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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11911XMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	4	$11,049.88	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
11915DMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	4	$10,853.55	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13745KMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$11,049.88	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13766MMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$11,049.88	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13767NMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$10,853.55	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13775BMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	3	$10,853.55	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13779FMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	3	$11,049.88	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
13780GMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$10,853.55	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
14889PMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$11,049.88	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
14925MMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$10,853.55	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
14932XMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1120 mg	5	$8,285.26	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
14942KMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1120 mg	5	$8,127.10	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
15068CMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$11,049.88	$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

Note

Authority Required (STREAMLINED)

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
15091GMP	DURVALUMAB Injection (PI, CMI) Available brands Imfinzi (durvalumab 120 mg/2.4 mL injection, 2.4 mL vial) Imfinzi (durvalumab 500 mg/10 mL injection, 10 mL vial)	1500 mg	5	$10,853.55	$25.00	$25.00