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
5714RMP	EPOETIN ALFA epoetin alfa 1000 units/0.5 mL injection, 6 x 0.5 mL syringes (PI, CMI)	2	12	5	$175.98	$31.60	$31.60
	Available brands
	Eprex 1000

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
5717XMP	EPOETIN ALFA epoetin alfa 8000 units/0.8 mL injection, 6 x 0.8 mL syringes (PI, CMI)	2	12	5	$1025.72	$31.60	$31.60
	Available brands
	Eprex 8000

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
5718YMP	EPOETIN ALFA epoetin alfa 40 000 units/mL injection, 1 mL syringe (PI, CMI)	2	2	5	$790.12	$31.60	$31.60
	Available brands
	Eprex 40,000

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
5720CMP	EPOETIN ALFA epoetin alfa 3000 units/0.3 mL injection, 6 x 0.3 mL syringes (PI, CMI)	2	12	5	$420.20	$31.60	$31.60
	Available brands
	Eprex 3000

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
5722EMP	EPOETIN ALFA epoetin alfa 10 000 units/mL injection, 6 x 1 mL syringes (PI, CMI)	2	12	5	$1241.44	$31.60	$31.60
	Available brands
	Eprex 10000