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lurbinectedin

lurbinectedin
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Zepzelca POWDER FOR INJECTION, INTRAVENOUS 4 mg      
Comments:

Restricted to oncology in the outpatient setting. Insurance certification or PAP eligibility review required prior to treatment. May be administered as "patient own medication" through PAP.

Reviewed: April 2021

High Value Care Committee: May 2021 - Approved

Last updated: Apr. 11, 2024






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