FLUTICASONE FUROATE + UMECLIDINIUM + VILANTEROL
fluticasone furoate 200 microgram/actuation + umeclidinium 62.5 microgram/actuation
+ vilanterol 25 microgram/actuation powder for inhalation, 30 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 12603)
Indication: Severe asthma
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $89.39 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Trelegy Ellipta 200/62.5/25 | |||||
fluticasone furoate 200 microgram/actuation + umeclidinium 62.5 microgram/actuation
+ vilanterol 25 microgram/actuation powder for inhalation, 30 actuations
Manner of administration:Inhalation By Mouth
Restriction (Streamlined authority code: 15601)
Indication: Severe asthma
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 2 | # of repeats: 5 | DPMQ: $167.56 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Trelegy Ellipta 200/62.5/25 | |||||