BLINATUMOMAB

BLINATUMOMAB (11115B)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11115B
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Consolidation treatment of relapsed or refractory B-precursor cell ALL
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 784 mcg # of repeats: 2 DPMA: $78,485.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)

BLINATUMOMAB (11116C)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11116C
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Induction treatment of relapsed or refractory B-precursor cell ALL
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 651 mcg # of repeats: 0 DPMA: $67,292.74 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)

BLINATUMOMAB (11117D)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11117D
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Consolidation treatment of relapsed or refractory B-precursor cell ALL
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 784 mcg # of repeats: 2 DPMA: $77,358.07 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)

BLINATUMOMAB (11118E)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11118E
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Induction treatment of relapsed or refractory B-precursor cell ALL
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 651 mcg # of repeats: 0 DPMA: $66,319.95 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)

BLINATUMOMAB (11119F)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11119F
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Induction treatment - balance of supply - relapsed or refractory B-precursor cell ALL
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 784 mcg # of repeats: 0 DPMA: $78,485.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)

BLINATUMOMAB (11120G)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11120G
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required

Restriction

Indication: Acute lymphoblastic leukaemia
Treatment phase: Induction treatment - balance of supply - relapsed or refractory B-precursor cell ALL
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 784 mcg # of repeats: 0 DPMA: $77,358.07 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)

BLINATUMOMAB (11850Q)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11850Q
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required

Restriction

Indication: Precursor B-cell acute lymphoblastic leukaemia (Pre-B-cell ALL)
Treatment phase: Initial treatment of newly-diagnosed Pre-B-cell ALL in the consolidation phase

Restriction

Indication: Precursor B-cell acute lymphoblastic leukaemia (Pre-B-cell ALL)
Treatment phase: Continuing treatment of Pre-B-cell ALL in complete haematological remission (CR)
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 784 mcg # of repeats: 1 DPMA: $77,358.07 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)

BLINATUMOMAB (11867N)

blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack
11867N
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required

Restriction

Indication: Precursor B-cell acute lymphoblastic leukaemia (Pre-B-cell ALL)
Treatment phase: Initial treatment of newly-diagnosed Pre-B-cell ALL in the consolidation phase

Restriction

Indication: Precursor B-cell acute lymphoblastic leukaemia (Pre-B-cell ALL)
Treatment phase: Continuing treatment of Pre-B-cell ALL in complete haematological remission (CR)
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 784 mcg # of repeats: 1 DPMA: $78,485.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Blincyto
(blinatumomab 38.5 microgram injection [1 vial] (&) inert substance solution [10 mL vial], 1 pack)