ACALABRUTINIB
acalabrutinib 100 mg tablet, 56
ACALABRUTINIB (13325H)
13325H
Manner of administration:Oral
Restriction
Indication: Mantle cell lymphoma
Treatment phase: Initial treatment
Restriction
Indication: Mantle cell lymphoma
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: 56 | # of repeats: 5 | DPMQ: $7,052.30 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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