CARFILZOMIB

Public
Chemotherapy Items for Public Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 12934)

Indication: Multiple myeloma
Treatment phase: Initial treatment - twice weekly treatment regimen

Restriction (Streamlined authority code: 12930)

Indication: Multiple myeloma
Treatment phase: Continuing treatment - twice weekly treatment regimen
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 120 mg # of repeats: 17 DPMA: $2,502.21 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kyprolis
(carfilzomib 10 mg injection, 1 vial)
Kyprolis
(carfilzomib 30 mg injection, 1 vial)
Kyprolis
(carfilzomib 60 mg injection, 1 vial)
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 12934)

Indication: Multiple myeloma
Treatment phase: Initial treatment - twice weekly treatment regimen

Restriction (Streamlined authority code: 12930)

Indication: Multiple myeloma
Treatment phase: Continuing treatment - twice weekly treatment regimen
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 120 mg # of repeats: 17 DPMA: $2,581.64 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kyprolis
(carfilzomib 10 mg injection, 1 vial)
Kyprolis
(carfilzomib 30 mg injection, 1 vial)
Kyprolis
(carfilzomib 60 mg injection, 1 vial)
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 12694)

Indication: Multiple myeloma
Treatment phase: Initial treatment - once weekly treatment regimen

Restriction (Streamlined authority code: 12849)

Indication: Multiple myeloma
Treatment phase: Continuing treatment - once weekly treatment regimen
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 160 mg # of repeats: 8 DPMA: $3,396.56 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kyprolis
(carfilzomib 10 mg injection, 1 vial)
Kyprolis
(carfilzomib 30 mg injection, 1 vial)
Kyprolis
(carfilzomib 60 mg injection, 1 vial)
Public
Chemotherapy Items for Public Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 12694)

Indication: Multiple myeloma
Treatment phase: Initial treatment - once weekly treatment regimen

Restriction (Streamlined authority code: 12849)

Indication: Multiple myeloma
Treatment phase: Continuing treatment - once weekly treatment regimen
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 160 mg # of repeats: 8 DPMA: $3,305.88 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kyprolis
(carfilzomib 10 mg injection, 1 vial)
Kyprolis
(carfilzomib 30 mg injection, 1 vial)
Kyprolis
(carfilzomib 60 mg injection, 1 vial)
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 14389)

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Initial treatment for Cycles 1 to 3

Restriction (Streamlined authority code: 14363)

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Continuing treatment for Cycles 3 to 12

Restriction (Streamlined authority code: 14364)

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Continuing treatment for Cycles 13 onwards
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 60 mg # of repeats: 17 DPMA: $1,359.27 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kyprolis
(carfilzomib 10 mg injection, 1 vial)
Kyprolis
(carfilzomib 30 mg injection, 1 vial)
Kyprolis
(carfilzomib 60 mg injection, 1 vial)
Public
Chemotherapy Items for Public Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 14389)

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Initial treatment for Cycles 1 to 3

Restriction (Streamlined authority code: 14363)

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Continuing treatment for Cycles 3 to 12

Restriction (Streamlined authority code: 14364)

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Continuing treatment for Cycles 13 onwards
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 60 mg # of repeats: 17 DPMA: $1,296.72 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kyprolis
(carfilzomib 10 mg injection, 1 vial)
Kyprolis
(carfilzomib 30 mg injection, 1 vial)
Kyprolis
(carfilzomib 60 mg injection, 1 vial)