Contents

HSD Monthly Claim Online Application

Program Information

Objectives
Background
Policy & Program Development
Principles
Private Hospitals
Funding and Reporting Arrangements

Appendix 1: AHMAC Highly Specialised Drugs Program

Membership of the Highly Specialised Drugs Working Party
Terms of Reference of the Highly Specialised Drugs Working Party
Selection Criteria for Drugs
Submissions to the Working Party

Appendix 2: Drugs Covered by the Program

Abacavir Sulphate (Ziagen)
Abacavir Sulfate with Lamivudine (Kivexa)
Abacavir Sulfate with Lamivudine and Zidovudine (Trizivir)
Abatacept (Orencia)
Adefovir Dipivoxil (Hepsera)
Apomorphine Hydrochloride (Apomine)
Atazanavir Sulfate (Reyataz)
Azithromycin (Zithromax)
Baclofen (Lioresal Intrathecal)
Bosentan Monohydrate (Tracleer)
Cidofovir(Vistide)
Cinacalcet (Sensipar)
Clarithromycin (Klacid)
Clozapine (Clozaril, Clopine)
Cyclosporin (Sandimmun)
Cyclosporin (Neoral, Cicloral)
Darbepoetin Alfa (Aranesp)
Darunavir(Prezista)
Deferasirox (Exjade)
Deferiprone (Ferriprox)
Delavirdine Mesylate (Rescriptor)
Desferrioxamine (Desferal, Hospira brand)
Didanosine (Videx)
Disodium Pamidronate (Aredia, Pamisol)
Dornase Alfa (Pulmozyme)
Doxorubicin hydrochloride pegylated liposomal (Caelyx)
Efavirenz (Stocrin)
Emtricitabine (Emtriva)
Enfuvirtide (Fuzeon)
Entecavir Monohydrate (Baraclude) Tablet 0.5mg
Entecavir Monohydrate (Baraclude) Tablet 1 mg
Epoetin Alfa (Eprex)
Epoetin Beta (NeoRecormon)
Epoprostenol Sodium (Flolan)
Etanercept (Enbrel)
Etravirine (Intelence)
Everolimus (Certican)
Filgrastim (Neupogen)
Fosamprenavir Calcium (Telzir)
Foscarnet Sodium (Foscavir)
Ganciclovir (Cymevene, Vitrasert)
Ibandronic Acid (Bondronat)
Iloprost Trometamol (Ventavis)
Indinavir Sulphate (Crixivan)
Infliximab (Remicade)
Interferon Alfa 2a (Roferon A)
Interferon Alfa 2b (Intron A)
Interferon Gamma 1b (Imukin)
Lamivudine (Zeffix)
Lamivudine and Zidovudine (Combivir)
Lanreotide Acetate (Somatuline)
Lanthanum Carbonate Hydrate  (Fosrenol)
Lenalidomide (Revlimid)
Lenograstim (Granocyte)
Lopinavir with Ritonavir (Kaletra)
Mycophenolate Mofetil (Cellcept)
Mycophenolate Sodium (Myfortic)
Natalizumab (Tysabri)
Nevirapine (Viramune)
Octreotide Acetate (Sandostatin, Hospira brand)
Pegfilgrastim (Neulasta)
Peginterferon Alfa-2a (Pegasys)
Peginterferon Alfa-2b (PEG-Intron)
Raltegravir Potassium (Isentress)
Ribavirin and Peginterferon alfa-2a (Pegasys RBV)
Ribavirin and Peginterferon alfa 2b (Pegatron)
Rifabutin (Mycobutin)
Ritonavir (Norvir)
Rituximab (Mabthera)
Saquinavir Mesylate (Invirase)
Sevelamer (Renagel)
Sildenafil Citrate (Revatio)
Sirolimus (Rapamune)
Sitaxentan Sodium (Thelin)
Stavudine (Zerit)
Tacrolimus (Prograf)
Telbivudine (Sebivo)
Tenofovir Disoproxil Fumarate (Viread)
Tenofovir Disoproxil Fumarate with Emtricitabine (Truvada)
Thalidomide (Thalidomide Pharmion)
Tipranavir (Aptivus)
Valaciclovir Hydrochloride (Valtrex)
Valganciclovir hydrochloride (Valcyte)
Zidovudine (Retrovir)
Zoledronic acid (Zometa)

Appendix 3: Agreed Prices

Appendix 4: Patient Eligibility Criteria

Appendix 5: Certification by Prescribing Doctors

Appendix 6: Community prescribers of AIDs & Hepatitis C medications

Appendix 7: Auditing Requirements & Information Systems

Appendix 8: Claiming Procedures