RIOCIGUAT
Body System:
Manner of administration:Oral
Restriction
Indication: Chronic thromboembolic pulmonary hypertension (CTEPH)
Treatment phase: Initial treatment
Restriction
Indication: Chronic thromboembolic pulmonary hypertension (CTEPH)
Treatment phase: Continuing treatment
Restriction
Indication: Chronic thromboembolic pulmonary hypertension (CTEPH)
Treatment phase: Balance of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 42 | # of repeats: 0 | DPMQ: $1,631.82 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Adempas | |||||
Body System:
Manner of administration:Oral
Restriction
Indication: Chronic thromboembolic pulmonary hypertension (CTEPH)
Treatment phase: Initial treatment
Restriction
Indication: Chronic thromboembolic pulmonary hypertension (CTEPH)
Treatment phase: Continuing treatment
Restriction
Indication: Chronic thromboembolic pulmonary hypertension (CTEPH)
Treatment phase: Balance of supply
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 42 | # of repeats: 0 | DPMQ: $1,680.70 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Adempas | |||||
Body System:
Manner of administration:Oral
Restriction
Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Initial 1 (new patients)
Restriction
Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Initial 2 (change)
Restriction
Indication: Pulmonary arterial hypertension (PAH)
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: 42 | # of repeats: 0 | DPMQ: $1,680.70 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Adempas | |||||
Body System:
Manner of administration:Oral
Restriction
Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Initial 1 (new patients)
Restriction
Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Initial 2 (change)
Restriction
Indication: Pulmonary arterial hypertension (PAH)
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: 42 | # of repeats: 0 | DPMQ: $1,631.82 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Adempas | |||||