Ulcerative colitis

The PBS subsidises adalimumab, golimumab, infliximab and vedolizumab for patients with moderate to severe ulcerative colitis.

Patient eligibility

Treatment with adalimumab, golimumab, infliximab and vedolizumab can be subsidised through the Pharmaceutical Benefits Scheme (PBS) under the National Health Act 1953, Sections 85 and 100 for moderate to severe ulcerative colitis.

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

The Schedule of Pharmaceutical Benefits outlines restrictions for prescribing adalimumab, golimumab, infliximab and vedolizumab.

Treatment with golimumab and vedolizumab are only available to adult patients.

Section 100 arrangements (infliximab and vedolizumab only)

These items are only for day admitted patients, non-admitted patients, or patients on discharge who are attending:

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

These items are not PBS subsidised for hospital in-patients. You must include the hospital name and provider number on the authority application form.

Toxicity and severity descriptors

Use the ulcerative colitis toxicity criteria and severity descriptors with the authority application when demonstrating a patient’s intolerance to prior treatments.

Applications

All applications must be completed by one of the following specialists with expertise in the management of moderate to severe ulcerative colitis:

  • gastroenterologist (code 87)
  • consultant physician, internal medicine specialising in gastroenterology (code 81)
  • consultant physician, general medicine specialising in gastroenterology (code 82)
  • paediatrician (paediatric patients only)
  • specialist paediatric gastroenterologist (paediatric patients only)

Adult patients

Initial treatment

Make all initial applications for authority approval to start, change or recommence PBS subsidised adalimumab, golimumab, infliximab and vedolizumab for the treatment of moderate to severe ulcerative colitis in writing and:

All applications must include the completed:

Initial grandfather treatment

For patients who received non-PBS subsidised vedolizumab treatment before 1 August 2015 or golimumab treatment before 1 June 2018 for the treatment of moderate to severe ulcerative colitis, make all initial grandfather applications in writing and:

All applications must include the completed:

A patient may qualify for PBS subsidised treatment under this restriction once only

Paediatric patients

Initial treatment

Make all initial applications for authority approval to start, change or recommence PBS subsidised adalimumab or infliximab for the treatment of moderate to severe ulcerative colitis in writing and:

All applications must include the completed:

Continuing treatment

To make continuing applications for treatment with adalimumab, golimumab, infliximab and vedolizumab call the PBS Complex Drugs Programs enquiry line.

Further information

For more information call the Complex Drugs Programs enquiry line.

Page last updated: 1 June 2018