AFATINIB

AFATINIB (11335N)

afatinib 20 mg tablet, 28
11335N
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
Treatment phase: Initial 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: 28 # of repeats: 3 DPMQ: $2,750.73 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Giotrif

AFATINIB (11336P)

afatinib 20 mg tablet, 28
11336P
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 7613)

Indication: Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer (NSCLC)
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: 28 # of repeats: 3 DPMQ: $2,750.73 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Giotrif