Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
14966QMP	PALOVAROTENE palovarotene 5 mg capsule, 28 (PI, CMI)	1	28	5	$50,114.93	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
14967RMP	PALOVAROTENE palovarotene 1 mg capsule, 28 (PI, CMI)	1	28	2	$10,153.33	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
14968TMP	PALOVAROTENE palovarotene 1.5 mg capsule, 28 (PI, CMI)	1	28	5	$15,148.53	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
14980KMP	PALOVAROTENE palovarotene 2.5 mg capsule, 28 (PI, CMI)	1	28	5	$25,138.93	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
14981LMP	PALOVAROTENE palovarotene 5 mg capsule, 28 (PI, CMI)	1	28	2	$50,114.93	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
14982MMP	PALOVAROTENE palovarotene 2.5 mg capsule, 28 (PI, CMI)	1	28	2	$25,138.93	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
14989XMP	PALOVAROTENE palovarotene 1.5 mg capsule, 28 (PI, CMI)	1	28	2	$15,148.53	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
15023QMP	PALOVAROTENE palovarotene 1 mg capsule, 28 (PI, CMI)	1	28	5	$10,153.33	$25.00	$25.00
	Available brands
	Sohonos

Source	General Schedule
Body System	MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM > OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM

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
15087CMP	PALOVAROTENE palovarotene 10 mg capsule, 28 (PI, CMI)	2	56	2	$199,970.94	$25.00	$25.00
	Available brands
	Sohonos