Product Details

Somatuline Autogel

Lanreotide Acetate
60 mg/0.5 mL
ER Solution for Injection
0.5-mL Single-Use Prefilled Syringe

DIN/PIN/NPN

02283395

Manufacturer

Ipsen Limited

Formulary Listing Date

2008-11-04  

Unit Price

1450.9198

Amount MOH Pays

760.0056

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

H01CB03

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02283395 Somatuline Autogel 1450.9198 760.0056
02555867 Mytolac 760.0056 760.0056
 

LU Clinical Criteria

NO  

Requirements


EAP Criteria

  NO

Product Monograph

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