ENCORAFENIB
Manner of administration:Oral
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 | |||||
Manner of administration:Oral
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: 4 | Max qty units: 168 | # of repeats: 3 | DPMQ: $6,863.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Braftovi | |||||
Manner of administration:Oral
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: 4 | Max qty units: 168 | # of repeats: 5 | DPMQ: $6,863.68 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Braftovi | |||||
Manner of administration:Oral
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 | |||||
Manner of administration:Oral
Restriction (Streamlined authority code: 12487)
Indication: Metastatic colorectal cancer
Treatment phase: Initial treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 126 | # of repeats: 3 | DPMQ: $5,174.94 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Braftovi | |||||
Manner of administration:Oral
Restriction (Streamlined authority code: 12484)
Indication: Metastatic colorectal cancer
Treatment phase: Continuing treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 3 | Max qty units: 126 | # of repeats: 5 | DPMQ: $5,174.94 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Braftovi | |||||