PEGVISOMANT
pegvisomant 10 mg injection [30 vials] (&) inert substance diluent [30 syringes],
1 pack
Manner of administration:Injection
Restriction
Indication: Acromegaly
Treatment phase: Initial treatment
Restriction
Indication: Acromegaly
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: $4,018.52 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Somavert | |||||
pegvisomant 10 mg injection [30 vials] (&) inert substance diluent [30 syringes],
1 pack
Manner of administration:Injection
Restriction
Indication: Acromegaly
Treatment phase: Initial treatment
Restriction
Indication: Acromegaly
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: $3,969.64 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Somavert | |||||