Systemic Juvenile idiopathic arthritis Initial PBS authority application Supporting information form (PB117)

You must lodge this form for a patient under 18 years of age starting initial PBS subsidised treatment with tocilizumab for the treatment of severe active systemic juvenile idiopathic arthritis (sJIA) or recommencing PBS subsidised tocilizumab treatment for the treatment of sJIA after a break in treatment which is at least 12 months. This form must be completed by a paediatric rheumatologist or a prescriber under the supervision of a paediatric rheumatology treatment centre.

 

Page last updated: 13 July 2016

This information was printed Thursday 29 September 2016 from humanservices.gov.au/health-professionals/forms/pb117 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.