Severe active granulomatosis with polyangiitis or severe active microscopic polyangiitis Initial PBS Authority application Supporting information form (PB174)

You must lodge this form for induction of remission for a patient starting initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with rituximab for severe active granulomatosis with polyangiitisor severe active microscopic polyangiitis, or reinduction of remission for a patient who has previously received and responded to PBS subsidised treatment with rituximab for these conditions.

 

Page last updated: 5 February 2016

This information was printed Friday 30 September 2016 from humanservices.gov.au/health-professionals/forms/pb174 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.