Registration | Keytruda PFP

You are registering for access to the KEYTRUDA^® PFP portal. Within this portal, prescribers are able to select the active, enrolling PFP in which to enrol eligible patients across multiple private and public practices. Hospital pharmacies can order KEYTRUDA stock for enrolled patients.

To streamline access to future PFPs, your data will be stored securely by the program administrator (Vivacity Health Pty Ltd). You can opt out of your data being retained for this purpose at any time by contacting the PFP Coordinator.

Title *

First name *

Last name *

Healthcare professional type *

Prescriber

Pharmacist

Email address *

Confirmation emails and reminders will be sent to this email address. Use this email address to log back in to the site.

Please use an email address accessible to all members of your team. This will help ensure continuity of treatment for individuals enrolled in a KEYTRUDA PFP.
Please register only one pharmacist per institution.

Hospital at which PFP will be run *

AHPRA number *

Please include the three letters of your AHPRA number followed by the 10 digits. If you don’t know your AHPRA number, click here to find out.

Department *

Phone (including area code) *

Stock delivery address (e.g. compounding or hospital pharmacy)

If utilising the services of a compounding organisation, please ensure their ability to compound the 100 mg vial of KEYTRUDA prior to organising your first shipment.

Storage requirements for KEYTRUDA:
KEYTRUDA (100 mg/4 mL concentrated injection single use vial) must be stored in a refrigerator (2°C to 8°C).
Protect from light. Do not freeze. Do not shake.
For further information regarding storage conditions after reconstitution or dilution of the medicinal product, please refer to the Approved Product Information.

Pharmacy name (max 30 characters) *

Building name *

Building floor *

Street address *

Suburb *

State *

Postcode *

Business hours *

Special delivery instructions

Phone (including area code)

Name of primary contact for stock delivery *

Name of secondary contact for stock delivery

You can enrol participants across different practices by selecting the hospital for each participant at enrolment. You can enrol up to 10 participants into a single PFP (across public and private practices).

By registering for the KEYTRUDA PFP portal, I understand and agree to the following:

Each PFP is restricted to participants who meet all PFP inclusion criteria.
A maximum of 10 (ten) participants can be enrolled per prescriber for any given program.
KEYTRUDA PFPs are undertaken to provide clinicians with experience using KEYTRUDA. If I have treated more than 10 participants with KEYTRUDA for the given indication through other programs or clinical trials, I am therefore considered experienced and will not be eligible to access that PFP.
Adverse event reporting is mandatory. I will report all adverse events to MSD using the adverse event form and fax to MSD on 02 8988 8123.
PFPs hosted on the portal are administered by Vivacity Health, an independent medical education provider. Vivacity Health may need to contact me to discuss or clarify my involvement in a given PFP. Vivacity Health will manage the secure online KEYTRUDA database. Prescribers are restricted to viewing only the participants they enrol into all active programs.

Merck Sharp & Dohme (Australia) Pty Limited Privacy Collection Statement

Merck Sharp & Dohme (Australia) Pty Limited (“MSD”) will collect, record and use your name, phone number, email address and address (‘personal information’) collected at registration for the purposes of running the KEYTRUDA Product Familiarisation Program – initials and date of birth will be collected for patients you enrol in the program. If you choose not to provide us with your personal information, we may not be able to fulfil these purposes. We will keep your personal information for only as long as is necessary to carry out the purposes described above (unless we are required or permitted by law to hold the information for a longer period). We may disclose your personal information to organisations who assist us and our affiliated companies (which may be located in other countries including United States, United Kingdom, Singapore, South America, Poland, China or India). If you would like to know more about our privacy policy, including how to access and seek correction of the personal information MSD holds about you, how to complain about a breach of the Australian Privacy Principles, and how MSD handles such complaints, please go to https://www.msdprivacy.com/au/en/index.html or contact our Privacy Officer at Locked Bag 2234, North Ryde, NSW 1670, T: +61 2 8988 8000, E: msd_privacy_office@msd.com

Vivacity Health Pty Ltd Privacy Statement

At Vivacity Health, we acknowledge and respect your privacy and any information you provide to us is protected under the privacy laws of Australia. As the administrator of this Product Familiarisation Program portal and active programs hosted, Vivacity Health will collect and hold your information so that we can fulfil the administrative and communication requirements demanded of these programs. By providing the information requested, you consent to Vivacity Health using your information for these purposes. If you would like a copy of our Privacy Policy, please contact The Privacy Officer, Vivacity Health, Level 8, 201 Pacific Highway, St Leonards NSW 2065; Phone: (02) 8404 4951; Fax: 1800 848 224.

Merck Sharp & Dohme (Australia) Pty Limited Privacy Collection Statement

Merck Sharp & Dohme (Australia) Pty Limited (“MSD”) will collect, record and use your name, phone number, email address and address (‘personal information’) collected at registration for the purposes of running the KEYTRUDA Product Familiarisation Program – initials and date of birth will be collected for participants you enrol in the program. If you choose not to provide us with your personal information, we may not be able to fulfil these purposes. We will keep your personal information for only as long as is necessary to carry out the purposes described above (unless we are required or permitted by law to hold the information for a longer period). We may disclose your personal information to organisations who assist us and our affiliated companies (which may be located in other countries including United States, United Kingdom, Singapore, South America, Poland, China or India). If you would like to know more about our privacy policy, including how to access and seek correction of the personal information MSD holds about you, how to complain about a breach of the Australian Privacy Principles, and how MSD handles such complaints, please go to https://www.msdprivacy.com/au/en/index.html or contact our Privacy Officer at Locked Bag 2234, North Ryde, NSW 1670, T: +61 2 8988 8000, E: msd_privacy_office@msd.com

Vivacity Health Pty Ltd Privacy Statement

At Vivacity Health, we acknowledge and respect your privacy and any information you provide to us is protected under the privacy laws of Australia. As the administrator of this Product Familiarisation Program portal and active programs hosted, Vivacity Health will collect and hold your information so that we can fulfil the administrative and communication requirements demanded of these programs. By providing the information requested, you consent to Vivacity Health using your information for these purposes. If you would like a copy of our Privacy Policy, please contact The Privacy Officer, Vivacity Health, Level 8, 201 Pacific Highway, St Leonards NSW 2065; Phone: (02) 8404 4951; Fax: 1800 848 224.

I agree to my data being retained and stored securely by the portal administrator (Vivacity Health) to streamline registration for future programs and to enable single-prescriber registration across public and private hospitals.

I agree data retention *

I have read and understood the statements above.

I have read and understood the statements above. *

I have read and understood the stock delivery and KEYTRUDA storage statements above.

I have read and understood the stock deliv *

I have read and understood the the terms of use and the Privacy collection statements.

Agreement med onc *

I have read and understood the the terms of use and the Privacy collection statements.

|I have read and understood the pharma *

Yes, I would like to register for the KEYTRUDA PFP Portal.

Yes, I would like to register for the KEYTRUDA PFP Portal. *