ALEMTUZUMAB

alemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial

ALEMTUZUMAB (10232M)

alemtuzumab 12 mg/1.2 mL injection, 1.2 mL vial
10232M
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction  6847

Indication: Multiple sclerosis
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 3 Max qty units: 3 # of repeats: 0 DPMQ: $30,849.27 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lemtrada