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
10228HMP	ALEMTUZUMAB alemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial (PI, CMI)	5	5	0	$51415.45	$31.60	$31.60
	Available brands
	Lemtrada

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
10232MMP	ALEMTUZUMAB alemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial (PI, CMI)	3	3	0	$30849.27	$31.60	$31.60
	Available brands
	Lemtrada

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
10243DMP	ALEMTUZUMAB alemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial (PI, CMI)	5	5	0	$51464.33	$31.60	$31.60
	Available brands
	Lemtrada

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
10246GMP	ALEMTUZUMAB alemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial (PI, CMI)	3	3	0	$30898.14	$31.60	$31.60
	Available brands
	Lemtrada