PEMBROLIZUMAB

pembrolizumab 100 mg/4 mL injection, 4 mL vial

PEMBROLIZUMAB (12126F)

pembrolizumab 100 mg/4 mL injection, 4 mL vial
12126F
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 13727)

Indication: Relapsed or refractory primary mediastinal B-cell lymphoma
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 13732)

Indication: Relapsed or refractory primary mediastinal B-cell lymphoma
Treatment phase: Continuing treatment
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 400 mg # of repeats: 6 DPMA: $14,870.58 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Keytruda
(pembrolizumab 100 mg/4 mL injection, 4 mL vial)