Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

Note

Authority Required

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11668DMP	INOTUZUMAB OZOGAMICIN Injection (PI, CMI) Available brands Besponsa (inotuzumab ozogamicin 1 mg injection, 1 vial)	2820 mcg	4	$38,021.29	$25.00	$25.00

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

Note

Authority Required

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11673JMP	INOTUZUMAB OZOGAMICIN Injection (PI, CMI) Available brands Besponsa (inotuzumab ozogamicin 1 mg injection, 1 vial)	3384 mcg	2	$50,649.42	$25.00	$25.00

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

Note

Authority Required

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11680RMP	INOTUZUMAB OZOGAMICIN Injection (PI, CMI) Available brands Besponsa (inotuzumab ozogamicin 1 mg injection, 1 vial)	2820 mcg	4	$37,452.57	$25.00	$25.00

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > MONOCLONAL ANTIBODIES AND ANTIBODY DRUG CONJUGATES

Caution

Note

Authority Required

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11696NMP	INOTUZUMAB OZOGAMICIN Injection (PI, CMI) Available brands Besponsa (inotuzumab ozogamicin 1 mg injection, 1 vial)	3384 mcg	2	$49,906.35	$25.00	$25.00