Section |
Status |
HCD |
Name |
10.01.03 |
Formulary
|
 |
Abatacept Orencia® |
08.01.05 |
Formulary
|
 |
Abemaciclib Verzenios® |
08.03.04.02 |
Formulary
|
 |
Abiraterone Actetate Zytiga® |
01.05.03 |
Formulary
|
 |
Adalimumab Humira® Imraldi ® |
10.01.03 |
Formulary
|
 |
Adalimumab Humira® Imraldi ® |
11.04.02 |
Formulary
|
 |
Adalimumab |
13.05.03 |
Formulary
|
 |
Adalimumab Humira® Imraldi ® |
08.01.05 |
Formulary
|
 |
Afatinib |
11.08.02 |
Formulary
|
 |
Aflibercept intravitreal injection Eylea |
08.01.05 |
Formulary
|
 |
Alectinib Alecensa ® |
08.02.03 |
Formulary
|
 |
Alemtuzumab Lemtrada® |
02.14 |
Restricted Use
|
 |
Alirocumab Praluent® |
10.01.03 |
Formulary
|
 |
Apremilast Otezla® |
08.01.05 |
Restricted Use
|
 |
Atezolizumab Tecentriq ® |
08.01.05 |
Restricted Use
|
 |
Avelumab Bavencio® |
08.02.04 |
Non Formulary
|
 |
Axicabtagene ciloleucel YESCARTA® |
08.01.05 |
Formulary
|
 |
Axitinib Inlyta® |
08.01.03 |
Formulary
|
 |
Azacitidine Vidaza® |
10.01.03 |
Formulary
|
 |
Baricitinib Olumiant® |
10.01.03 |
Formulary
|
 |
Belimumab Benlysta® |
08.01.01 |
Formulary
|
 |
Bendamustine |
03.04.02 |
Formulary
|
 |
Benralizumab Fasenra® |
08.01.05 |
Formulary
|
 |
Bevacizumab Avastin® |
11.08.02 |
Formulary
|
 |
Bevacizumab intravitreal injection Avastin® |
08.01.05 |
Formulary
|
 |
Blinatumomab Blincyto® |
05.03.03 |
Formulary
|
 |
Boceprevir Victrelis® |
08.01.05 |
Formulary
|
 |
Bortezomib Velcade® |
08.01.05 |
Formulary
|
 |
Bosutinib Bosulif® |
04.09.03 |
Formulary
|
 |
Botulinum Toxin Type A Xeomin® |
04.09.03 |
Formulary
|
 |
Botulinum Toxin Type A Botox® |
04.09.03 |
Formulary
|
 |
Botulinum Toxin Type A Dysport® |
08.01.05 |
Formulary
|
 |
Brentuximab vedotin Adcetris® |
08.01.05 |
Formulary
|
 |
Brigatinib Alunbrig® |
13.05.03 |
Formulary
|
 |
Brodalumab Kyntheum ® |
08.01.05 |
Restricted Use
|
 |
Cabazitaxel |
08.01.05 |
Formulary
|
 |
Cabozantinib Cabometyx® Cometriq® |
08.01.05 |
Formulary
|
 |
Carfilzomib Kyprolis® |
08.01.05 |
Restricted Use
|
 |
Ceritinib Zykadia® |
10.01.03 |
Formulary
|
 |
Certolizumab Pegol Cimzia® |
08.01.05 |
Restricted Use
|
 |
Cetuximab Erbitux® |
08.01.03 |
Formulary
|
 |
Cladribine MAVENCLAD ® |
05.01.07 |
Formulary
|
 |
Colistimethate sodium nebuliser |
08.01.05 |
Formulary
|
 |
Crizotinib Xalkori® |
08.01.05 |
Formulary
|
 |
Dabrafenib Tafinlar ® |
05.03.03.02 |
Formulary
|
 |
Daclatasvir Daklinza® |
08.01.05 |
Formulary
|
 |
Daratumumab DARZALEX ® |
09.01.03 |
Formulary
|
 |
Darbepoetin Alfa Aranesp® |
08.01.05 |
Formulary
|
 |
Dasatinib Sprycel® |
11.04.01 |
Formulary
|
 |
Dexamethasone Ozurdex ® |
11.04.01 |
Restricted Use
|
 |
Dexamethasone intravitreal implant Ozurdex® |
08.02.04 |
Formulary
|
 |
Dimethyl fumarate Tecfidera ® |
13.05.03 |
Formulary
|
 |
Dimethyl fumerate Skilarence® |
08.02.04 |
Formulary
|
 |
Dinutuximab beta Qarziba® |
13.05.03 |
Restricted Use
|
 |
Dupilumab Dupixent® |
08.01.05 |
Restricted Use
|
 |
Durvalumab Imfinzi® |
05.03.01 |
Restricted Use
|
 |
Elbasvir & Grazoprevir. Zepatier ® |
09.01.04 |
Formulary
|
 |
Eltrombopag Revolade® |
01.05 |
Formulary
|
 |
Eluxadoline Truberzi ® |
08.01.05 |
Formulary
|
 |
Encorafenib Braftovi® |
05.03.03 |
Formulary
|
 |
Entecavir Baraclude® |
08.01.05 |
Formulary
|
 |
Enzalutamide Xtandi® |
08.01.05 |
Formulary
|
 |
Eribulin Halaven® Solution for Injection |
08.01.05 |
Formulary
|
 |
Erlotinib Tarceva® |
10.01.03 |
Formulary
|
 |
Etanercept Enbrel®, Benepali® |
08.01.05 |
Restricted Use
|
 |
Everolimus Afinitor® |
02.14 |
Restricted Use
|
 |
Evolocumab Repatha® |
08.02.04 |
Formulary
|
 |
Fingolimod |
11.04.01 |
Restricted Use
|
 |
Fluocinolone intravitreal implant Iluvien® |
08.01.05 |
Restricted Use
|
 |
Gefitinib Iressa® |
08.01.05 |
Formulary
|
 |
GEMTUZUMAB - OZOGAMICIN |
01.05.03 |
Formulary
|
 |
Golimumab Simponi® |
10.01.03 |
Formulary
|
 |
Golimumab Simponi® |
13.05.03 |
Formulary
|
 |
Guselkumab Tremfya® |
08.01.05 |
Restricted Use
|
 |
Ibrutinib Imbruvica® |
08.01.05 |
Formulary
|
 |
Idelalisib Zydelig® |
08.01.05 |
Formulary
|
 |
Imatinib Gilvec® |
01.05.03 |
Formulary
|
 |
Infliximab Remicade® / Inflectra® / Remsima® |
10.01.03 |
Formulary
|
 |
Infliximab Remicade®, Remsima®, Inflectra® |
08.01.05 |
Formulary
|
 |
Inotuzumab ozogamicin Besponsa® |
08.01.05 |
Formulary
|
 |
Ipilimumab Yervoy® |
08.01.05 |
Formulary
|
 |
Ixazomib Ninlaro® |
13.05.03 |
Restricted Use
|
 |
Ixekizumab Taltz® |
08.01.05 |
Formulary
|
 |
Lapatinib Tyverb® |
05.03.03.02 |
Formulary
|
 |
Ledipasvir & Sofosbuvir Harvoni® |
08.02.04 |
Formulary
|
 |
Lenalidomide |
08.01.03 |
Formulary
|
 |
Liposomal Cytarabine–Daunorubicin Vyxeos® |
08.03.04.03 |
Formulary
|
 |
Lutetium (177Lu) oxodotreotide Lutathera® |
03.04.02 |
Restricted Use
|
 |
Mepolizumab Nucala® |
04.05.01 |
Non Formulary
|
 |
Naltrexone/bupropion Mysimba® |
08.01.05 |
Restricted Use
|
 |
Necitumumab Portrazza® |
08.01.05 |
Formulary
|
 |
Nilotinib Tasigna® |
08.01.05 |
Formulary
|
 |
Nintedanib Ofev® |
08.01.05 |
Restricted Use
|
 |
Nintedanib Vargatef® |
08.01.05 |
Restricted Use
|
 |
Niraparib Zejula® |
08.01.05 |
Restricted Use
|
 |
Nivolumab Opdivo® |
10.02 |
Formulary
|
 |
Nusinersen Spinraza® |
01.09.01 |
Restricted Use
|
 |
Obeticholic acid Ocaliva® |
08.01.05 |
Formulary
|
 |
Obinutuzumab Gazyvaro® |
08.02 |
Formulary
|
 |
Ocrelizumab Ocrevus® |
08.01.05 |
Formulary
|
 |
Ofatumumab Arzerra® |
08.01.05 |
Formulary
|
 |
Olaparib Lynparza® |
08.01.05 |
Formulary
|
 |
Olaratumab Lartruvo® |
03.04.02 |
Formulary
|
 |
Omalizumab Xolair® |
05.03.03.02 |
Formulary
|
 |
Ombitasvir + paritaprevir + Ritonavir Viekirax® |
08.01.05 |
Restricted Use
|
 |
Osimertinib TAGRISSO® |
08.01.05 |
Formulary
|
 |
Paclitaxel Albumin Abraxane® |
08.01.05 |
Restricted Use
|
 |
Palbociclib. IBRANCE® |
08.01.05 |
Formulary
|
 |
Panitumumab Vectibix® |
08.01.05 |
Formulary
|
 |
Panobinostat Farydak® |
08.01.05 |
Restricted Use
|
 |
Pazopanib Votrient® |
08.01.05 |
Restricted Use
|
 |
Pegaspargase Oncaspar® |
08.02.04 |
Formulary
|
 |
Peginterferon Alfa Pegasys® |
08.02.04 |
Formulary
|
 |
Peginterferon Alfa ViraferonPeg® |
08.02.04 |
Formulary
|
 |
Peginterferon Beta Plegridy ® |
08.01.02 |
Formulary
|
 |
Pegylated Liposomal Doxorubicin Hydrochloride |
08.01.05 |
Formulary
|
 |
Pembrolizumab Keytruda® |
08.01.03 |
Formulary
|
 |
Pemetrexed Alimta® |
08.01.05 |
Formulary
|
 |
Pertuzumab Perjeta® Concentrate for Solution for Infusion |
03.11 |
Formulary
|
 |
Pirfenidone Capsules Esbriet® |
08.01.02 |
Formulary
|
 |
Pixantrone Pixuvri® solution for infusion |
08.02.04 |
Formulary
|
 |
Pomalidomide Imnovid® |
08.01.05 |
Formulary
|
 |
Ponatinib Iclusig ® |
08.01 |
Restricted Use
|
 |
Radium-223 Xofigo® solution for injection |
08.01.05 |
Restricted Use
|
 |
Ramucirumab Cyramza ® |
11.08.02 |
Formulary
|
 |
Ranibizumab Lucentis® |
08.01.05 |
Restricted Use
|
 |
Regorafenib Stivarga ® |
03.01 |
Formulary
|
 |
Reslizumab Cinqaero® |
08.01.05 |
Restricted Use
|
 |
Ribociclib Kisqali® |
13.05.03 |
Formulary
|
 |
Risankizumab Skyrizi® |
08.02.03 |
Formulary
|
 |
Rituximab MabThera® / Truxima® |
10.01.03 |
Formulary
|
 |
Rituximab (rheumatology) MabThera® / Truxima® |
09.01.04 |
Formulary
|
 |
Romiplostim Nplate® |
08.01.05 |
Formulary
|
 |
Ruxolitinib Jakavi® |
10.02.01 |
Formulary
|
 |
Sarilumab Kevzara ® |
10.01.03 |
Formulary
|
 |
Secukinumab Cosentyx ® |
13.05.03 |
Formulary
|
 |
Secukinumab Cosentyx® |
05.03.03.02 |
Formulary
|
 |
Simeprevir Olysio® |
05.03.03.02 |
Formulary
|
 |
Sofosbuvir Sovaldi® |
05.03.03.02 |
Formulary
|
 |
Sofosbuvir + Velpatasvir Epclusa® |
05.03.03.02 |
Formulary
|
 |
Sofosbuvir-Velpatasvir-Voxilaprevir Vosevi® |
08.01.05 |
Formulary
|
 |
Sorafenib Nexavar® |
08.01.05 |
Restricted Use
|
 |
Sunitinib Sutent® |
08.02.04 |
Restricted Use
|
 |
Talimogene Imlygic® |
05.03.03 |
Formulary
|
 |
Telaprevir Incivo® |
05.03.01 |
Formulary
|
 |
Tenofovir Disproxil Viread® |
08.02.04 |
Formulary
|
 |
Teriflunomide Aubagio® |
08.02.04 |
Formulary
|
 |
Thalidomide Pharmion® |
13.05.03 |
Formulary
|
 |
Tildrakizumab Ilumetri® |
08.01.05 |
Restricted Use
|
 |
Tisagenlecleucel Kymriah® |
08.01.05 |
Formulary
|
 |
Tivozanib Fotivda ® |
10.01.03 |
Formulary
|
 |
Tocilizumab RoActemra® |
01.05.03 |
Formulary
|
 |
Tofacitinib Xeljanz® |
10.02.01 |
Formulary
|
 |
Tofacitinib Xeljanz® |
06.05.02 |
Formulary
|
 |
Tolvaptan Samsca® |
08.01.05 |
Formulary
|
 |
Trabectedin Yondelis® |
08.01.05 |
Restricted Use
|
 |
Trametinib Mekinist® |
08.01.05 |
Formulary
|
 |
Trastuzumab Herceptin® |
08.01.05 |
Formulary
|
 |
Trastuzumab emtansine Kadcyla® |
01.05.03 |
Formulary
|
 |
Ustekinumab Stelara® |
10.01.03 |
Formulary
|
 |
Ustekinumab Stelara® |
13.05.03 |
Formulary
|
 |
Ustekinumab Stelara® |
01.05.03 |
Formulary
|
 |
Vedolizumab Entyvio® |
08.01.05 |
Formulary
|
 |
Venetoclax Venclyxto ® |
08.01.05 |
Restricted Use
|
 |
Vismodegib Erivedge ® |