TEZACAFTOR + IVACAFTOR (&) IVACAFTOR

tezacaftor 100 mg + ivacaftor 150 mg tablet [28] (&) ivacaftor 150 mg tablet [28], 56

TEZACAFTOR + IVACAFTOR (&) IVACAFTOR (11854X)

tezacaftor 100 mg + ivacaftor 150 mg tablet [28] (&) ivacaftor 150 mg tablet [28], 56
11854X
Body System:
Manner of administration:Oral
Public
S100 HSD Public
Authority Required

Restriction

Indication: Cystic fibrosis - homozygous for the F508del mutation
Treatment phase: Initial treatment

Restriction

Indication: Cystic fibrosis - homozygous for the F508del mutation
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $18,952.50 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Symdeko