PEMBROLIZUMAB

PEMBROLIZUMAB (15329T)

pembrolizumab 100 mg/4 mL injection, 4 mL vial
15329T
Body System:
Manner of administration:Injection
Public
Chemotherapy Items for Public Hospital use
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 18413)

Indication: Resectable locally advanced squamous cell carcinoma of the oral cavity, pharynx or larynx
Quantities & Cost
Max amount # of repeats DPMA Max safety net General Patient Charge
Max amount: 400 mg # of repeats: 7 DPMA: $14,621.47 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Keytruda
(pembrolizumab 100 mg/4 mL injection, 4 mL vial)