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
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
5649HMP	DARBEPOETIN ALFA darbepoetin alfa 100 microgram/0.5 mL injection, 0.5 mL pen device (PI, CMI)	8	8	5	$1,651.12	$25.00	$25.00
	Available brands
	Aranesp SureClick

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
5650JMP	DARBEPOETIN ALFA darbepoetin alfa 150 microgram/0.3 mL injection, 0.3 mL pen device (PI, CMI)	8	8	5	$2,460.16	$25.00	$25.00
	Available brands
	Aranesp SureClick

Source	S100 HSD Private
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
6320PMP	DARBEPOETIN ALFA darbepoetin alfa 10 microgram/0.4 mL injection, 4 x 0.4 mL syringes (PI, CMI)	2	8	5	$242.22	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Private
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
6324WMP	DARBEPOETIN ALFA darbepoetin alfa 50 microgram/0.5 mL injection, 4 x 0.5 mL syringes (PI, CMI)	2	8	5	$911.06	$25.00	$25.00
	Available brands
	Aranesp

Source	S100 HSD Private
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
6493RMP	DARBEPOETIN ALFA darbepoetin alfa 150 microgram/0.3 mL injection, 0.3 mL pen device (PI, CMI)	8	8	5	$2,509.04	$25.00	$25.00
	Available brands
	Aranesp SureClick