ECULIZUMAB

ECULIZUMAB (12877R)

eculizumab 300 mg/30 mL injection, 30 mL vial
12877R
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Paroxysmal nocturnal haemoglobinuria (PNH)
Treatment phase: Initial treatment - Initial 2 (switching from PBS-subsidised ravulizumab for pregnancy)

Restriction

Indication: Paroxysmal nocturnal haemoglobinuria (PNH)
Treatment phase: Grandfather 1 (transition from non-PBS-subsidised treatment) - maintenance phase

Restriction

Indication: Paroxysmal nocturnal haemoglobinuria (PNH)
Treatment phase: Grandfather 2 (transition from LSDP-funded eculizumab)

Restriction

Indication: Paroxysmal nocturnal haemoglobinuria (PNH)
Treatment phase: First Continuing Treatment

Restriction

Indication: Paroxysmal nocturnal haemoglobinuria (PNH)
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: 6 Max qty units: 6 # of repeats: 5 DPMQ: $32,151.60 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Soliris