TOFERSEN

TOFERSEN (15528G)

Tofersen 100 mg/15 mL injection, 15 mL vial
15528G
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Extended first continuing treatment (additional 3 doses)
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: $28,400.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Qalsody

TOFERSEN (15531K)

Tofersen 100 mg/15 mL injection, 15 mL vial
15531K
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Subsequent continuing treatment

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Grandfather arrangements - Transitioning from non-PBS to PBS-subsidised 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: $28,449.24 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Qalsody

TOFERSEN (15532L)

Tofersen 100 mg/15 mL injection, 15 mL vial
15532L
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Subsequent continuing treatment

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Grandfather arrangements - Transitioning from non-PBS to PBS-subsidised 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: $28,400.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Qalsody

TOFERSEN (15533M)

Tofersen 100 mg/15 mL injection, 15 mL vial
15533M
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Extended first continuing treatment (additional 3 doses)
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: $28,449.24 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Qalsody

TOFERSEN (15538T)

Tofersen 100 mg/15 mL injection, 15 mL vial
15538T
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Initial treatment

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: First 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: 6 DPMQ: $28,400.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Qalsody

TOFERSEN (15540X)

Tofersen 100 mg/15 mL injection, 15 mL vial
15540X
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: Initial treatment

Restriction

Indication: Amyotrophic lateral sclerosis
Treatment phase: First 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: 6 DPMQ: $28,449.24 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Qalsody