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Section 100 including the Highly Specialised Drugs Program

Section 100 including the Highly Specialised Drugs Program

1. The Highly Specialised Drugs (HSD) Program

Under this program the Commonwealth funds an agreed list of highly specialised drugs for specified medical indications for use by outpatients and those attending day services in a public hospital. Details of these indications can be found on the Australian Department of Health and Ageing website.

Prior to prescribing, a medical practitioner is required to complete a declaration form.

2. The Complex Authority Required Highly Specialised Drugs Program (CAR HSD) Program

Under this program the Commonwealth provides funding for a separate range of drugs and requires a medical practitioner to obtain the prior written approval of Medicare Australia before prescribing. Other restrictions may also apply. Details of the specified medical indications can be found on the Australian Department of Health and Ageing website.

Currently, the drugs funded under this program include:

abatacept
adalimumab
bosentan
epoprostenol
etanercept
iloprost
infliximab
lenalidomide
omalizumab
rituximab
sildenafil
sitaxentan
tadalafil

As written approval from Medicare Australia is required before prescribing these drugs there is no declaration form to complete.

Bosentan, epoprostenol, iloprost, sildenafil and sitaxentan may only be prescribed by physicians associated with Pulmonary Arterial Hypertension (PAH) Designated Prescribing Centres. In NSW these centres are:

Childrens Hospital at Westmead
Coffs Harbour Hospital
Concord Repariation General Hospital
John Hunter Hospital
Liverpool Hospital
Nepean Hospital
Royal North Shore Hospital
Royal Prince alfred Hospital
St George Hospital
St Vincent's Hospital
Westmead Hospital

3. The Trastuzumab (Herceptin) Special Authority Program for early stage breast cancer

Under this program the Commonwealth provides funding for treatment with trastuzumab (Herceptin) (commenced on 1 October 2006). Reimbursement is available for public patients through the arrangements similar to the Highly Specialised Drugs Program (HSD) in public hospitals. As a consequence specific requirements must be followed to ensure funding. As prior written approval from Medicare Australia is required there is no declaration form to complete. Details can be found on the Australian Department of Health and Ageing website.

Policy Directives

The Policy Directive PD 2008_036 Highly Specialised Drugs Program Funding Requirements details the Commonwealth and NSW Ministry of Health requirements for Area Health Services and hospitals involved with the Highly Specialised Drugs Program and the Complex Authority Required Highly Specialised Drugs Program.

Financial Reporting

For all queries related to financial reporting please contact:

Paul Sponberg

Finance and Business Management Branch

NSW Ministry of Health

Tel (02) 9391 9156