TRIENTINE HCL 250 MG CAPSULE

Drug Details

General

Brand Name: TRIENTINE HCL 250 MG CAPSULE
Generic Name: trientine HCl
Manufacturer: CAMBER PHARMACE
NDC: 31722068301
Package size: 100EA

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: 6.86
Retail Pharmacy Eff Date: 09/05/2023
Specialty Pharmacy Cost: 6.44
Specialty Pharmacy Eff Date: 08/29/2023
Long-term Care Pharmacy Cost: 6.762
Long-term Care Pharmacy Eff Date: 08/29/2023
340B Rate: 3.01
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.