Source	S100 HSD Private
Body System	MUSCULO-SKELETAL SYSTEM > DRUGS FOR TREATMENT OF BONE DISEASES > DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION

Note

Authority Required

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
13136JMP	BUROSUMAB burosumab 20 mg/mL injection, 1 mL vial (PI, CMI)	1	1	5	$8046.67	$31.60	$31.60
	Available brands
	Crysvita

Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > DRUGS FOR TREATMENT OF BONE DISEASES > DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION

Note

Authority Required

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
13140NMP	BUROSUMAB burosumab 10 mg/mL injection, 1 mL vial (PI, CMI)	1	1	5	$3999.00	$31.60	$31.60
	Available brands
	Crysvita

Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > DRUGS FOR TREATMENT OF BONE DISEASES > DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION

Note

Authority Required

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
13145WMP	BUROSUMAB burosumab 20 mg/mL injection, 1 mL vial (PI, CMI)	1	1	5	$7998.00	$31.60	$31.60
	Available brands
	Crysvita

Source	S100 HSD Private
Body System	MUSCULO-SKELETAL SYSTEM > DRUGS FOR TREATMENT OF BONE DISEASES > DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION

Note

Authority Required

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
13154HMP	BUROSUMAB burosumab 30 mg/mL injection, 1 mL vial (PI, CMI)	1	1	5	$12045.67	$31.60	$31.60
	Available brands
	Crysvita

Source	S100 HSD Public
Body System	MUSCULO-SKELETAL SYSTEM > DRUGS FOR TREATMENT OF BONE DISEASES > DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION

Note

Authority Required

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
13155JMP	BUROSUMAB burosumab 30 mg/mL injection, 1 mL vial (PI, CMI)	1	1	5	$11997.00	$31.60	$31.60
	Available brands
	Crysvita

Source	S100 HSD Private
Body System	MUSCULO-SKELETAL SYSTEM > DRUGS FOR TREATMENT OF BONE DISEASES > DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION

Note

Authority Required

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
13163TMP	BUROSUMAB burosumab 10 mg/mL injection, 1 mL vial (PI, CMI)	1	1	5	$4047.67	$31.60	$31.60
	Available brands
	Crysvita