TORIPALIMAB

TORIPALIMAB (15125C)

Toripalimab 240 mg/6 mL injection, 6 mL vial
15125C
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17616)

Indication: Recurrent or metastatic nasopharyngeal carcinoma
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 240 mg # of repeats: 7 DPMA: $9,548.26 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Zytorvi
(Toripalimab 240 mg/6 mL injection, 6 mL vial)

TORIPALIMAB (15126D)

Toripalimab 240 mg/6 mL injection, 6 mL vial
15126D
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17616)

Indication: Recurrent or metastatic nasopharyngeal carcinoma
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 240 mg # of repeats: 7 DPMA: $9,726.33 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Zytorvi
(Toripalimab 240 mg/6 mL injection, 6 mL vial)