This document outlines details of PBS-subsidised lumasiran for patients with primary hyperoxaluria type 1 (PH1).
For information on how to process a PBS Authority, see Processing Complex Authority Required Listings.
Primary hyperoxaluria type 1 (PH1) quick reference
Table 1
Restrictions | Authority level and section | PA assessment | Processing system | Prescriber type | Prescriber self-serve |
Initial PB389 form | Written Electronic S85: lumasiran | No | OPA | Must be treated by: - a nephrologist with experience in the management of hyperoxaluria
- a paediatrician with experience in the management of hyperoxaluria
- an authorised prescriber in consultation with one of the above specialty types
| Yes - delayed assessment due to DPMQ (cost) |
Grandfather PB391 form | Written Electronic S85: lumasiran | No | OPA | Must be treated by: - a nephrologist with experience in the management of hyperoxaluria
- a paediatrician with experience in the management of hyperoxaluria
- an authorised prescriber in consultation with one of the above specialty types
| Yes - delayed assessment due to DPMQ (cost) |
Continuing PB390 form | Written Electronic S85: lumasiran | No | OPA | Must be treated by: - a nephrologist with experience in the management of hyperoxaluria
- a paediatrician with experience in the management of hyperoxaluria
- an authorised prescriber in consultation with one of the above specialty types
| Yes |
Enquiries about lumasiran (Oxlumo®) payments
Table 2
Step | Action |
1 | Transfer enquiries Transfer enquiries about prescription arrangements to PBS Complex Drugs Programs, option 4. |
2 | Advise approved supplier Service Officers who receive a call about payments of lumasiran (Oxlumo®) must advise the approved supplier of the following: - the first payment is processed through PBS Online
- the second payment is processed through a bulk adjustment
Note: the agency will monitor claims to make sure pharmacies get both payments within their usual timeframes. Escalate any further enquiries via email to PBS Claiming Support. |