Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5637QMP	DARBEPOETIN ALFA darbepoetin alfa 10 microgram/0.4 mL injection, 4 x 0.4 mL syringes (PI, CMI)	2	8	5	$224.36	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5638RMP	DARBEPOETIN ALFA darbepoetin alfa 20 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$422.54	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5639TMP	DARBEPOETIN ALFA darbepoetin alfa 30 microgram/0.3 mL injection, 4 x 0.3 mL syringes (PI, CMI)	2	8	5	$578.08	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5640WMP	DARBEPOETIN ALFA darbepoetin alfa 40 microgram/0.4 mL injection, 4 x 0.4 mL syringes (PI, CMI)	2	8	5	$701.66	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5641XMP	DARBEPOETIN ALFA darbepoetin alfa 50 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$867.48	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5642YMP	DARBEPOETIN ALFA darbepoetin alfa 60 microgram/0.3 mL injection, 4 x 0.3 mL syringes (PI, CMI)	2	8	5	$1,018.64	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5643BMP	DARBEPOETIN ALFA darbepoetin alfa 150 microgram/0.3 mL injection, 4 x 0.3 mL syringes (PI, CMI)	2	8	5	$2,460.18	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5644CMP	DARBEPOETIN ALFA darbepoetin alfa 80 microgram/0.4 mL injection, 4 x 0.4 mL syringes (PI, CMI)	2	8	5	$1,340.82	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIANEMIC PREPARATIONS > OTHER ANTIANEMIC PREPARATIONS

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
5645DMP	DARBEPOETIN ALFA darbepoetin alfa 20 microgram/0.5 mL injection, 0.5 mL pen device (PI, CMI)	8	8	5	$422.56	$25.00	$25.00
	Available brands
	Aranesp SureClick