Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5637QMP	DARBEPOETIN ALFA darbepoetin alfa 10 microgram/0.4 mL injection, 4 x 0.4 mL syringes (PI, CMI)	2	8	5	$224.36	$31.60	$31.60
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5638RMP	DARBEPOETIN ALFA darbepoetin alfa 20 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$422.54	$31.60	$31.60
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5641XMP	DARBEPOETIN ALFA darbepoetin alfa 50 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$867.48	$31.60	$31.60
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5643BMP	DARBEPOETIN ALFA darbepoetin alfa 150 microgram/0.3 mL injection, 4 x 0.3 mL syringes (PI, CMI)	2	8	5	$2460.18	$31.60	$31.60
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5644CMP	DARBEPOETIN ALFA darbepoetin alfa 80 microgram/0.4 mL injection, 4 x 0.4 mL syringes (PI, CMI)	2	8	5	$1340.82	$31.60	$31.60
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5645DMP	DARBEPOETIN ALFA darbepoetin alfa 20 microgram/0.5 mL injection, 0.5 mL pen device (PI, CMI)	8	8	5	$422.56	$31.60	$31.60
	Available brands
	Aranesp SureClick

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5646EMP	DARBEPOETIN ALFA darbepoetin alfa 40 microgram/0.4 mL injection, 0.4 mL pen device (PI, CMI)	8	8	5	$701.60	$31.60	$31.60
	Available brands
	Aranesp SureClick

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5647FMP	DARBEPOETIN ALFA darbepoetin alfa 60 microgram/0.3 mL injection, 0.3 mL pen device (PI, CMI)	8	8	5	$1018.64	$31.60	$31.60
	Available brands
	Aranesp SureClick

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5650JMP	DARBEPOETIN ALFA darbepoetin alfa 150 microgram/0.3 mL injection, 0.3 mL pen device (PI, CMI)	8	8	5	$2460.16	$31.60	$31.60
	Available brands
	Aranesp SureClick

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5651KMP	DARBEPOETIN ALFA darbepoetin alfa 100 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$1651.16	$31.60	$31.60
	Available brands
	Aranesp