Gastrointestinal stromal tumour (GIST), adjuvant - imatinib mesylate
Through the Pharmaceutical Benefits Scheme (PBS), under Section 85 arrangements of the National Health Act 1953, authority to prescribe imatinib mesylate (Glivec®) is required for the treatment of completely resected primary gastrointestinal stromal tumour with high risk of recurrence.
Patients are eligible for a maximum of 12 months of combined non PBS subsidised and PBS subsidised imatinib mesylate treatment at a maximum dose of 400 mg per day.
Up to five repeats will be authorised for an intital application.
A competed authority prescription for the remainder of the treatment must be submitted by mail.
The maximum dose that can be prescribed for GIST - adjuvant is 400 mg per day.
Glivec® is available in a tablet form:
- Glivec 100 mg tablets in a pack size of 60 and
- Glivec 400 mg tablets in a pack size of 30.
Patients must meet the relevant restrictions as per the criteria and be eligible to receive pharmaceutical benefits.
The following reports are required for initial PBS subsidised applications:
A copy of pathology report(s) from an approved Australian pathology authority confirming:
- the diagnosis of a gastrointestinal stromal tumour
- the presence of CD117 on immunohistochemical staining
- the size and mitotic rate of the tumour
- the date of tumour resection, which must not be more than three months prior to the date of the initial application
Applications for initial approvals must be in writing.
Send all written applications to:
Prior written approval of specialised drugs
Reply paid 9826
Hobart Tasmania 7001
(No stamp required if posted in Australia)
For more information call 1800 700 270* (option 3) Monday to Friday 8.00am to 5.00pm EST.
* Call charges apply from mobile or pay phones only
Lodge this form for a patient starting initial PBS subsidised treatment for GIST – adjuvant treatment.
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Last updated: 4 April, 2012