ELEXACAFTOR + TEZACAFTOR + IVACAFTOR (&) IVACAFTOR

elexacaftor 100 mg + tezacaftor 50 mg + ivacaftor 75 mg granules [28] (&) ivacaftor 75 mg granules [28], 56

ELEXACAFTOR + TEZACAFTOR + IVACAFTOR (&) IVACAFTOR (14280N)

elexacaftor 100 mg + tezacaftor 50 mg + ivacaftor 75 mg granules [28] (&) ivacaftor 75 mg granules [28], 56
14280N
Body System:
Manner of administration:Oral
Private
S100 HSD Private
Authority Required

Restriction

Indication: Cystic fibrosis
Treatment phase: Initial treatment

Restriction

Indication: Cystic fibrosis
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: $20,355.13 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Trikafta