ENFORTUMAB VEDOTIN

ENFORTUMAB VEDOTIN (13634N)

13634N
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 14416)

Indication: Locally advanced (Stage III) or metastatic (Stage IV) urothelial cancer
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 125 mg # of repeats: 8 DPMA: $6,346.01 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Padcev
(enfortumab vedotin 20 mg injection, 1 vial)
Padcev
(enfortumab vedotin 30 mg injection, 1 vial)

ENFORTUMAB VEDOTIN (13648H)

13648H
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 14416)

Indication: Locally advanced (Stage III) or metastatic (Stage IV) urothelial cancer
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 125 mg # of repeats: 8 DPMA: $6,214.62 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Padcev
(enfortumab vedotin 20 mg injection, 1 vial)
Padcev
(enfortumab vedotin 30 mg injection, 1 vial)