PAXLOVID 150-100 MG PACK (EUA)

Drug Details

General

Brand Name: PAXLOVID 150-100 MG PACK (EUA)
Generic Name: nirmatrelvir/ritonavir
Manufacturer: PFIZER LABS.
NDC: 00069110104
Package size: 4EA

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: .0098
Retail Pharmacy Eff Date: 05/24/2022
Specialty Pharmacy Cost: .0092
Specialty Pharmacy Eff Date: 05/24/2022
Long-term Care Pharmacy Cost: .00966
Long-term Care Pharmacy Eff Date: 05/24/2022
340B Rate: .0043
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.