ZANUBRUTINIB

zanubrutinib 80 mg capsule, 120
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Mantle cell lymphoma
Treatment phase: Initial treatment

Restriction

Indication: Mantle cell lymphoma
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: 120 # of repeats: 5 DPMQ: $7,932.89 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Brukinsa
zanubrutinib 80 mg capsule, 120
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Waldenstrom macroglobulinaemia
Treatment phase: Initial treatment

Restriction

Indication: Waldenstrom macroglobulinaemia
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: 120 # of repeats: 5 DPMQ: $7,932.89 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Brukinsa
zanubrutinib 80 mg capsule, 120
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)
Treatment phase: Treatment of relapsed/refractory disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 120 # of repeats: 5 DPMQ: $7,932.89 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Brukinsa
zanubrutinib 80 mg capsule, 120
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)
Treatment phase: First line drug treatment of this indication
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 120 # of repeats: 5 DPMQ: $7,932.89 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Brukinsa