POMALIDOMIDE

POMALIDOMIDE (12661J)

pomalidomide 4 mg capsule, 14
12661J
Body System:
Manner of administration:Oral
Private
S100 HSD Private
Authority Required

Restriction

Indication: Multiple myeloma
Treatment phase: Initial treatment with triple therapy (this drug, bortezomib and dexamethasone)

Restriction

Indication: Multiple myeloma
Treatment phase: Continuing treatment with triple therapy (this drug, bortezomib and dexamethasone)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 14 # of repeats: 2 DPMQ: $987.97 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Pomalidomide Sandoz
Pomolide

POMALIDOMIDE (12665N)

pomalidomide 4 mg capsule, 14
12665N
Body System:
Manner of administration:Oral
Public
S100 HSD Public
Authority Required

Restriction

Indication: Multiple myeloma
Treatment phase: Initial treatment with triple therapy (this drug, bortezomib and dexamethasone)

Restriction

Indication: Multiple myeloma
Treatment phase: Continuing treatment with triple therapy (this drug, bortezomib and dexamethasone)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 14 # of repeats: 2 DPMQ: $941.43 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Pomalidomide Sandoz
Pomolide