Product Details
Vitrakvi
Larotrectinib20 mg/mL
Oral Solution
100-mL Bottle Pack
DIN/PIN/NPN
02490331
Manufacturer
Bayer Inc., Health Care Division
Formulary Listing Date
2023-02-24
Unit Price
4187.0000
Amount MOH Pays
4187.0000
Coverage Status
Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
L01EX12
Interchangeable Products
NOLU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Oncology Drugs | Larotrectinib
For the treatment of unresectable locally advanced, or metastatic solid tumours in patients meeting ALL the following criteria:
Notes:
Renewal Criteria: Recommended dose: Approval duration of initials: 3 months Approval duration of first renewal: 3 months Approval duration of 2nd renewal: 6 months Approval duration of 3rd and subsequent renewals: 1 year EAP Drug Request Form: |