Drug - Gattex [NPS Pharmaceuticals]
Therapeutic area - Gastrointestinal
- Patient has a diagnosis of short bowel syndrome AND
- Patient has been on parenteral nutritional support for 1 year and is currently on parenteral nutrition support AND
- Patient has a documented high risk of infection or hospitalization related to parenteral nutritional support
Initial authorizations are approved for 6 months.
Provider must provide medical documentation showing a clinically significant reduction in parenteral nutrition volume since starting therapy has been achieved.
- Kit = 1 (30 vials)
- Single use vials = 34
Gattex comes as a single-use vial kit and a kit containing 30 single-use vials. The recommended dose is 0.05 mg/kg/day.
MHCP Provider Call Center 651-431-2700 or 800-366-5411