SOME pharmacies have had problems with prescribing and claiming omalizumab PBS items since 01 Aug and the Department of Health and Aged Care has launched a search for a solution.
For existing omalizumab prescriptions dated prior to 01 Aug, suppliers can dispense either 150mg syringe Omlyclo or 150mg pen device Xolair.
The patient does not need to obtain a new prescription for the 150mg pen device.
Lately, some pharmacies have faced issues such as receiving PBS Online claim rejections R738 (the item provided was not a PBS benefit at the date of prescribing), due to the incorrect bio grouping between the Private Hospital and Public Hospital omalizumab 75mg item codes.
Services Australia will monitor and honour eligible PBS claims with the rejection R738 in a separate payment after the data is corrected in the 01 September 2025 schedule update.
The Online PBS Authorities application is also not correctly assessing that the patient has an authority in their history for the "same drug".
If prescribers receive a rejection RC820 via HPOS, phone Services Australia to override the rejection.
Services Australia is currently implementing an urgent ICT fix for this and will advise when it is resolved.
The above article was sent to subscribers in Pharmacy Daily's issue from 12 Aug 25
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