RUXOLITINIB

ruxolitinib 5 mg tablet, 56

RUXOLITINIB (13239T)

ruxolitinib 5 mg tablet, 56
13239T
Manner of administration:Oral
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 13911)

Indication: Grade II to IV acute graft versus host disease (aGVHD)
Treatment phase: Initial 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: 56 # of repeats: 0 DPMQ: $2,305.13 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Jakavi