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    NitroMist

    Drug - NitroMist® (nitroglycerin) [NovaDel]

    July 2011

    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.

    Criteria

    • 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

    Rationale

    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.

    Questions?

    MHCP Provider Call Center 651-431-2700 or 800-366-5411

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