Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > CYTOTOXIC ANTIBIOTICS AND RELATED SUBSTANCES

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
5705GMPNP	DOXORUBICIN HYDROCHLORIDE (AS PEGYLATED LIPOSOMAL) doxorubicin hydrochloride (as pegylated liposomal) 20 mg/10 mL injection, 10 mL vial (PI, CMI)	4	4	5	$553.68	$31.60	$31.60
	Available brands
	Caelyxa
	Liposomal Doxorubicin SUNa

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > CYTOTOXIC ANTIBIOTICS AND RELATED SUBSTANCES

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
6249XMPNP	DOXORUBICIN HYDROCHLORIDE (AS PEGYLATED LIPOSOMAL) doxorubicin hydrochloride (as pegylated liposomal) 20 mg/10 mL injection, 10 mL vial (PI, CMI)	4	4	5	$584.21	$31.60	$31.60
	Available brands
	Caelyxa
	Liposomal Doxorubicin SUNa