ADALIMUMAB

adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe

ADALIMUMAB (12408C)

adalimumab 80 mg/0.8 mL injection, 0.8 mL syringe
12408C
Body System:
Manner of administration:Injection
General Schedule
Authority Required

Restriction

Indication: Moderate to severe hidradenitis suppurativa
Treatment phase: First continuing treatment

Restriction

Indication: Moderate to severe hidradenitis suppurativa
Treatment phase: Subsequent continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $1,346.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Humira
Yuflyma