Metastatic breast cancer Initial PBS authority application form (PB099)

Use this form for a patient starting initial PBS subsidised treatment with lapatinib for late stage metastatic breast cancer where disease has progressed despite treatment with trastuzumab.

Lapatinib is not PBS subsidised when used in combination with Commonwealth subsidised trastuzumab.

PBS is the Pharmaceutical Benefits Scheme.

This form can be uploaded through HPOS. Read more about form upload in HPOS.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 11 October 2017