CABOTEGRAVIR (&) RILPIVIRINE

CABOTEGRAVIR (&) RILPIVIRINE (12937X)

cabotegravir 600 mg/3 mL modified release injection [3 mL vial] (&) rilpivirine 900 mg/3 mL modified release injection [3 mL vial], 1 pack
12937X
Body System:
Manner of administration:Injection
S100 HSD Community Access
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 12636)

Indication: HIV infection
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: $2,828.88 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Cabenuva