Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10523WMP	PONATINIB ponatinib 15 mg tablet, 60 (PI, CMI)	1	60	2	$5,491.11	$25.00	$25.00
	Available brands
	Iclusig

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10524XMP	PONATINIB ponatinib 45 mg tablet, 30 (PI, CMI)	1	30	2	$6,174.58	$25.00	$25.00
	Available brands
	Iclusig

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10917NMP	IMATINIB imatinib 400 mg capsule, 30 (PI, CMI)	1	30	2	$189.48	$25.00	$25.00
	Available brands
	ARX-IMATINIBa
	IMATINIB-DRLAa
	Imatinib GHa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
10924YMP	IMATINIB imatinib 100 mg capsule, 60 (PI, CMI)	1	60	2	$99.84	$25.00	$25.00
	Available brands
	ARX-IMATINIBa
	IMATINIB-DRLAa

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
11115BMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	784 mcg	2	$78,485.38	$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
11116CMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	651 mcg	0	$67,292.74	$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
11117DMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	784 mcg	2	$77,358.07	$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
11118EMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	651 mcg	0	$66,319.95	$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
11119FMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	784 mcg	0	$78,485.38	$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
11120GMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	784 mcg	0	$77,358.07	$25.00	$25.00

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11453TMP	PONATINIB ponatinib 45 mg tablet, 30 (PI, CMI)	1	30	2	$6,174.58	$25.00	$25.00
	Available brands
	Iclusig

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11454WMP	PONATINIB ponatinib 15 mg tablet, 60 (PI, CMI)	1	60	2	$5,491.11	$25.00	$25.00
	Available brands
	Iclusig

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

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11771MMP	IMATINIB imatinib 400 mg capsule, 30 (PI, CMI)	1	30	2	$189.48	$25.00	$25.00
	Available brands
	ARX-IMATINIBa
	IMATINIB-DRLAa
	Imatinib GHa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11780BMP	IMATINIB imatinib 100 mg tablet, 60 (PI, CMI)	1	60	2	$99.84	$25.00	$25.00
	Available brands
	Gilmata
	Gliveca
	IMATINIB RBXa
	Imaniba
	Imatinib Sandoza
	Imatinib-Tevaa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11783EMP	IMATINIB imatinib 100 mg capsule, 60 (PI, CMI)	1	60	2	$99.84	$25.00	$25.00
	Available brands
	ARX-IMATINIBa
	IMATINIB-DRLAa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
11789LMP	IMATINIB imatinib 400 mg tablet, 30 (PI, CMI)	1	30	2	$189.48	$25.00	$25.00
	Available brands
	Gilmata
	Gliveca
	IMATINIB RBXa
	Imaniba
	Imatinib Sandoza
	Imatinib-Tevaa

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
14718PMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	784 mcg	1	$77,358.07	$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
14736NMP	BLINATUMOMAB Injection (PI, CMI) Available brands Blincyto (blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)	784 mcg	1	$78,485.38	$25.00	$25.00

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
9123EMP	IMATINIB imatinib 100 mg tablet, 60 (PI, CMI)	1	60	2	$99.84	$25.00	$25.00
	Available brands
	Gilmata
	Gliveca
	IMATINIB RBXa
	Imaniba
	Imatinib Sandoza
	Imatinib-Tevaa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
9124FMP	IMATINIB imatinib 400 mg tablet, 30 (PI, CMI)	1	30	2	$189.48	$25.00	$25.00
	Available brands
	Gilmata
	Gliveca
	IMATINIB RBXa
	Imaniba
	Imatinib Sandoza
	Imatinib-Tevaa

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
9125GMP	DASATINIB dasatinib 20 mg tablet, 60 (PI, CMI)	1	60	2	$259.39	$25.00	$25.00
	Available brands
	DASATINIB-TEVAa
	Dasatinib ARXa
	Dasatinib Dr.Reddy'sa
	Dasatinib SUNa
	Dasatinib Sandoza
	Dasatinib Viatrisa
	Sprycela

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
9126HMP	DASATINIB dasatinib 50 mg tablet, 60 (PI, CMI)	1	60	2	$421.56	$25.00	$25.00
	Available brands
	DASATINIB-TEVAa
	Dasatinib ARXa
	Dasatinib Dr.Reddy'sa
	Dasatinib SUNa
	Dasatinib Sandoza
	Dasatinib Viatrisa
	Sprycela

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
9127JMP	DASATINIB dasatinib 70 mg tablet, 60 (PI, CMI)	1	60	2	$519.83	$25.00	$25.00
	Available brands
	DASATINIB-TEVAa
	Dasatinib ARXa
	Dasatinib Dr.Reddy'sa
	Dasatinib SUNa
	Dasatinib Sandoza
	Dasatinib Viatrisa
	Sprycela

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

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
9343RMP	DASATINIB dasatinib 100 mg tablet, 30 (PI, CMI)	1	30	2	$421.56	$25.00	$25.00
	Available brands
	DASATINIB-TEVAa
	Dasatinib ARXa
	Dasatinib Dr.Reddy'sa
	Dasatinib SUNa
	Dasatinib Sandoza
	Dasatinib Viatrisa
	Sprycela