Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12761PMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL pen devices (PI, CMI)	1	4	3	$801.70	$31.60	$31.60
	Available brands
	Actemra ACTPen

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12762QMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes (PI, CMI)	1	4	3	$801.70	$31.60	$31.60
	Available brands
	Actemra Subcutaneous Injection

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

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
12763RMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	0	$399.39	$31.60	$31.60
	Available brands
	Actemra

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

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
12766XMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	0	$217.62	$31.60	$31.60
	Available brands
	Actemra

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12767YMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL pen devices (PI, CMI)	1	4	1	$801.70	$31.60	$31.60
	Available brands
	Actemra ACTPen

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12768BMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes (PI, CMI)	1	4	1	$801.70	$31.60	$31.60
	Available brands
	Actemra Subcutaneous Injection

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

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
12775JMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	1	1	0	$80.97	$31.60	$31.60
	Available brands
	Actemra

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

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
12787BMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	1	1	0	$93.85	$31.60	$31.60
	Available brands
	Actemra

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

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
12791FMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	0	$200.71	$31.60	$31.60
	Available brands
	Actemra

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12792GMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL pen devices (PI, CMI)	1	4	3	$801.70	$31.60	$31.60
	Available brands
	Actemra ACTPen

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

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
12794JMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	1	1	0	$80.97	$31.60	$31.60
	Available brands
	Actemra

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

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
12795KMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	0	$217.62	$31.60	$31.60
	Available brands
	Actemra

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

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
12796LMP	TOCILIZUMAB tocilizumab 200 mg/10 mL injection, 10 mL vial (PI, CMI)	1	1	0	$200.71	$31.60	$31.60
	Available brands
	Actemra

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

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
12802TMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	0	$399.39	$31.60	$31.60
	Available brands
	Actemra

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

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
12805YMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	0	$424.25	$31.60	$31.60
	Available brands
	Actemra

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
12806BMP	TOCILIZUMAB tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes (PI, CMI)	1	4	3	$801.70	$31.60	$31.60
	Available brands
	Actemra Subcutaneous Injection

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

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
12810FMP	TOCILIZUMAB tocilizumab 400 mg/20 mL injection, 20 mL vial (PI, CMI)	1	1	0	$424.25	$31.60	$31.60
	Available brands
	Actemra

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

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
12811GMP	TOCILIZUMAB tocilizumab 80 mg/4 mL injection, 4 mL vial (PI, CMI)	1	1	0	$93.85	$31.60	$31.60
	Available brands
	Actemra