GLOFITAMAB

GLOFITAMAB (15228L)

Glofitamab 10 mg/10 mL injection, 10 mL vial
15228L
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required

Restriction

Indication: Relapsed or refractory diffuse large B-cell lymphoma (DLBCL)
Treatment phase: Initial treatment (Cycle 1, Day 15)
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 10000 mcg # of repeats: 0 DPMA: $5,357.33 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Columvi
(Glofitamab 10 mg/10 mL injection, 10 mL vial)