Rheumatoid arthritis - initial PBS authority application form (PB109)
Use this form to apply for initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with biological agents for severe active rheumatoid arthritis.
Biological agents refers to all of the following:
- certolizumab pegol
This form can be uploaded or completed online 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.
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Page last updated: 30 September 2019