Drug - NitroMist® (nitroglycerin) [NovaDel]
Indications and usage
NitroMist® (nitroglycerin) is a lingual aerosol that delivers 400 mcg per spray, (230 metered sprays per container). It is a nitrate vasodilator indicated for acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease.
- The patient is being treated for angina pectoris AND
- The patient has used nitroglycerine sublingual tablets in the past 6 months AND
- Prescriber provides clinical rationale that NitroMist would be expected to offer superior results to the sublingual tablets
After an AWP-15% discount, the cost of NitroMist is $194/bottle.
On average, a cost of one bottle of 100 tablets of 0.4 mg (400 mcg) sublingual tablets is $13.00.
MA pays for 941 claims per quarter of 0.4 mcg sublingual tablets.
MHCP Provider Call Center 651-431-2700 or 800-366-5411