Source	S100 HSD Private
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

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
6280MMP	VALACICLOVIR valaciclovir 500 mg tablet, 100 (PI, CMI)	5	500	2	$216.88	$31.60	$31.60
	Available brands
	APX-Valaciclovira
	Valaciclovir RBXa
	Valtrexa * Additional charge for this brand is $14.05B	5	500	2	$230.93	$31.60	$45.65

Source	S100 HSD Public
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

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
9568NMP	VALACICLOVIR valaciclovir 500 mg tablet, 100 (PI, CMI)	5	500	2	$200.00	$31.60	$31.60
	Available brands
	APX-Valaciclovira
	Valaciclovir RBXa
	Valtrexa * Additional charge for this brand is $13.50B	5	500	2	$213.50	$31.60	$45.10