Acromegaly Initial PBS Authority application form (PB181)

Use this form for a patient aged 18 years or older, who has acromegaly.

Use this form if the patient is either starting initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with pasireotide or has been on treatment with pasireotide prior to 1 September 2016.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 14 October 2016

This information was printed Monday 24 October 2016 from It may not include all of the relevant information on this topic. Please consider any relevant site notices at when using this material.