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

Caution

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
13820JMP	NATALIZUMAB natalizumab 150 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	5	$983.46	$31.60	$31.60
	Available brands
	Tysabri

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

Caution

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
13825PMP	NATALIZUMAB natalizumab 150 mg/mL injection, 2 x 1 mL syringes (PI, CMI)	1	2	5	$937.30	$31.60	$31.60
	Available brands
	Tysabri

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

Caution

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
9505GMP	NATALIZUMAB natalizumab 300 mg/15 mL injection, 15 mL vial (PI, CMI)	1	1	5	$937.30	$31.60	$31.60
	Available brands
	Tysabri

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

Caution

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
9624MMP	NATALIZUMAB natalizumab 300 mg/15 mL injection, 15 mL vial (PI, CMI)	1	1	5	$983.46	$31.60	$31.60
	Available brands
	Tysabri