BRIMONIDINE 0.2% EYE DROP

Drug Details

General

Brand Name: BRIMONIDINE 0.2% EYE DROP
Generic Name: brimonidine tartrate
Manufacturer: SANDOZ
NDC: 61314014305
Package size: 5ML

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†: No

Drug Pricing

Retail Pharmacy Cost: .80466
Retail Pharmacy Eff Date: 02/27/2024
Specialty Pharmacy Cost: .79057
Specialty Pharmacy Eff Date: 02/27/2024
Long-term Care Pharmacy Cost: .78534
Long-term Care Pharmacy Eff Date: 02/27/2024
340B Rate: .86
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.