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Multiple myeloma – lenalidomide Initial PBS …

1 of 4 Multiple myeloma lenalidomideInitial PBS authority applicationand supporting informationPurpose of this formYou must lodge this form for a patient starting Initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with lenalidomide for Multiple applications must be in writing and must include sufficient information to determine the patient s eligibility according to the PBS assessments, pathology tests and diagnostic imaging studies must be made within 1 month of the date of application unless otherwise information on this form is correct at the time of publishing and is subject to 100 arrangementsThis item is only available to a patient who is attending: an approved private hospital a public participating hospital or a public hospital and is a day admitted patient non-admitted patient or patient on discharge. This item is not available as a PBS benefit for in-patients of the hospital.

4203.1209 1 of 4 Multiple myeloma – lenalidomide Initial PBS authority application and supporting information Purpose of this form You must lodge this form for a patient starting initial Pharmaceutical

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