IVACAFTOR
Manner of administration:Oral
Restriction
Indication: Cystic fibrosis
Treatment phase: Initial treatment - New patient (non-gating mutations)
Restriction
Indication: Cystic fibrosis
Treatment phase: Continuing treatment (non-gating mutations)
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 56 | # of repeats: 5 | DPMQ: $20,355.13 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Kalydeco | |||||
Manner of administration:Oral
Restriction
Indication: Cystic fibrosis
Treatment phase: Initial treatment - New patient (non-gating mutations)
Restriction
Indication: Cystic fibrosis
Treatment phase: Continuing treatment (non-gating mutations)
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 56 | # of repeats: 5 | DPMQ: $20,306.25 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Kalydeco | |||||
Manner of administration:Oral
Restriction
Indication: Cystic fibrosis
Treatment phase: Initial treatment - New patient (gating mutations)
Restriction
Indication: Cystic fibrosis
Treatment phase: Continuing treatment (gating mutations)
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 56 | # of repeats: 5 | DPMQ: $20,306.25 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Kalydeco | |||||
Manner of administration:Oral
Restriction
Indication: Cystic fibrosis
Treatment phase: Initial treatment - New patient (gating mutations)
Restriction
Indication: Cystic fibrosis
Treatment phase: Continuing treatment (gating mutations)
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 56 | # of repeats: 5 | DPMQ: $20,355.13 | Max safety net: $25.00 | General Patient Charge: $25.00 |
| Available brands | |||||
| Kalydeco | |||||