PEMBROLIZUMAB

PEMBROLIZUMAB (12122B)

pembrolizumab 100 mg/4 mL injection, 4 mL vial
12122B
Body System:
Manner of administration:Injection
Private
Chemotherapy Items for Private Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 16933)

Indication: Unresectable Stage III or Stage IV malignant melanoma
Treatment phase: Initial treatment - 6 weekly treatment regimen
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 400 mg # of repeats: 2 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)