SOFOSBUVIR-VELPATASVIR 400-100

Drug Details

General

Brand Name: SOFOSBUVIR-VELPATASVIR 400-100
Generic Name: sofosbuvir/velpatasvir
Manufacturer: ASEGUA THERAPEU
NDC: 72626270101
Package size: 28EA
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%

Drug Pricing

Retail Pharmacy Cost: 282.85715
Retail Pharmacy Eff Date: 11/24/2020
Specialty Pharmacy Cost: 277.90714
Specialty Pharmacy Eff Date: 11/24/2020
Long-term Care Pharmacy Cost: 276.06857
Long-term Care Pharmacy Eff Date: 11/24/2020
340B Cost: 122.85714
Premium Preferred Generic Incentive†: Yes

Program Coverage

Medicaid

Effective date: 09/25/2019
Compound-only use: No

CHIP

Compound-only use: No
Compound-only use: No