patient must not receive concomitant treatment with any other PBS-subsidised anti-resorptive agent for this condition;

Patient must not receive more than one PBS-subsidised treatment per year

The fracture must have been demonstrated radiologically and the year of plain x-ray or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan must be documented in the patient's medical records when treatment is initiated

A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body

Compliance with Authority Required procedures - Streamlined Authority Code 4157

 

 

 

 

 

 

 

]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Note

All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. 

See http://www.frli.gov.au.