Acute Lymphoblastic Leukaemia Ponatinib - Initial PBS Authority application Supporting information form (PB169)

Use this form for a patient starting initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with ponatinib for acute lymphoblastic leukaemia.

 

Page last updated: 5 February 2016

This information was printed Thursday 29 September 2016 from humanservices.gov.au/health-professionals/forms/pb169 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.