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Primary hyperoxaluria type 1 (PH1) Program in Pharmaceutical Benefits Scheme (PBS) 012-25090506

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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.