OMALIZUMAB

Omalizumab 75 mg/0.5 mL injection, 0.5 mL pen device

OMALIZUMAB (15543C)

Omalizumab 75 mg/0.5 mL injection, 0.5 mL pen device
15543C
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 19214)

Indication: Uncontrolled severe asthma
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 5 DPMQ: $102.99 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Omlyclo