PONATINIB

ponatinib 15 mg tablet, 60
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: Initial treatment

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: Initial treatment

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: First continuing treatment

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: Subsequent continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 60 # of repeats: 5 DPMQ: $5,224.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iclusig
ponatinib 15 mg tablet, 60
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Initial treatment

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 60 # of repeats: 2 DPMQ: $5,224.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iclusig
ponatinib 45 mg tablet, 30
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Initial treatment

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 2 DPMQ: $5,874.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iclusig
ponatinib 45 mg tablet, 30
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: Initial treatment

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: Initial treatment

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: First continuing treatment

Restriction

Indication: Chronic Myeloid Leukaemia (CML)
Treatment phase: Subsequent continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $5,874.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iclusig
ponatinib 45 mg tablet, 30
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Initial treatment

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 2 DPMQ: $5,874.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iclusig
ponatinib 15 mg tablet, 60
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Initial treatment

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 60 # of repeats: 2 DPMQ: $5,224.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iclusig