|
Brand Name
|
Generic Name
|
Route of Administration
|
Lowest WAC Unit
|
Lowest AWP Unit
|
| Xpovio (100 MG Once Weekly) |
Selinexor |
ORAL |
$4340.25 |
$5208.30 |
|
Manufacturer
|
NDC Number
|
Package Description
|
WAC Per Package
|
WAC Per Unit
|
Effective Date
|
AWP Per Package
|
AWP Per Unit
|
Effective Date
|
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|
Brand Name
|
Generic Name
|
Route of Administration
|
Lowest WAC Unit
|
Lowest AWP Unit
|
| Xpovio (40 MG Once Weekly) |
Selinexor |
ORAL |
$2170.12 |
$2604.15 |
|
Manufacturer
|
NDC Number
|
Package Description
|
WAC Per Package
|
WAC Per Unit
|
Effective Date
|
AWP Per Package
|
AWP Per Unit
|
Effective Date
|
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|
Brand Name
|
Generic Name
|
Route of Administration
|
Lowest WAC Unit
|
Lowest AWP Unit
|
| Xpovio (40 MG Twice Weekly) |
Selinexor |
ORAL |
$4340.25 |
$5208.30 |
|
Manufacturer
|
NDC Number
|
Package Description
|
WAC Per Package
|
WAC Per Unit
|
Effective Date
|
AWP Per Package
|
AWP Per Unit
|
Effective Date
|
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|
Brand Name
|
Generic Name
|
Route of Administration
|
Lowest WAC Unit
|
Lowest AWP Unit
|
| Xpovio (60 MG Once Weekly) |
Selinexor |
N/A |
$8680.50 |
$10416.60 |
|
Manufacturer
|
NDC Number
|
Package Description
|
WAC Per Package
|
WAC Per Unit
|
Effective Date
|
AWP Per Package
|
AWP Per Unit
|
Effective Date
|
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|
Brand Name
|
Generic Name
|
Route of Administration
|
Lowest WAC Unit
|
Lowest AWP Unit
|
| Xpovio (60 MG Twice Weekly) |
Selinexor |
ORAL |
$1446.75 |
$1736.10 |
|
Manufacturer
|
NDC Number
|
Package Description
|
WAC Per Package
|
WAC Per Unit
|
Effective Date
|
AWP Per Package
|
AWP Per Unit
|
Effective Date
|
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|
Brand Name
|
Generic Name
|
Route of Administration
|
Lowest WAC Unit
|
Lowest AWP Unit
|
| Xpovio (80 MG Once Weekly) |
Selinexor |
ORAL |
$4340.25 |
$5208.30 |
|
Manufacturer
|
NDC Number
|
Package Description
|
WAC Per Package
|
WAC Per Unit
|
Effective Date
|
AWP Per Package
|
AWP Per Unit
|
Effective Date
|
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|
Brand Name
|
Generic Name
|
Route of Administration
|
Lowest WAC Unit
|
Lowest AWP Unit
|
| Xpovio (80 MG Twice Weekly) |
Selinexor |
ORAL |
$1085.06 |
$1302.08 |
|
Manufacturer
|
NDC Number
|
Package Description
|
WAC Per Package
|
WAC Per Unit
|
Effective Date
|
AWP Per Package
|
AWP Per Unit
|
Effective Date
|
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