Gilenya (Fingolimod)
fingolimod 250 microgram capsule, 28 · ORAL · PBS code 11818B
STREAMLINEDWhat it costs
AU$951.05 PBS-determined price per 28 units
Most patients pay only the standard PBS co-payment, not the full price above — up to AU$25.00 per script (general) or AU$7.70 (concession/Safety Net) in 2026. The figure above is what the PBS pays the pharmacy; the Australian Government subsidises the rest. Always confirm the current amount with your pharmacist.
- • First listed on the PBS: 2019-11-01.
- • Repeats: 5.
- • PBS program: GE.
Eligibility criteria for subsidised access
The following is the government's own wording from the PBS Schedule, shown unchanged.
Listing of Pharmaceutical Benefits (NHL) - Schedule 4 part 1
Multiple sclerosis
Initial treatment
The condition must be diagnosed as clinically definite relapsing-remitting multiple sclerosis by magnetic resonance imaging of the brain and/or spinal cord; or
The condition must be diagnosed as clinically definite relapsing-remitting multiple sclerosis by accompanying written certification provided by a radiologist that a magnetic resonance imaging scan is contraindicated because of the risk of physical (not psychological) injury to the patient; AND
The treatment must be the sole PBS-subsidised disease modifying therapy for this condition; AND
Patient must have experienced at least 2 documented attacks of neurological dysfunction, believed to be due to multiple sclerosis, in the preceding 2 years of commencing a PBS-subsidised disease modifying therapy for this condition; AND
Patient must be ambulatory (without assistance or support); AND
Must be treated by a medical practitioner; or
Must be treated by a nurse practitioner in consultation with a specialist physician; AND
Patient must weigh 40 kg or less.
Where applicable, the date of the magnetic resonance imaging scan must be recorded in the patient's medical records.
Listing of Pharmaceutical Benefits (NHL) - Schedule 4 part 1
Multiple sclerosis
Continuing treatment
The condition must be diagnosed as clinically definite relapsing-remitting multiple sclerosis; AND
The treatment must be the sole PBS-subsidised disease modifying therapy for this condition; AND
Patient must have previously received PBS-subsidised treatment with this drug for this condition; AND
Patient must not show continuing progression of disability while on treatment with this drug; AND
Patient must have demonstrated compliance with, and an ability to tolerate this therapy; AND
Patient must weigh 40 kg or less; AND
Must be treated by a medical practitioner; or
Must be treated by a nurse practitioner in consultation with a specialist physician.
Sponsor: Novartis Pharmaceuticals Australia Pty Limited ABN 18 004 244 160
Not medical advice. Voxsanity republishes public PBS data in plain English. PBS listing status and criteria can change; always confirm current subsidised availability with your doctor or pharmacist.
Source: Pharmaceutical Benefits Scheme (PBS), © Commonwealth of Australia. Data used and redistributed under permission; not modified from its original wording where displayed verbatim.