ELOTUZUMAB

ELOTUZUMAB (12983H)

12983H
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required

Restriction

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Continuing treatment
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 1200 mg # of repeats: 5 DPMA: $5,041.26 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Empliciti
(elotuzumab 300 mg injection, 1 vial)
Empliciti
(elotuzumab 400 mg injection, 1 vial)

ELOTUZUMAB (12995Y)

12995Y
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required

Restriction

Indication: Relapsed and/or refractory multiple myeloma
Treatment phase: Continuing treatment
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 1200 mg # of repeats: 5 DPMA: $5,156.23 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Empliciti
(elotuzumab 300 mg injection, 1 vial)
Empliciti
(elotuzumab 400 mg injection, 1 vial)