Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10083QMP	PLERIXAFOR plerixafor 24 mg/1.2 mL injection, 1.2 mL vial (PI, CMI)	1	1	1	$4016.84	$31.60	$31.60
	Available brands
	Mozobila
	PLERIXAFOR EUGIAa
	Plerixafor ARXa

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSTIMULANTS > IMMUNOSTIMULANTS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10084RMP	PLERIXAFOR plerixafor 24 mg/1.2 mL injection, 1.2 mL vial (PI, CMI)	1	1	1	$4065.51	$31.60	$31.60
	Available brands
	Mozobila
	PLERIXAFOR EUGIAa
	Plerixafor ARXa