BENRALIZUMAB

BENRALIZUMAB (11994G)

benralizumab 30 mg/mL injection, 1 mL pen device
11994G
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 1 (New patients; or Recommencement of treatment in a new treatment cycle following a break in PBS subsidised biological medicine therapy)

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 2 (Change of 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: 1 # of repeats: 4 DPMQ: $3,145.45 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Fasenra Pen

BENRALIZUMAB (11995H)

benralizumab 30 mg/mL injection, 1 mL pen device
11995H
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Uncontrolled severe asthma
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: 1 # of repeats: 2 DPMQ: $3,145.45 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Fasenra Pen

BENRALIZUMAB (11996J)

benralizumab 30 mg/mL injection, 1 mL pen device
11996J
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Uncontrolled severe asthma
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: 1 # of repeats: 2 DPMQ: $3,194.33 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Fasenra Pen

BENRALIZUMAB (11997K)

benralizumab 30 mg/mL injection, 1 mL pen device
11997K
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 1 (New patients; or Recommencement of treatment in a new treatment cycle following a break in PBS subsidised biological medicine therapy)

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 2 (Change of 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: 1 # of repeats: 4 DPMQ: $3,194.33 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Fasenra Pen

BENRALIZUMAB (11999M)

benralizumab 30 mg/mL injection, 1 mL pen device
11999M
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Balance of supply
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $3,194.33 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Fasenra Pen

BENRALIZUMAB (12000N)

benralizumab 30 mg/mL injection, 1 mL pen device
12000N
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Balance of supply
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $3,145.45 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Fasenra Pen