Asthma

The PBS subsidises biological agents for patients with asthma.

Patient eligibility

The Pharmaceutical Benefits Scheme (PBS) subsidises treatment with biological agents under the National Health Act 1953, section 100 for patients with asthma.

Where the term biological agents appears it refers to benralizumab, mepolizumab and omalizumab.

Patients must be eligible for the PBS and meet the relevant restriction criteria.

The Schedule of Pharmaceutical Benefits on the PBS website outlines the restrictions for prescribing biological agents.

Section 100 arrangements

These items are only PBS subsidised for a day admitted patient, non-admitted patient, or patients on discharge attending either:

  • an approved private hospital
  • a public participating hospital
  • a public hospital.

You must include the hospital name and provider number on the authority application form. These items aren't PBS subsidised for hospital in-patients.

Toxicity and severity descriptors

When demonstrating a patient's intolerance to prior treatment, use the asthma toxicity and severity descriptors with the authority application.

Treatment specifics

Adult patients must be treated by a respiratory physician, clinical immunologist, allergist or general physician with expertise managing asthma to be eligible for PBS subsidised treatment with biological agents.

Paediatric patients must be treated by paediatric respiratory physician, clinical immunologist, allergist, paediatrician or general physician experienced in the management of patients with severe asthma, in consultation with a respiratory physician.

Applications Adult patients

Initial treatment

Apply for authority approval to prescribe initial PBS subsidised biological agents to treat patients aged 12 years and older with asthma in writing and either:

All applications must include the completed:

Initial grandfather treatment

For patients who received non-PBS subsidised benralizumab treatment before 1 December 2018 for asthma, apply for initial grandfather authority approval in writing and either:

All applications must include the completed:

Change of treatment

Apply for authority approval to change PBS subsidised biological agents to treat patients aged 12 years and older with asthma in writing and either:

All applications must include the completed:

Continuing treatment

Apply for authority approval to continue PBS subsidised biological agents to treat patients aged 12 years and older with asthma in writing and either:

All applications must include the completed:

Applications Paediatric patients

Initial treatment

Apply for authority approval to prescribe initial PBS subsidised omalizumab to treat paediatric patients with severe allergic asthma in writing and either:

All applications must include the completed:

Continuing treatment

Apply for authority approval to continue PBS subsidised omalizumab to treat paediatric patients with severe allergic asthma in writing and either:

All applications must include the completed:

More information

Call the PBS Complex Drugs Programs enquiry line for more information.

Page last updated: 5 December 2019