Australian plan for PBS efficient funding of chemotherapy claims

From December 1, 2017, approved suppliers will be required to enter a Compounder ID when submitting claims for eligible Australia’s Prescription Benefits Scheme (PBS) efficient funding of chemotherapy claims (EFC) items through PBS Online. Claims submitted without a compounder ID will not be paid, the country’s health regulator has announced..

Currently, approved suppliers have the option to select the ‘ZZZ001’ compounder ID code where the compounder ID is unknown. From December 1, this code will no longer be available. Approved suppliers will need to ensure they know their compounder ID prior to submitting a claim.

New payment arrangements to Therapeutic Goods Administration (TGA)-licensed compounders will commence on December 1, 2017. The A$20($16) component of the compounding fee will be paid based on the compounder ID included within each eligible PBS EFC infusible item.