Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
13313QMP	AVATROMBOPAG avatrombopag 20 mg tablet, 30 (PI, CMI)	1	30	5	$2601.06	$31.60	$31.60
	Available brands
	Doptelet

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
13317XMP	AVATROMBOPAG avatrombopag 20 mg tablet, 30 (PI, CMI)	1	30	5	$2649.94	$31.60	$31.60
	Available brands
	Doptelet

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
5825NMP	ELTROMBOPAG eltrombopag 25 mg tablet, 28 (PI, CMI)	1	28	5	$1228.12	$31.60	$31.60
	Available brands
	Revolade

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
5826PMP	ELTROMBOPAG eltrombopag 50 mg tablet, 28 (PI, CMI)	1	28	5	$2456.24	$31.60	$31.60
	Available brands
	Revolade

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
5827QMP	ELTROMBOPAG eltrombopag 25 mg tablet, 28 (PI, CMI)	1	28	5	$1277.00	$31.60	$31.60
	Available brands
	Revolade

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
5828RMP	ELTROMBOPAG eltrombopag 50 mg tablet, 28 (PI, CMI)	1	28	5	$2505.12	$31.60	$31.60
	Available brands
	Revolade

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
9696HMP	ROMIPLOSTIM romiplostim 250 microgram injection, 1 vial (PI, CMI)	1	1	5	$494.12	$31.60	$31.60
	Available brands
	Nplate

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
9697JMP	ROMIPLOSTIM romiplostim 250 microgram injection, 1 vial (PI, CMI)	1	1	5	$522.76	$31.60	$31.60
	Available brands
	Nplate

Source	S100 HSD Public
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
9698KMP	ROMIPLOSTIM romiplostim 500 microgram injection, 1 vial (PI, CMI)	1	1	5	$988.24	$31.60	$31.60
	Available brands
	Nplate

Source	S100 HSD Private
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTIHEMORRHAGICS > VITAMIN K AND OTHER HEMOSTATICS

Note

Authority Required

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
9699LMP	ROMIPLOSTIM romiplostim 500 microgram injection, 1 vial (PI, CMI)	1	1	5	$1036.65	$31.60	$31.60
	Available brands
	Nplate