Primary hyperoxaluria type 1

Treatment Phase: Initial treatment - loading dose

Clinical criteria:

  • The condition must be primary hyperoxaluria type 1 confirmed by genetic testing,

AND

  • Patient must have undergone treatment with pyridoxine therapy; OR

  • Patient must have a PH1 allele that is considered not responsive to pyridoxine therapy; OR

  • Patient must be contraindicated for pyridoxine therapy as determined by the treating or consulting clinician,

AND

  • Patient must have urinary oxalate greater than or equal to 0.70 mmol/24 h/1.73 m2 measured by mean 24-h urinary oxalate excretion from a valid 24-h urine collection; OR

  • Patient must have urinary oxalate:creatinine ratio greater than the upper limit of normal based on age on at least two of three single-void collections during screening; OR

  • Patient must have clinical symptoms indicative of hyperoxaluria, such as (i) nephrocalcinosis; (ii) renal stones; (iii) renal impairment; (iv) systemic oxalosis,

AND

  • Patient must not have previously undergone liver transplant for primary hyperoxaluria type 1.

Treatment criteria:

  • Must be treated by a nephrologist with experience in the management of hyperoxaluria; OR

  • Must be treated by a paediatrician with experience in the management of hyperoxaluria; OR

  • Must be treated by an authorised prescriber in consultation with one of the above specialty types.

At the time of the authority application, prescribers should request the appropriate number of vials based on the patient's weight, as per the TGA approved Product Information. Up to 2 repeats may be requested for initial treatment.

The authority application must be made via the Online PBS Authorities System, or in writing via HPOS form upload or mail.

If the application is submitted through HPOS form upload or mail, it must include:

(i) details of the proposed prescription; and

(ii) a completed authority application form relevant to the indication and treatment phase (the latest version is located on the website specified in the Administrative Advice).

Note

Any queries concerning the arrangements to prescribe may be directed to Services Australia on 1800 700 270 (hours of operation 8 a.m. to 5 p.m. Monday to Friday).

Prescribing information (including Authority Application forms and other relevant documentation as applicable) is available on the Services Australia website at www.servicesaustralia.gov.au

Applications for authorisation under this restriction should be made using the Online PBS Authorities system (see www.servicesaustralia.gov.au/hpos)

Alternatively, applications for authority to prescribe should be submitted online using the form upload facility in Health Professional Online Services (HPOS) at www.servicesaustralia.gov.au/hpos

Or mailed to:

Services Australia

Complex Drugs

Reply Paid 9826

HOBART TAS 7001

Note

No increase in the maximum quantity or number of units may be authorised.

Note

No increase in the maximum number of repeats may be authorised.

Note

Special Pricing Arrangements apply.