Age-related macular degeneration
Authority to supply anecortave (Retaane®), ranibizumab (Lucentis®) or verteporfin (Visudyne®) for the treatment of subfoveal choroidal neovascularisation due to age-related macular degeneration through the Pharmaceutical Benefits Scheme (PBS) under Section 85 arrangements of the National Health Act 1953.
Restriction details
The Schedule of Pharmaceutical Benefits (the Schedule) outlines restrictions for prescribing anecortave, ranibizumab and verteporfin to patients.
View a full transcript of the Schedule restriction details
.
Initial treatment
Applications must be submitted in writing by the treating ophthalmologist. An initial application must be submitted for each eye.
Continuing treatment
After an application for initial treatment has been approved, applications for continuing treatment in the same eye may be made in writing or by calling 1800 700 270** and selecting option 3 (8 am to 5 pm EST Monday to Friday).
Item details
Dose
Anecortave is available as a single use posterior juxtascleral depot injection (15 mg / 0.5 ml).
Ranibizumab is available as a single use intravitreal injection (3.0 mg / 0.3 ml).
Verteporfin is available as a single use powder for intravenous infusion (15 mg—sterile).
Applications for treatment
All applications for anecortave and verteporfin will be limited to provide for one treatment only.
Applications for ranibizumab may be for the initial treatment and two repeats.
Where both eyes are being treated simultaneously, a quantity of two may be requested on the same prescription.
Maximum number of treatments per eye
Anecortave
10
Verteporfin
15
This includes treatment administered under both the Medicare Benefits Schedule (MBS) Visudyne Program and the PBS. The number of MBS treatments already received must be supplied with the initial application.
Medicare Australia must be notified if treatment with verteporfin is abandoned before completion of the laser activation step, but after infusion of verteporfin, so that it will not count towards the total.
You can notify Medicare Australia by calling 1800 700 270** and selecting option 3 (8 am to 5 pm EST Monday to Friday).
Patient eligibility
Patients must meet the relevant criteria as indicated in the restrictions and be eligible to receive pharmaceutical benefits.
Test requirements
Anecortave and verteporfin only
A copy of the fluorescein angiogram which demonstrates the subfoveal choroidal neovascularisation is predominantly classic (greater than or equal to 50 per cent) must be provided with each initial application for the affected eye(s).
Patients must have a baseline visual acuity equal to or better than 6/60 (20/200).
Ranibizumab only
A copy of the fluorescein angiography diagnosing subfoveal choroidal neovascularisation must be provided with each initial application for the affected eye(s).
Where a fluorescein angiogram cannot be performed due to a contraindication, as listed in the Therapeutic Goods Administration approved product information, details of the contraindication must be provided. A copy of the report of an alternative method of diagnosis must be included in the application, for example, Optical Coherence Tomography (OCT) or red free photography.
Lodgment
All initial applications must be in writing and sent to:
Medicare Australia
Prior written approval of specialised drugs
Reply paid 9826
GPO Box 9826
Hobart TAS 7001
(No stamp required if posted in Australia)
Please ensure that all written applications for initial PBS authorisation include:
- a completed authority prescription form
- a completed subfoveal choroidal neovascularisation—PBS supporting information form
- a copy of the fluorescein angiogram, or OCT or red free photography reports where a fluorescein angiogram is contraindicated.
Emergency treatments only
To avoid delay in starting treatment, the initial application, angiogram report, and a copy of the prescription may be faxed to Medicare Australia on 03 6215 5474 (8 am to 5 pm EST Monday to Friday). Medicare Australia will then contact the prescriber by telephone. The original authority application form and angiogram must be posted to Medicare Australia.
**Call charges apply from mobile or pay phones only.
Application form for initial PBS subsidised treatment
Application form for initial PBS subsidised treatment [PDF, 215Kb]
Some documents on this page may require the free Adobe PDF reader.
Last updated: 15 September, 2008