ENCORAFENIB

ENCORAFENIB (11937G)

encorafenib 50 mg capsule, 28
11937G
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 10271)

Indication: Unresectable Stage III or Stage IV malignant melanoma
Treatment phase: Initial treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 9 Max qty units: 252 # of repeats: 3 DPMQ: $7,035.45 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Braftovi

ENCORAFENIB (11954E)

encorafenib 50 mg capsule, 28
11954E
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17949)

Indication: Unresectable Stage III or Stage IV malignant melanoma
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 9 Max qty units: 252 # of repeats: 5 DPMQ: $7,035.45 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Braftovi