Use this form to apply for initial PBS subsidised treatment with brentuximab vedotin for relapsed or refractory Hodgkin lymphoma and who is ASCT naïve.
- Relapsed or refractory Hodgkin lymphoma - brentuximab (autologous stem cell transplant (ASCT) naïve) initial PBS authority form
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.