Severe chronic plaque psoriasis - initial PBS authority application form (PB112)

Use this form to apply for initial PBS subsidised treatment with biological agents for adult patients with severe chronic plaque psoriasis.

Biological agents refers to all of the following:

  • adalimumab
  • etanercept
  • guselkumab
  • infliximab
  • ixekizumab
  • secukinumab
  • tildrakizumab
  • ustekinumab.
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: 13 February 2019