BREZTRI AEROSPHERE INHALER

Drug Details

General

Brand Name: BREZTRI AEROSPHERE INHALER
Generic Name: budesonide/glycopyr/formoterol
Manufacturer: ASTRAZENECA
NDC: 00310461639
Package size: 5.9GM

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: 58.1266
Retail Pharmacy Eff Date: 01/16/2024
Specialty Pharmacy Cost: 57.10938
Specialty Pharmacy Eff Date: 01/16/2024
Long-term Care Pharmacy Cost: 56.73156
Long-term Care Pharmacy Eff Date: 01/16/2024
340B Rate: 25.92754
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.