ADALIMUMAB
Manner of administration:Injection
Restriction
Indication: Enthesitis/spondylitis related juvenile idiopathic arthritis
Treatment phase: Transitioning from non-PBS to PBS-subsidised treatment - Grandfather arrangements
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 5 | DPMQ: $606.96 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial treatment - Initial 1 (new patient)
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial treatment - Initial 2 (change or recommencement of treatment after a break
in biological medicine of less than 12 months)
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial treatment - Initial 3 (recommencement of treatment after a break in biological
medicine of more than 12 months)
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial 1 (new patient) or Initial 2 (change or recommencement of treatment after
a break in biological medicine of less than 12 months) or Initial 3 (recommencement
of treatment after a break in biological medicine of more than 12 months) - balance
of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 0 | DPMQ: $545.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial treatment - Initial 1 (new patient)
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial treatment - Initial 2 (change or recommencement of treatment after a break
in biological medicine of less than 12 months)
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial treatment - Initial 3 (recommencement of treatment after a break in biological
medicine of more than 12 months)
Restriction
Indication: Severe active juvenile idiopathic arthritis
Treatment phase: Initial 1 (new patient) or Initial 2 (change or recommencement of treatment after
a break in biological medicine of less than 12 months) or Initial 3 (recommencement
of treatment after a break in biological medicine of more than 12 months) - balance
of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 0 | DPMQ: $576.74 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Vision threatening non-infectious uveitis
Treatment phase: Balance of Supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 0 | DPMQ: $606.96 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Enthesitis/spondylitis related juvenile idiopathic arthritis
Treatment phase: Initial treatment
Restriction
Indication: Enthesitis/spondylitis related juvenile idiopathic arthritis
Treatment phase: Initial treatment - balance of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 3 | DPMQ: $606.96 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial 1 treatment (Whole body) - biological medicine-naive patient
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial 2 treatment (Whole body) - Change of treatment, or, recommencement of treatment
after a break in biological medicine of less than 5 years
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial 3 treatment (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: Balance of supply - Initial 1, 2 or 3 treatment (Whole body, or, face/hand/foot)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial 1 treatment (Face, hand, foot) - biological medicine-naive patient
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial 2 treatment (Face, hand, foot) - Change of treatment, or, recommencement of
treatment after a break in biological medicine of less than 5 years
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 4 | DPMQ: $606.96 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Moderate to severe ulcerative colitis
Treatment phase: Initial treatment - Initial 1 (new patient)
Restriction
Indication: Moderate to severe ulcerative colitis
Treatment phase: Initial treatment - Initial 2 (change or recommencement of treatment after a break
in biological medicine of less than 5 years)
Restriction
Indication: Moderate to severe ulcerative colitis
Treatment phase: Initial treatment - Initial 3 (recommencement of treatment after a break in biological
medicine of more than 5 years)
Restriction
Indication: Moderate to severe ulcerative colitis
Treatment phase: Initial 1 (new patient) or Initial 2 (change or recommencement of treatment after
a break in biological medicine of less than 5 years) or Initial 3 (recommencement
of treatment after a break in biological medicine of more than 5 years) - balance
of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 3 | DPMQ: $606.96 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Severe Crohn disease
Treatment phase: Balance of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 0 | DPMQ: $606.96 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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Manner of administration:Injection
Restriction
Indication: Severe Crohn disease
Treatment phase: Initial 1 (new patient)
Restriction
Indication: Severe Crohn disease
Treatment phase: Initial 2 (change or recommencement of treatment after a break in targeted therapy
of less than 12 months)
Restriction
Indication: Severe Crohn disease
Treatment phase: Initial 3 (recommencement of treatment after a break in targeted therapy of more than
12 months)
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 3 | DPMQ: $606.96 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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