LANREOTIDE

S100 HSD Community Access
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 16024)

Indication: Acromegaly
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 16055)

Indication: Acromegaly
Treatment phase: Continuing treatment

Restriction (Streamlined authority code: 16057)

Indication: Functional carcinoid tumour
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 15955)

Indication: Functional carcinoid tumour
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $2,310.62 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Mytolac
Somatuline Autogel