IVACAFTOR

ivacaftor 25 mg granules, 56 sachets

IVACAFTOR (14156C)

ivacaftor 25 mg granules, 56 sachets
14156C
Manner of administration:Oral
Public
S100 HSD Public
Authority Required

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