DOXORUBICIN

Public
Chemotherapy Items for Public Hospital use
No restrictions
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 135 mg # of repeats: 11 DPMA: $149.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Adriamycin
(doxorubicin hydrochloride 50 mg/25 mL injection, 25 mL vial)
Doxorubicin ACC
(doxorubicin hydrochloride 200 mg/100 mL injection, 100 mL vial)
Private
Chemotherapy Items for Private Hospital use
No restrictions
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 135 mg # of repeats: 11 DPMA: $196.18 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Adriamycin
(doxorubicin hydrochloride 50 mg/25 mL injection, 25 mL vial)
Doxorubicin ACC
(doxorubicin hydrochloride 200 mg/100 mL injection, 100 mL vial)