ETANERCEPT
etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes],
1 pack
ETANERCEPT (9037P)
9037P
Manner of administration:Injection
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 1, Whole body (new patient)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 2, Whole body (change or recommencement of treatment after
a break in biological medicine of less than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 3, Whole body (recommencement of treatment after a break
in biological medicine of more than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 1, Face, hand, foot (new patient)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 2, Face, hand, foot (change or recommencement of treatment
after a break in biological medicine of less than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 3, Face, hand, foot (recommencement of treatment after
a break in biological medicine of more than 5 years)
Restriction
Indication: Severe chronic plaque psoriasis
Treatment phase: Initial treatment - Initial 1, Whole body or Face, hand, foot (new patient) or Initial
2, Whole body or Face, hand, foot (change or recommencement of treatment after a break
in biological medicine of less than 5 years) or Initial 3, Whole body or Face, hand,
foot (recommencement of treatment after a break in biological medicine of more than
5 years) - balance of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 3 | DPMQ: $846.44 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Enbrel | |||||