Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
12604JMP	ALIROCUMAB alirocumab 150 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$498.31	$30.00	$30.00
	Available brands
	Praluent

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
12607MMP	ALIROCUMAB alirocumab 75 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$498.31	$30.00	$30.00
	Available brands
	Praluent

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
12608NMP	ALIROCUMAB alirocumab 150 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$498.31	$30.00	$30.00
	Available brands
	Praluent

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, PLAIN

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
12613WMP	ALIROCUMAB alirocumab 75 mg/mL injection, 2 x 1 mL pen devices (PI, CMI)	1	2	5	$498.31	$30.00	$30.00
	Available brands
	Praluent