TADALAFIL

Body System:

Manner of administration:Oral

Private

S100 HSD Private

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 - combination therapy (dual or triple therapy, excluding selexipag) in an untreated patient

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 2 - starting combination therapy (dual or triple therapy, excluding selexipag) in a treated patient where a diagnosis of pulmonary arterial hypertension is established through a prior PBS authority application

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 3 - changing to this drug in combination therapy (dual or triple therapy)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Continuing treatment of combination therapy (dual or triple therapy, excluding selexipag)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Triple therapy - Initial treatment or continuing treatment of triple combination therapy (including dual therapy in lieu of triple therapy) that includes selexipag

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 56	# of repeats: 5	DPMQ: $503.44	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Adcirca
TADALIS 20
Tadalca

12151M

Body System:

Manner of administration:Oral

Public

S100 HSD Public

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 - combination therapy (dual or triple therapy, excluding selexipag) in an untreated patient

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 3 - changing to this drug in combination therapy (dual or triple therapy)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Continuing treatment of combination therapy (dual or triple therapy, excluding selexipag)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Triple therapy - Initial treatment or continuing treatment of triple combination therapy (including dual therapy in lieu of triple therapy) that includes selexipag

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 56	# of repeats: 5	DPMQ: $475.54	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Adcirca
TADALIS 20
Tadalca

1304P

Body System:

Manner of administration:Oral

Private

S100 HSD Private

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 (new patients)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 2 (change)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: 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: 56	# of repeats: 5	DPMQ: $503.44	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Adcirca
TADALIS 20
Tadalca

1308W

Body System:

Manner of administration:Oral

Public

S100 HSD Public

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 (new patients)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 2 (change)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: 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: 56	# of repeats: 5	DPMQ: $475.54	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Adcirca
TADALIS 20
Tadalca

14229X

Body System:

Manner of administration:Oral

Private

S100 HSD Private

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 (new patients)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 2 (change)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: 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: 60	# of repeats: 5	DPMQ: $538.77	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Tadalis 20

14240L

Body System:

Manner of administration:Oral

Private

S100 HSD Private

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 - combination therapy (dual or triple therapy, excluding selexipag) in an untreated patient

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 3 - changing to this drug in combination therapy (dual or triple therapy)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Continuing treatment of combination therapy (dual or triple therapy, excluding selexipag)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Triple therapy - Initial treatment or continuing treatment of triple combination therapy (including dual therapy in lieu of triple therapy) that includes selexipag

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 60	# of repeats: 5	DPMQ: $538.77	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Tadalis 20

14271D

Body System:

Manner of administration:Oral

Public

S100 HSD Public

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 - combination therapy (dual or triple therapy, excluding selexipag) in an untreated patient

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 3 - changing to this drug in combination therapy (dual or triple therapy)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Continuing treatment of combination therapy (dual or triple therapy, excluding selexipag)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Triple therapy - Initial treatment or continuing treatment of triple combination therapy (including dual therapy in lieu of triple therapy) that includes selexipag

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 60	# of repeats: 5	DPMQ: $509.51	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Tadalis 20

14281P

Body System:

Manner of administration:Oral

Public

S100 HSD Public

Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 1 (new patients)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: Initial 2 (change)

Restriction

Indication: Pulmonary arterial hypertension (PAH)

Treatment phase: 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: 60	# of repeats: 5	DPMQ: $509.51	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
Tadalis 20

4596X

Body System:

Manner of administration:Oral

Repatriation Pharmaceutical Benefits

Authority Required

Restriction

Indication: Erectile dysfunction

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 4	# of repeats: 5	DPMQ: -	Max safety net: -	General Patient Charge: -
Available brands
Apo-Tadalafil			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cialis			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cidala			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cilatil			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cipla Tadalafil			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Tadalafil GH			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Tadalafil Sandoz			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
TADALAFIL-WGR			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70

4597Y

Body System:

Manner of administration:Oral

Repatriation Pharmaceutical Benefits

Authority Required

Restriction

Indication: Erectile dysfunction

Quantities & Cost

Max qty packs	Max qty units	# of repeats	DPMQ	Max safety net	General Patient Charge
Max qty packs: 1	Max qty units: 4	# of repeats: 5	DPMQ: -	Max safety net: -	General Patient Charge: -
Available brands
Apo-Tadalafil			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cialis			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cidala			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cilatil			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Cipla Tadalafil			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Tadalafil GH			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Tadalafil Sandoz			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
TADALAFIL-WGR			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70
Tadalaccord			DPMQ: $106.55	Max safety net: $7.70	General Patient Charge: $7.70

TADALAFIL (12150L)

Restriction

Restriction

Restriction

Restriction

Restriction

TADALAFIL (12151M)

Restriction

Restriction

Restriction

Restriction

Restriction

TADALAFIL (1304P)

Restriction

Restriction

Restriction

TADALAFIL (1308W)

Restriction

Restriction

Restriction

TADALAFIL (14229X)

Restriction

Restriction

Restriction

TADALAFIL (14240L)

Restriction

Restriction

Restriction

Restriction

Restriction

TADALAFIL (14271D)

Restriction

Restriction

Restriction

Restriction

Restriction

TADALAFIL (14281P)

Restriction

Restriction

Restriction

TADALAFIL (4596X)

Restriction

TADALAFIL (4597Y)

Restriction