DULAGLUTIDE

DULAGLUTIDE (11364D)

dulaglutide 1.5 mg/0.5 mL injection, 4 x 0.5 mL pen devices
11364D
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Diabetes mellitus type 2
Treatment phase: First PBS-prescription for this drug
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 4 # of repeats: 5 DPMQ: $134.60 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trulicity

DULAGLUTIDE (14150R)

dulaglutide 1.5 mg/0.5 mL injection, 4 x 0.5 mL pen devices
14150R
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15263)

Indication: Diabetes mellitus type 2
Treatment phase: Subsequent PBS-prescriptions for any GLP-1 receptor agonist
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 4 # of repeats: 5 DPMQ: $134.60 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trulicity