ADYNOVATE 1,500 UNIT VIAL

Drug Details

General

Brand Name: ADYNOVATE 1,500 UNIT VIAL
Generic Name: antihemo.FVIII,full length peg
Manufacturer: BAXALTA US INC.
NDC: 00944462701
Package size: 1EA

Drug Information

Family Planning drug: No
Diabetic Supply Drug: No
HTW drug: No
HTWPlus drug: No
Long-acting reversible contraception product: No
Refill-to-soon Utilization*: 75%
Specialty Drug†: Yes

Drug Pricing

Retail Pharmacy Cost: 2.4402
Retail Pharmacy Eff Date: 01/03/2024
Specialty Pharmacy Cost: 2.2908
Specialty Pharmacy Eff Date: 01/03/2024
Long-term Care Pharmacy Cost: 2.40534
Long-term Care Pharmacy Eff Date: 01/03/2024
340B Rate: 1.6932
Premium Preferred Generic Incentive‡: No

* Impacts only claims paid by HHSC: traditional Medicaid, CSHCN, HTW, and KHC Programs.

† Refer to the Specialty Drug Handbook for more information..

‡ Refer to the Premium Preferred Generic Drugs section for information about traditional Medicaid claim pricing and PPG pricing incentives.