INFLIXIMAB

INFLIXIMAB (10057H)

infliximab 100 mg injection, 1 vial
10057H
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 9632)

Indication: Acute severe ulcerative colitis
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 5 Max qty units: 5 # of repeats: 1 DPMQ: $831.89 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis

INFLIXIMAB (10067W)

infliximab 100 mg injection, 1 vial
10067W
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4524)

Indication: Acute severe ulcerative colitis
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 5 Max qty units: 5 # of repeats: 1 DPMQ: $791.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis

INFLIXIMAB (10184B)

infliximab 100 mg injection, 1 vial
10184B
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

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: Balance of supply
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $173.77 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis

INFLIXIMAB (10196P)

infliximab 100 mg injection, 1 vial
10196P
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

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: Balance of supply
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $158.20 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis

INFLIXIMAB (11389K)

Supply only until 01/07/2027
infliximab 100 mg injection, 1 vial
11389K
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Severe Crohn disease
Treatment phase: Subsequent continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $158.20 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis

INFLIXIMAB (11396T)

infliximab 100 mg injection, 1 vial
11396T
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 18868)

Indication: Severe Crohn disease
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 5 Max qty units: 5 # of repeats: 2 DPMQ: $831.89 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remsima
Renflexis

INFLIXIMAB (11399Y)

Supply only until 01/07/2027
infliximab 100 mg injection, 1 vial
11399Y
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Severe Crohn disease
Treatment phase: Subsequent continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $173.77 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis

INFLIXIMAB (11400B)

infliximab 100 mg injection, 1 vial
11400B
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 18819)

Indication: Severe Crohn disease
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 5 Max qty units: 5 # of repeats: 2 DPMQ: $791.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remsima
Renflexis

INFLIXIMAB (11412P)

Supply only until 01/09/2027
infliximab 100 mg injection, 1 vial
11412P
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Complex refractory Fistulising Crohn disease
Treatment phase: Subsequent continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $173.77 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis

INFLIXIMAB (11423F)

infliximab 100 mg injection, 1 vial
11423F
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 19207)

Indication: Complex refractory Fistulising Crohn disease
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 5 Max qty units: 5 # of repeats: 2 DPMQ: $791.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remsima
Renflexis