FINASTERIDE

Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Benign prostatic hyperplasia
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 56 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Finpro DPMQ: $170.76 Max safety net: $7.70 General Patient Charge: $7.70
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Benign prostatic hyperplasia
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
APO-Finasteride DPMQ: $191.46 Max safety net: $7.70 General Patient Charge: $7.70
Finasta DPMQ: $191.46 Max safety net: $7.70 General Patient Charge: $7.70
Finasteride-GA 5 DPMQ: $191.46 Max safety net: $7.70 General Patient Charge: $7.70
Finasteride GH 5 DPMQ: $144.84 Max safety net: $7.70 General Patient Charge: $7.70
Finasteride Mylan 5 DPMQ: $144.84 Max safety net: $7.70 General Patient Charge: $7.70
Finide DPMQ: $144.84 Max safety net: $7.70 General Patient Charge: $7.70
Finnacar DPMQ: $182.34 Max safety net: $7.70 General Patient Charge: $7.70
Pharmacor Finasteride 5 DPMQ: $191.46 Max safety net: $7.70 General Patient Charge: $7.70
Proscar DPMQ: $191.46 Max safety net: $7.70 General Patient Charge: $7.70
finasteride 5 mg tablet, 30
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Benign prostatic hyperplasia
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
APO-Finasteride DPMQ: $100.78 Max safety net: $7.70 General Patient Charge: $7.70
Finasta DPMQ: $100.78 Max safety net: $7.70 General Patient Charge: $7.70
Finasteride-GA 5 DPMQ: $100.78 Max safety net: $7.70 General Patient Charge: $7.70
Finasteride GH 5 DPMQ: $78.58 Max safety net: $7.70 General Patient Charge: $7.70
Finasteride Mylan 5 DPMQ: $78.58 Max safety net: $7.70 General Patient Charge: $7.70
Finide DPMQ: $78.58 Max safety net: $7.70 General Patient Charge: $7.70
Finnacar DPMQ: $96.43 Max safety net: $7.70 General Patient Charge: $7.70
Pharmacor Finasteride 5 DPMQ: $100.78 Max safety net: $7.70 General Patient Charge: $7.70
Proscar DPMQ: $100.78 Max safety net: $7.70 General Patient Charge: $7.70
finasteride 5 mg tablet, 28
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Benign prostatic hyperplasia
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 28 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Finpro DPMQ: $90.92 Max safety net: $7.70 General Patient Charge: $7.70