Product Details
Jamp Lamivudine HBV
Lamivudine100 mg
Tablet
DIN/PIN/NPN
02512467
Manufacturer
Jamp Pharma Corporation
Formulary Listing Date
2021-09-30
Unit Price
2.6154
Amount MOH Pays
2.6154
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
J05AF05
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02512467 | Jamp Lamivudine HBV | 2.6154 | 2.6154 |
02239193 | Heptovir | 5.4765 | 2.6154 |
02393239 | Apo-Lamivudine HBV | 2.6154 | 2.6154 |
LU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
502 | 1 year | Confirmed chronic Hepatitis B infection in persons with - HBV DNA greater than or equal to 1000 IU/mL AND - ALT levels greater than ULN OR - Evidence of fibrosis or - Documented evidence of cirrhosis |
503 | 1 year | Patients with chronic Hepatitis B infection currently receiving treatment with lamivudine and requires treatment continuation. |
504 | 1 year | Patients with chronic Hepatitis B infection who are scheduled to undergo chemotherapy or significant immunosuppressive treatment. |