ETANERCEPT

ETANERCEPT (11225T)

etanercept 50 mg/mL injection, 4 x 1 mL syringes
11225T
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 16720)

Indication: Severe chronic plaque psoriasis
Treatment phase: Subsequent continuing treatment, whole body

Restriction (Streamlined authority code: 16795)

Indication: Severe chronic plaque psoriasis
Treatment phase: Subsequent continuing treatment, face, hand, foot
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: $846.42 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Brenzys
Erelzi
Nepexto