Rheumatoid arthritis Initial PBS authority application form (PB109)

Use this form for an adult patient starting initial PBS subsidised treatment with a bDMARD, excluding rituximab, for the treatment of rheumatoid arthritis.

A rheumatologist or clinical immunologist with expertise in the management of rheumatoid arthritis must complete this form.

PBS is the Pharmaceutical Benefits Scheme.

bDMARD is the biological Disease Modifying Anti Rheumatic Drug.

 
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: 27 August 2017