FINGOLIMOD
Manner of administration:Oral
Restriction (Streamlined authority code: 16325)
Indication: Multiple sclerosis
Treatment phase: Initial treatment
Restriction (Streamlined authority code: 16346)
Indication: Multiple sclerosis
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: 5 | DPMQ: $1,064.24 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Gilenya | |||||
Manner of administration:Oral
Restriction (Streamlined authority code: 16323)
Indication: Multiple sclerosis
Treatment phase: Initial treatment
Restriction (Streamlined authority code: 16301)
Indication: Multiple sclerosis
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: 5 | DPMQ: $794.21 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
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