TREMELIMUMAB

TREMELIMUMAB (15090F)

tremelimumab 300 mg/15 mL injection, 15 mL vial
15090F
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17477)

Indication: Advanced (unresectable) Barcelona Clinic Liver Cancer Stage B or Stage C hepatocellular carcinoma
Treatment phase: Initial treatment
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 300 mg # of repeats: 0 DPMA: $16,651.41 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Imjudo
(tremelimumab 300 mg/15 mL injection, 15 mL vial)

TREMELIMUMAB (15108E)

tremelimumab 300 mg/15 mL injection, 15 mL vial
15108E
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17477)

Indication: Advanced (unresectable) Barcelona Clinic Liver Cancer Stage B or Stage C hepatocellular carcinoma
Treatment phase: Initial treatment
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 300 mg # of repeats: 0 DPMA: $16,928.92 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Imjudo
(tremelimumab 300 mg/15 mL injection, 15 mL vial)