GUSELKUMAB
guselkumab 100 mg/mL injection, 1 x 1 mL syringe
GUSELKUMAB (11614G)
11614G
Manner of administration:Injection
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 1, Whole body (new patient)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 2, Whole body (change or recommencement of treatment after
a break in biological medicine of less than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 3, Whole body (recommencement of treatment after a break
in biological medicine of more than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 1, Face, hand, foot (new patient)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 2, Face, hand, foot (change or recommencement of treatment
after a break in biological medicine of less than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 3, Face, hand, foot (recommencement of treatment after
a break in biological medicine of more than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Balance of supply - Initial treatment - Initial 1, Whole body or Face, hand, foot
(new patient) or Initial 2, Whole body or Face, hand, foot (change or recommencement
of treatment after a break in biological medicine of less than 5 years) or Initial
3, Whole body or Face, hand, foot (recommencement of treatment after a break in biological
medicine of more than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Continuing treatment, Whole body
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Continuing treatment, Face, hand, foot
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Balance of supply - Continuing treatment, Whole body or Continuing treatment, Face,
hand, foot
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 2 | DPMQ: $3,615.82 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Tremfya | |||||