Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10109CMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	7	$209.07	$25.00	$25.00
	Available brands
	Omlycloa

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10110DMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	7	$117.60	$25.00	$25.00
	Available brands
	Omlycloa
	Xolaira

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10118MMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	7	$104.54	$25.00	$25.00
	Available brands
	Omlycloa
	Xolaira

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10122RMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	7	$226.31	$25.00	$25.00
	Available brands
	Omlycloa

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10956PMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	6	$117.60	$25.00	$25.00
	Available brands
	Omlycloa
	Xolaira

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10967FMP	OMALIZUMAB omalizumab 75 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	1	1	6	$104.54	$25.00	$25.00
	Available brands
	Omlycloa
	Xolaira

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10968GMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	6	$226.31	$25.00	$25.00
	Available brands
	Omlyclo

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
10973MMP	OMALIZUMAB omalizumab 150 mg/mL injection, 1 mL syringe (PI, CMI)	1	1	6	$209.07	$25.00	$25.00
	Available brands
	Omlyclo

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
11996JMP	BENRALIZUMAB benralizumab 30 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	2	$3,194.33	$25.00	$25.00
	Available brands
	Fasenra Pen

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
11997KMP	BENRALIZUMAB benralizumab 30 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	4	$3,194.33	$25.00	$25.00
	Available brands
	Fasenra Pen

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
11999MMP	BENRALIZUMAB benralizumab 30 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	0	$3,194.33	$25.00	$25.00
	Available brands
	Fasenra Pen

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
12007YMP	MEPOLIZUMAB mepolizumab 100 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	7	$1,556.10	$25.00	$25.00
	Available brands
	Nucala

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
12021QMP	MEPOLIZUMAB mepolizumab 100 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	0	$1,556.10	$25.00	$25.00
	Available brands
	Nucala

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
12043WMP	MEPOLIZUMAB mepolizumab 100 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	0	$1,604.98	$25.00	$25.00
	Available brands
	Nucala

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
12051GMP	MEPOLIZUMAB mepolizumab 100 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	7	$1,604.98	$25.00	$25.00
	Available brands
	Nucala

Source	S100 HSD Private
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
12052HMP	MEPOLIZUMAB mepolizumab 100 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	5	$1,604.98	$25.00	$25.00
	Available brands
	Nucala

Source	S100 HSD Public
Body System	RESPIRATORY SYSTEM > DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES > OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES

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
12064YMP	MEPOLIZUMAB mepolizumab 100 mg/mL injection, 1 mL pen device (PI, CMI)	1	1	5	$1,556.10	$25.00	$25.00
	Available brands
	Nucala