OMALIZUMAB

OMALIZUMAB (14883H)

omalizumab 150 mg/mL injection, 1 mL pen device
14883H
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Balance of supply
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $226.31 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14884J)

omalizumab 150 mg/mL injection, 1 mL pen device
14884J
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 1 (New patients; or Recommencement of treatment in a new treatment cycle following a break in PBS subsidised biological medicine therapy)

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 2 (Change of 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: 1 # of repeats: 7 DPMQ: $209.07 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14903J)

omalizumab 150 mg/mL injection, 1 mL pen device
14903J
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Severe chronic spontaneous urticaria
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 2 DPMQ: $443.74 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14922J)

omalizumab 150 mg/mL injection, 1 mL pen device
14922J
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Uncontrolled severe asthma
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: 1 # of repeats: 5 DPMQ: $209.07 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14923K)

omalizumab 150 mg/mL injection, 1 mL pen device
14923K
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 1 (New patients; or Recommencement of treatment in a new treatment cycle following a break in PBS subsidised biological medicine therapy)

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Initial treatment - Initial 2 (Change of 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: 1 # of repeats: 7 DPMQ: $226.31 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14928Q)

omalizumab 150 mg/mL injection, 1 mL pen device
14928Q
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Uncontrolled severe asthma
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: 1 # of repeats: 5 DPMQ: $226.31 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14929R)

omalizumab 150 mg/mL injection, 1 mL pen device
14929R
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Uncontrolled severe asthma
Treatment phase: Balance of supply
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $209.07 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14937E)

omalizumab 150 mg/mL injection, 1 mL pen device
14937E
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Severe chronic spontaneous urticaria
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $418.14 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14938F)

omalizumab 150 mg/mL injection, 1 mL pen device
14938F
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Severe chronic spontaneous urticaria
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $443.74 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14945N)

omalizumab 150 mg/mL injection, 1 mL pen device
14945N
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Severe chronic spontaneous urticaria
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 2 DPMQ: $418.14 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair