DURVALUMAB

durvalumab 120 mg/2.4 mL injection, 2.4 mL vial

DURVALUMAB (13779F)

13779F
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 18257)

Indication: Extensive-stage small cell lung cancer
Treatment phase: Initial treatment
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 1500 mg # of repeats: 3 DPMA: $11,049.88 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Imfinzi
(durvalumab 120 mg/2.4 mL injection, 2.4 mL vial)
Imfinzi
(durvalumab 500 mg/10 mL injection, 10 mL vial)