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High cost medicines formulary

SA Health has established a Statewide Formulary for High Cost Medicines which aims to ensure that eligible patients will have equal opportunity to receive a high cost medicine. Eligibility is based upon their clinical condition instead of being based upon where they live or what hospital they attend. 

All public hospitals must comply with the SA Health Statewide Formulary for High Cost Medicines policy (PDF 281KB). This will enhance equity of access within the South Australian public health system.

High cost medicines...what are they?

High cost medicines for statewide use are those for which the predicted annual expenditure is equal to or greater than:

  • $10,000 per patient per treatment course or
  • $100,000 per public hospital or
  • $300,000 across the South Australian public hospital system.

High cost medicines that are listed on the Pharmaceutical Benefits Scheme (PBS) and used in accordance with the PBS criteria for subsidy are exempt from the SA Health policy and are therefore outside the scope of SAMEP.

Applications

Information on how to apply for individual or statewide use of high cost medicines, see the Individual patient use of high cost medicines page or the High Cost Medicine reviews page. 

Forms

Individual patient use form (PDF 1118KB)

Formulary form (DOC 603KB)

Further information

For more information on the High Cost Medicines, contact the Executive Officer of South Australian Medicines Evaluation Panel.

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