Product Details

Faslodex

Fulvestrant
50 mg/mL
Solution for Injection

DIN/PIN/NPN

02248624

Manufacturer

AstraZeneca

Formulary Listing Date

2019-03-28

Unit Price

129.5704

Amount MOH Pays

58.2895

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

10:00 Antineoplastic Agents

Therapeutic Note

NO

ATC Code

L02BA03

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02460130	Teva-Fulvestrant Injection	58.2895	58.2895
02483610	Fulvestrant Injection	58.2895	58.2895
02248624	Faslodex	129.5704	58.2895

LU Clinical Criteria

NO

EAP Criteria

NO

Product Monograph

View Monograph