High risk and intermediate-2 risk myelofibrosis
Treatment Phase: Continuing treatment
Clinical criteria:
AND
Treatment criteria:
-
Must be treated by a medical practitioner; OR
-
Must be treated by a nurse practitioner where both of the following are occurring:
(i) patient care is being shared with a medical practitioner, (ii) the prescription
continues existing therapy with this medicine.
Note
Risk of myelofibrosis is defined in accordance with the Myelofibrosis International
Prognostic Scoring System (IPSS) or the Dynamic International Prognostic Scoring System
(DIPSS) or the Age-Adjusted DIPSS.
Note
No increase in the maximum quantity or number of units may be authorised.
Note
No increase in the maximum number of repeats may be authorised.
Note
Special Pricing Arrangements apply.
Intermediate-1 risk myelofibrosis
Treatment Phase: Continuing treatment
Clinical criteria:
AND
Treatment criteria:
-
Must be treated by a medical practitioner; OR
-
Must be treated by a nurse practitioner where both of the following are occurring:
(i) patient care is being shared with a medical practitioner, (ii) the prescription
continues existing therapy with this medicine.
Note
Risk of myelofibrosis is defined in accordance with the Myelofibrosis International
Prognostic Scoring System (IPSS) or the Dynamic International Prognostic Scoring System
(DIPSS) or the Age-Adjusted DIPSS.
Note
No increase in the maximum quantity or number of units may be authorised.
Note
No increase in the maximum number of repeats may be authorised.
Note
Special Pricing Arrangements apply.