TOCILIZUMAB

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

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
10056GMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	0	$203.73	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

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

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
10060LMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	0	$430.28	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

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

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
10064QMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	0	$405.39	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

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

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
10068XMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	1	1	0	$94.86	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

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

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
10077JMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	1	1	0	$82.19	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

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

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
10079LMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	0	$220.55	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11720WMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes (PI, CMI)	1	4	2	$813.27	$31.60	$31.60
	Available brands
	Actemra Subcutaneous Injection

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TOCILIZUMAB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11734NMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL pen devices (PI, CMI)	1	4	1	$813.27	$31.60	$31.60
	Available brands
	Actemra ACTPen

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TOCILIZUMAB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11742BMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL pen devices (PI, CMI)	1	4	2	$813.27	$31.60	$31.60
	Available brands
	Actemra ACTPen

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TOCILIZUMAB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11748HMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes (PI, CMI)	1	4	1	$813.27	$31.60	$31.60
	Available brands
	Actemra Subcutaneous Injection

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ADALIMUMAB

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

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
12348XMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)	1	2	5	$505.95	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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ADALIMUMAB

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

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
12349YMP	ADALIMUMAB adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)	2	2	5	$652.33	$31.60	$31.60
	Available brands
	Amgevitaa

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ADALIMUMAB

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

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
12355GMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)	1	2	5	$505.95	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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ADALIMUMAB

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

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
12368YMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)	1	2	5	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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ADALIMUMAB

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

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
12384TMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)	1	2	5	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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ADALIMUMAB

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

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
12417MMP	ADALIMUMAB adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)	2	2	5	$618.90	$31.60	$31.60
	Available brands
	Amgevitaa

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ADALIMUMAB

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

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
13210GMP	ADALIMUMAB adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)	1	2	5	$534.86	$31.60	$31.60
	Available brands
	Adalicipa
	Hadlimaa
	Humiraa
	Yuflymaa

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ADALIMUMAB

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

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
13212JMP	ADALIMUMAB adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)	1	2	5	$505.95	$31.60	$31.60
	Available brands
	Adalicipa
	Hadlimaa
	Humiraa
	Hyrimoza
	Yuflymaa

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ADALIMUMAB

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

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
13228FMP	ADALIMUMAB adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes (PI, CMI)	1	2	5	$505.95	$31.60	$31.60
	Available brands
	Adalicipa
	Hadlimaa
	Humiraa
	Yuflymaa

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ADALIMUMAB

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

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
13229GMP	ADALIMUMAB adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices (PI, CMI)	1	2	5	$534.86	$31.60	$31.60
	Available brands
	Adalicipa
	Hadlimaa
	Humiraa
	Hyrimoza
	Yuflymaa

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ADALIMUMAB

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

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
13292NMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	5	$598.79	$31.60	$31.60
	Available brands
	Humiraa

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ADALIMUMAB

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

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
13293PMP	ADALIMUMAB adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes (PI, CMI)	1	2	5	$567.42	$31.60	$31.60
	Available brands
	Humiraa

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ETANERCEPT

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

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
13294QMP	ETANERCEPT etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack (PI, CMI)	2	2	5	$743.62	$31.60	$31.60
	Available brands
	Enbrel

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ETANERCEPT

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

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
13295RMP	ETANERCEPT etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack (PI, CMI)	2	2	5	$782.03	$31.60	$31.60
	Available brands
	Enbrel

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TOCILIZUMAB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13301CMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes (PI, CMI)	1	4	2	$813.27	$31.60	$31.60
	Available brands
	Actemra Subcutaneous Injection

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TOCILIZUMAB

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

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
13305GMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	5	$203.73	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13306HMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL pen devices (PI, CMI)	1	4	2	$813.27	$31.60	$31.60
	Available brands
	Actemra ACTPen

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ETANERCEPT

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

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
13308KMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL syringes (PI, CMI)	1	1	5	$743.60	$31.60	$31.60
	Available brands
	Enbrela

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TOCILIZUMAB

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

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
13311NMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	2	2	5	$179.63	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

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

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
13312PMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	5	$220.55	$31.60	$31.60
	Available brands
	Actemra

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ETANERCEPT

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

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
13319BMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL pen devices (PI, CMI)	1	1	5	$743.60	$31.60	$31.60
	Available brands
	Enbrela

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TOCILIZUMAB

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

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
13324GMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	2	2	5	$164.38	$31.60	$31.60
	Available brands
	Actemra

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ETANERCEPT

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

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
13326JMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL pen devices (PI, CMI)	1	1	5	$782.01	$31.60	$31.60
	Available brands
	Enbrela

space

ETANERCEPT

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

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
13332QMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL syringes (PI, CMI)	1	1	5	$782.01	$31.60	$31.60
	Available brands
	Enbrela

space

TOCILIZUMAB

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

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
13338BMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	5	$430.28	$31.60	$31.60
	Available brands
	Actemra

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TOCILIZUMAB

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

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
13339CMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	5	$405.39	$31.60	$31.60
	Available brands
	Actemra

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TOFACITINIB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13737BMP	TOFACITINIB tofacitinib 5 mg tablet, 56 (PI, CMI)	1	56	5	$1212.40	$31.60	$31.60
	Available brands
	Xeljanz

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TOFACITINIB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13738CMP	TOFACITINIB tofacitinib 1 mg/mL oral liquid, 240 mL (PI, CMI)	1	1	5	$1212.40	$31.60	$31.60
	Available brands
	Xeljanz

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TOFACITINIB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13755YMP	TOFACITINIB tofacitinib 5 mg tablet, 56 (PI, CMI)	1	56	3	$1212.40	$31.60	$31.60
	Available brands
	Xeljanz

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TOFACITINIB SO

Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.

Supply only until 01/01/2026

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13757CMP	TOFACITINIB tofacitinib 5 mg tablet, 56 (PI, CMI)	1	56	5	$1212.40	$31.60	$31.60
	Available brands
	Xeljanz SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

space

TOFACITINIB

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13770RMP	TOFACITINIB tofacitinib 1 mg/mL oral liquid, 240 mL (PI, CMI)	1	1	3	$1212.40	$31.60	$31.60
	Available brands
	Xeljanz

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TOFACITINIB SO

Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.

Supply only until 01/01/2026

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
13776CMP	TOFACITINIB tofacitinib 1 mg/mL oral liquid, 240 mL (PI, CMI)	1	1	5	$1212.40	$31.60	$31.60
	Available brands
	Xeljanz SO Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule. Supply only

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ETANERCEPT

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

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
5733RMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL syringes (PI, CMI)	1	1	0	$743.60	$31.60	$31.60
	Available brands
	Enbrela

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ETANERCEPT

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

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
5734TMP	ETANERCEPT etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack (PI, CMI)	1	1	0	$371.81	$31.60	$31.60
	Available brands
	Enbrel

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ETANERCEPT

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

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
5735WMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL pen devices (PI, CMI)	1	1	0	$743.60	$31.60	$31.60
	Available brands
	Enbrela

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ETANERCEPT

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

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
6367DMP	ETANERCEPT etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack (PI, CMI)	1	1	0	$395.35	$31.60	$31.60
	Available brands
	Enbrel

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ETANERCEPT

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

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
9615CMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL syringes (PI, CMI)	1	1	0	$782.01	$31.60	$31.60
	Available brands
	Enbrela

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ETANERCEPT

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

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
9641KMP	ETANERCEPT etanercept 50 mg/mL injection, 4 x 1 mL pen devices (PI, CMI)	1	1	0	$782.01	$31.60	$31.60
	Available brands
	Enbrela

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ADALIMUMAB

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

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
9662MMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)	1	2	0	$505.95	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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ADALIMUMAB

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

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
9663NMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)	1	2	0	$505.95	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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ADALIMUMAB

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

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
9679KMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes (PI, CMI)	1	2	0	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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ADALIMUMAB

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

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
9680LMP	ADALIMUMAB adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices (PI, CMI)	1	2	0	$534.86	$31.60	$31.60
	Available brands
	Abriladaa
	Amgevitaa
	Hadlimaa
	Hyrimoza

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Legend
aBrand equivalent a
MPMedical Practitioner
SO

Products that are in a Supply Only state will be available for dispensing, but not for prescribing. PBS Prescriptions written prior to the Supply Only period are able to be dispensed using either the Supply Only product where available, or an equivalent product as specified on the PBS schedule.

Supply Only