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

Caution

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
10387QMP	POMALIDOMIDE pomalidomide 4 mg capsule, 21 (PI, CMI)	1	21	0	$3325.83	$31.60	$31.60
	Available brands
	Pomalidomide Sandoz
	Pomalyst
	Pomolide

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

Caution

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
10406QMP	POMALIDOMIDE pomalidomide 3 mg capsule, 21 (PI, CMI)	1	21	0	$2494.38	$31.60	$31.60
	Available brands
	Pomalidomide Sandoz
	Pomalyst
	Pomolide

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

Caution

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
12665NMP	POMALIDOMIDE pomalidomide 4 mg capsule, 14 (PI, CMI)	1	14	2	$2217.22	$31.60	$31.60
	Available brands
	Pomalidomide Sandoz
	Pomalyst
	Pomolide

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

Caution

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
12666PMP	POMALIDOMIDE pomalidomide 3 mg capsule, 14 (PI, CMI)	1	14	2	$1662.92	$31.60	$31.60
	Available brands
	Pomalidomide Sandoz
	Pomalyst
	Pomolide

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

Caution

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
13788QMP	POMALIDOMIDE pomalidomide 2 mg capsule, 21 (PI, CMI)	1	21	0	$1662.92	$31.60	$31.60
	Available brands
	Pomalidomide Sandoz
	Pomolide

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

Caution

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
13794BMP	POMALIDOMIDE pomalidomide 1 mg capsule, 14 (PI, CMI)	1	14	2	$621.91	$31.60	$31.60
	Available brands
	Pomolide

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

Caution

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
13803LMP	POMALIDOMIDE pomalidomide 1 mg capsule, 21 (PI, CMI)	1	21	0	$932.87	$31.60	$31.60
	Available brands
	Pomalidomide Sandoz
	Pomolide

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

Caution

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
13815DMP	POMALIDOMIDE pomalidomide 2 mg capsule, 14 (PI, CMI)	1	14	2	$1108.61	$31.60	$31.60
	Available brands
	Pomolide