ELAFIBRANOR

ELAFIBRANOR (15084X)

Elafibranor 80 mg tablet, 30
15084X
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Primary biliary cholangitis (previously known as Primary biliary cirrhosis)
Treatment phase: Transitioning from non-PBS to PBS-subsidised supply - Grandfather arrangements
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $5,885.13 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iqirvo

ELAFIBRANOR (15089E)

Elafibranor 80 mg tablet, 30
15089E
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17501)

Indication: Primary biliary cholangitis (previously known as Primary biliary cirrhosis)
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: 30 # of repeats: 5 DPMQ: $5,885.13 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iqirvo

ELAFIBRANOR (15107D)

Elafibranor 80 mg tablet, 30
15107D
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Primary biliary cholangitis (previously known as Primary biliary cirrhosis)
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: 30 # of repeats: 5 DPMQ: $5,885.13 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Iqirvo