OMALIZUMAB

OMALIZUMAB (14885K)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14885K
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: $418.14 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14895Y)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14895Y
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: 1 Max qty units: 1 # of repeats: 2 DPMQ: $418.14 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14906M)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14906M
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: $418.14 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14912W)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14912W
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: $443.75 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14913X)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14913X
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: 1 Max qty units: 1 # of repeats: 5 DPMQ: $418.14 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14930T)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14930T
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: 1 Max qty units: 1 # of repeats: 5 DPMQ: $443.75 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14940H)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14940H
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: 1 Max qty units: 1 # of repeats: 2 DPMQ: $443.75 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14951X)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14951X
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: $443.75 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14952Y)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14952Y
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: $418.14 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair

OMALIZUMAB (14953B)

omalizumab 300 mg/2 mL injection, 2 mL pen device
14953B
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: $443.75 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Xolair