Severe chronic plaque psoriasis

The PBS subsidises biological agents for adult patients with severe chronic plaque psoriasis.

Biological agents as systemic monotherapy other than methotrexate can be subsidised through the Pharmaceutical Benefits Scheme (PBS) under sections 85 and 100 of the National Health Act 1953 for adult patients with severe chronic plaque psoriasis.

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

Section 100 arrangements only for infliximab

This item is available to a patient who is attending:

  • an approved private hospital
  • a public participating hospital, or
  • a public hospital

and is a:

  • day admitted patient
  • non-admitted patient, or
  • patient on discharge

This items is not PBS subsidised for in patients of the hospital. You must include the hospital name and provider number on the authority application form.

Patient eligibility

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

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

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

Toxicity criteria and severity descriptors

Use the severe chronic plaque psoriasis toxicity criteria and severity descriptors in conjunction with the authority application when demonstrating the patient’s intolerance to acitretin, methotrexate, cyclosporin or phototherapy.

Demonstration of a response

The same indices of disease severity used to establish the baseline must be used for all continuing treatment authority applications. This ensures consistency in demonstrating a response.

You can provide new baseline Psoriasis Area and Severity Index (PASI) assessment when applying to change or recommence PBS subsidised treatment with biological agents.

Once a patient has failed or ceased to respond to treatment with a maximum of 3 different biological agents, they are deemed to have completed a treatment cycle and must have, at a minimum, a 5 year break in PBS subsidised biological agent treatment before they are eligible to commence a new treatment cycle.

Applications

Patients must be treated by a dermatologist.

Initial treatment

Make all initial applications for authority approval to prescribe biological agents for the treatment of severe chronic plaque psoriasis in writing and:

All applications must include a completed:

Initial grandfather treatment – ixekizumab only

For patients who received non-PBS subsidised ixekizumab before 1 February 2017 for the treatment of severe chronic plaque psoriasis, make all initial grandfather applications in writing and:

All applications must include a completed:

Continuing, changing or recommencing treatment

Make all applications for authority approval to continue, change or recommence PBS subsidised biological agents for the treatment of severe chronic plaque psoriasis in writing and:

All applications must include a completed:

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

Subsequent continuing treatment with etanercept biosimilar as per the PBS restriction is Authority Required (Streamlined) and doesn't require prior authority approval from the Department of Human Services.

Further information

For more information call the PBS Complex Drugs Programs enquiry line.

Page last updated: 4 December 2017