Rx0000144 |
Helsinn Therapeutics, Inc |
09/30/2019 |
69639012001 |
Valchlor 0.02% Gel 60gm tube |
09/26/2019 |
273.68 |
4183.46 |
07/08/2029 |
Single Source Drug |
8575 |
None |
The increase in WAC is based on business factors, including the cost of funding assistance programs for eligible patients and clinical research, including research relating to potential new indications. |
None |
None |
1 |
03/20/2018 |
Actelion Pharmaceuticals, Ltd. |
330000000 |
None |
None |
3654.00 |
3355.00 |
2013 |
3165.00 |
None |
None |
Rx0000119 |
Heron Therapeutics, Inc. |
12/31/2019 |
47426020101 |
CINVANTI; 130 mg; single-dose vial |
10/01/2019 |
7.72 |
351.47 |
None |
Single Source Drug |
278108 |
None |
Increase due to market factors |
None |
There were no noted changes to the drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Product was developed by Heron |
Rx0000119 |
Heron Therapeutics, Inc. |
06/30/2019 |
47426010106 |
Granisetron extended-release injection |
06/01/2019 |
90.42 |
3706.86 |
None |
Single Source Drug |
14393 |
None |
Increase due to market factors. |
None |
There were no noted changes to the drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Product was developed by Heron |
Rx0000119 |
Heron Therapeutics, Inc. |
12/31/2019 |
47426010106 |
Sustol (granisetron) ER injection. 10 mg/.4mL. 6 kits/carton. |
12/15/2019 |
92.67 |
3799.53 |
None |
Single Source Drug |
14393 |
None |
Increase due to market factors. |
None |
There were no noted changes to the drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Product was developed by Heron |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
03/31/2019 |
00143978710 |
Enalaprilat Intravenous Injectable 1.25 MG/1ML, 10 Vials |
01/01/2019 |
9.23 |
40.00 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
03/31/2019 |
00143978610 |
Enalaprilat Intravenous Injectable 1.25 MG/2ML, 10 Vials |
01/01/2019 |
16.49 |
71.44 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
09/30/2019 |
00641039112 |
Heparin Sodium (Porcine) Injection Solution 1000 UNIT/ML. 25 Vials |
07/12/2019 |
17.05 |
51.15 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
09/30/2019 |
00641246055 |
Heparin Sodium (Porcine) Injection Solution 5000 UNIT/ML, 25 Vials |
07/12/2019 |
41.15 |
210.00 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
03/31/2019 |
00641605425 |
Meperidine HCl Injection Solution 100 MG/ML, 25 Vials |
01/01/2019 |
5.93 |
65.87 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
03/31/2019 |
00641605225 |
Meperidine HCl Injection Solution 25 MG/ML, 25 Vials |
01/01/2019 |
5.20 |
57.70 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
03/31/2019 |
00641605325 |
Meperidine HCl Injection Solution 50 MG/ML, 25 Vials |
01/01/2019 |
5.41 |
60.10 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
09/30/2019 |
00054021125 |
Protriptyline HCl Oral Tablet 10 MG, 100 Tablets |
09/06/2019 |
232.75 |
477.75 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000178 |
Hikma Pharmaceuticals USA Inc |
09/30/2019 |
00054021025 |
Protriptyline HCl Oral Tablet 5 MG, 100 Tablets |
09/06/2019 |
232.75 |
477.75 |
None |
Non-innovator Multiple Source Drug |
None |
1 |
None |
1 |
This WAC increase is not necessitated by a change or improvement in the prescription drug. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Hikma is limiting its response to that which is otherwise in the public domain or publicly available. Hikma did not acquire this product. |
Rx0000145 |
Horizon Therapeutics USA, Inc. |
09/30/2019 |
75987008010 |
Drug product name: KRYSTEXXA. Drug product strength: 1 mL sterile concentrate for dilution containing 8 mg of pegloticase protein, expressed in uricase protein amounts. Drug product dosage form: vial. Drug product package size: 2 mL single use vial. |
07/01/2019 |
1055.78 |
22602.00 |
None |
Single Source Drug |
None |
1 |
None |
1 |
None |
1 |
01/13/2016 |
Crealta Holdings LLC |
None |
1 |
Horizon acquired this particular product as part of the overall acquisition of Crealta Holdings LLC, and its acquisition price was incorporated into that deal’s overall purchase price of approximately $510 million with no means of individually identifying the purchase price of this asset. |
14000.00 |
14000.00 |
2010 |
2300.00 |
None |
Consistent with the relevant statutes and regulations, all information contained in this report is limited to that which Horizon believes is otherwise in the public domain or publicly available. Please note the Patent Expiration date for KRYSTEXXA is not publicly available. |