Ankylosing spondylitis

The Pharmaceutical Benefits Scheme (PBS) subsidises biological agents for patients with ankylosing spondylitis.

Patient eligibility

The PBS subsidises treatment with biological agents under the National Health Act 1953, sections 85 and 100 for an adult patient with ankylosing spondylitis.

Where the term biological agent appears it refers to adalimumab, certolizumab, etanercept, golimumab, infliximab and secukinumab.

Patients must be eligible for the PBS and meet the relevant restrictions criteria.

The Schedule of Pharmaceutical Benefits on the PBS website outlines restrictions for prescribing biological agents.

Section 100 arrangements

Infliximab only

Infliximab is only available for a day admitted patient, non-admitted patients, or patients on discharge who are attending either:

  • an approved private hospital
  • a public participating hospital
  • a public hospital.

Infliximab isn’t PBS subsidised for hospital in-patients. You must include the hospital name and provider number on the authority application form.

Toxicity and severity descriptors

When demonstrating a patient’s intolerance to prior treatment, use the ankylosing spondylitis toxicity criteria and severity descriptors with the authority application.

Treatment specifics

The treating rheumatologist or a clinical immunologist with expertise in managing active ankylosing spondylitis must complete all applications.

Applications

Initial treatment

Apply for initial authority approval to prescribe PBS subsidised biological agents to treat ankylosing spondylitis in writing and either:

All applications must include the completed:

Initial grandfather treatment secukinumab only

For patients who received non-PBS subsidised secukinumab treatment before 1 October 2016 for ankylosing spondylitis, apply for initial grandfather approval in writing and either:

All applications must include the completed:

Changing or recommencing treatment

Apply for authority approval to change and recommence PBS subsidised biological agents to treat ankylosing spondylitis in writing and either:

All applications must include the completed:

You can use this authority application form to submit a demonstration to the current PBS subsidised treatment.

Continuing treatment

Apply for authority approval to continue PBS subsidised biological agents to treat ankylosing spondylitis in writing and either:

All applications must include the completed:

After we approve the first application for continuing treatment with infliximab, subsequent continuing applications for biosimilar brands are:

  • S100 - HSD (Public) - Authority Required (Streamlined) and don’t require authority approval from us
  • S100 - HSD (Private) - Authority Required (Telephone) - you can call the PBS authority approvals line to request authority approval.

After we approve the first application for continuing treatment with etanercept, subsequent continuing applications for biosimilar brands of etanercept are Authority Required (Streamlined). They don’t need prior authority approval from us.

More information

Call the PBS Complex Drugs Programs enquiry line for more information.

Page last updated: 1 November 2018