Section |
Status |
HCD |
Name |
05.03.01 |
Formulary
|
|
Abacavir |
05.03.01 |
Formulary
|
|
Abacavir & Lamivudine |
05.03.01 |
Formulary
|
|
Abacavir & Lamivudine & Dolutegravir |
05.03.01 |
Formulary
|
|
Abacavir & Lamivudine & Zidovudine |
08.03.04.01 |
Formulary
|
|
Abemaciclib Verzenios® |
08.03.04.02 |
Formulary
|
|
Abiraterone |
13.05.03 |
Formulary
|
|
Abrocitinib Cibinqo® |
08.01.05 |
Formulary
|
|
Acalabrutinib Calquence® |
01.05.03 |
Formulary
|
|
Adalimumab |
11.04.02 |
Formulary
|
|
Adalimumab |
13.05.03 |
Formulary
|
|
Adalimumab |
05.03.03.01 |
Formulary
|
|
Adefovir Dipivoxil Hepsera® |
08.01.05 |
Formulary
|
|
Afatinib |
08.01.05 |
Formulary
|
|
Aflibercept Zaltrap® |
11.08.02 |
Formulary
|
|
Aflibercept Eylea® |
09.08.01 |
Formulary
|
|
Agalsidase Alfa |
09.08.01 |
Formulary
|
|
Agalsidase Beta |
08.01.05 |
Formulary
|
|
Alectinib Alecensa® |
09.08.01 |
Formulary
|
|
Alglucosidase Alfa Myozyme® |
02.12 |
Formulary
|
|
Alirocumab |
13.05.01 |
Formulary
|
|
Alitretinoin Toctino® |
08.03.04.01 |
Formulary
|
|
Alpelisib Piqray® |
02.05.01 |
Formulary
|
|
Ambrisentan |
05.02.03 |
Formulary
|
|
Amphotericin |
05.02.04 |
Formulary
|
|
Anidulafungin |
02.11 |
Formulary
|
|
Antithrombin III Kybernin® |
08.02.02 |
Formulary
|
|
Antithymocyte immunoglobulin (rabbit) Thymoglobuline® |
10.01.03 |
Formulary
|
|
Apremilast Otezla® |
13.05.03 |
Formulary
|
|
Apremilast Otezla® |
08.01.05 |
Formulary
|
|
Asciminib Scemblix® |
09.08.01 |
Formulary
|
|
Asfotase alfa Strensiq® |
05.03.01 |
Formulary
|
|
Atazanavir |
05.03.01 |
Formulary
|
|
Atazanavir sulfate and cobicistat |
08.01.05 |
Formulary
|
|
Atezolizumab |
09.08.01 |
Formulary
|
|
Avalglucosidase alfa Nexviadyme® |
09.01.04 |
Formulary
|
|
Avatrombopag Doptelet® |
08.02.03 |
Formulary
|
|
Avelumab Bavencio® |
08.01.05 |
Formulary
|
|
Axicabtagene ciloleucel |
08.01.05 |
Formulary
|
|
Axitinib Inlyta® |
05.01.02.03 |
Formulary
|
|
Aztreonam nebuliser solution Cayston® |
10.01.03 |
Formulary
|
|
Baricitinib Olumiant® |
05.01.09 |
Formulary
|
|
Bedaquiline |
08.02.02 |
Formulary
|
|
Belumosudil Rezurock® |
03.04.02 |
Formulary
|
|
Benralizumab Fasenra® |
03.05.02 |
Formulary
|
|
Beractant Survanta® |
08.01.05 |
Formulary
|
|
Bevacizumab Avastin® |
05.03.01 |
Formulary
|
|
Bictegraivr/emtricitabine/tenofovir alafenamide Biktarvy® |
10.01.03 |
Formulary
|
|
Bimekizumab Bimzelx® |
08.01.05 |
Formulary
|
|
Bortezomib |
02.05.01 |
Formulary
|
|
Bosentan |
08.01.05 |
Formulary
|
|
Bosutinib Bosulif® |
04.09.03 |
Formulary
|
|
Botulinum Toxin Type A Vistabel® |
04.09.03 |
Formulary
|
|
Botulinum Toxin Type A Dysport® |
04.09.03 |
Formulary
|
|
Botulinum Toxin Type A Botox® |
04.09.03 |
Formulary
|
|
Botulinum Toxin Type A injection Xeomin ® |
04.09.03 |
Formulary
|
|
Botulinum Toxin Type B NeuroBloc® |
08.01.05 |
Formulary
|
|
Brentuximab vedotin Adcetris® |
08.01.05 |
Formulary
|
|
Brigatinib Alunbrig® |
13.05.03 |
Formulary
|
|
Brodalumab Kyntheum® |
11.08.02 |
Formulary
|
|
Brolucizumab Beovu® |
05.03.03.02 |
Formulary
|
|
Bulevirtide Hepcludex® |
03.04.03 |
Formulary
|
|
C1 Esterase Inhibitor |
08.01.05 |
Formulary
|
|
Cabozantinib Cometriq® |
04.06 |
Formulary
|
|
Cannabidiol Epidyolex® |
04.08.01 |
Formulary
|
|
Cannabidiol Epidyolex® |
09.01.04 |
Formulary
|
|
Caplacizumab Cablivi ® |
08.01.05 |
Formulary
|
|
Carfilzomib Kyprolis® |
09.08.01 |
Formulary
|
|
Carglumic Acid Carbaglu® |
09.08.01 |
Formulary
|
|
Carnitine |
05.02.04 |
Formulary
|
|
Caspofungin |
08.01.05 |
Formulary
|
|
Cemiplimab Libtayo® |
08.01.05 |
Formulary
|
|
Ceritinib |
09.08.01 |
Formulary
|
|
Chenodexoycholic acid Xenbilox® |
01.09.01 |
Formulary
|
|
Cholic acid |
05.03.02.02 |
Formulary
|
|
Cidofovir infusion |
09.05.01.02 |
Formulary
|
|
Cinacalcet |
08.01.03 |
Formulary
|
|
Clofarabine Evoltra® |
05.03.01 |
Formulary
|
|
Cobicistat Tybost® |
03.04.03 |
Formulary
|
|
Conestat Alfa Ruconest® |
08.01.05 |
Formulary
|
|
Crizotinib |
08.01.05 |
Formulary
|
|
Dabrafenib Tafinlar® |
05.03.03.02 |
Formulary
|
|
Daclatasvir |
08.02.04 |
Formulary
|
|
Daclizumab Zinbryta® |
08.01.05 |
Formulary
|
|
Dacomitinib Vizimpro® |
08.01.05 |
Formulary
|
|
Daratumumab Darzalex® |
09.01.03 |
Formulary
|
|
Darbepoetin Alfa Aranesp® |
08.03.04.02 |
Formulary
|
|
Darolutamide Nubeqa® |
05.03.01 |
Formulary
|
|
Darunavir |
05.03.01 |
Formulary
|
|
Darunavir and Cobicistat |
20 |
Non Formulary
|
|
DAUNORUBICIN saline pre-filled syringe |
08.01.03 |
Formulary
|
|
Daunorubicin/cytarabine Vyxeos® |
09.01.03 |
Formulary
|
|
Deferasirox |
09.01.03 |
Formulary
|
|
Deferiprone Ferriprox® |
20 |
Non Formulary
|
|
DEFIBROTIDE |
20 |
Non Formulary
|
|
DEFIBROTIDE Capsules 400 mg |
05.01.09 |
Formulary
|
|
Delamanid |
09.01.03 |
Formulary
|
|
Desferrioxamine Mesilate |
13.05.03 |
Formulary
|
|
Deucravacitinib Sotyktu |
11.04.01 |
Formulary
|
|
Dexamethasone 700 microgram intravitreal implant Ozurdex® |
05.03.01 |
Formulary
|
|
Didanosine |
13.14.07 |
Formulary
|
|
Difelikefalin Kapruvia® |
08.02.04 |
Formulary
|
|
Dimethyl fumarate Tecfidera® |
13.05.03 |
Formulary
|
|
Dimethyl fumarate Skilarence® |
08.01.05 |
Formulary
|
|
Dinutuximab beta Qarziba® |
08.02.04 |
Formulary
|
|
Diroximel fumarate Vumerity® |
05.03.01 |
Formulary
|
|
Dolutegravir |
05.03.01 |
Formulary
|
|
Dolutegravir Sodium & Lamivudine Dovato® |
05.03.01 |
Formulary
|
|
Dolutegravir Sodium & Rilpivirine Hydrochloride Juluca® |
03.07 |
Formulary
|
|
Dornase Alfa |
08.01.05 |
Formulary
|
|
Dostarlimab Jemperli |
03.04.02 |
Formulary
|
|
Dupilumab Dupixent® |
13.05.03 |
Formulary
|
|
Dupilumab Dupixent® |
13.05.03 |
Non Formulary
|
|
Dupilumab Dupixent® |
08.01.05 |
Formulary
|
|
Durvalumab Imfinzi® |
09.01.03 |
Formulary
|
|
Eculizumab |
05.03.01 |
Formulary
|
|
Efavirenz Sustiva® |
05.03.03.02 |
Formulary
|
|
Elbasvir & grazoprevir Zepatier® |
09.01.04 |
Formulary
|
|
Eltrombopag |
05.03.01 |
Formulary
|
|
Emtricitabine |
05.03.01 |
Formulary
|
|
Emtricitabine & Elvitegravir & Cobicistat & Tenofovir alafenamide Genvoya® |
05.03.01 |
Formulary
|
|
Emtricitabine & Rilpivirine & Tenofovir alafenamide Odefsey® |
05.03.01 |
Formulary
|
|
Emtricitabine & Rilpivirine & Tenofovir disoproxil Eviplera® |
05.03.01 |
Formulary
|
|
Emtricitabine & Tenofovir alafenamide Descovy® |
05.03.01 |
Formulary
|
|
Emtricitabine & Tenofovir Disoproxil |
08.01.05 |
Formulary
|
|
Encorafenib Braftovi® |
05.03.01 |
Formulary
|
|
Enfuvirtide |
05.03.03.01 |
Formulary
|
|
Entecavir |
08.01.05 |
Formulary
|
|
Entrectinib Rozlytrek® |
08.01.05 |
Formulary
|
|
Epcoritamab Tepkinly® |
09.01.03 |
Formulary
|
|
Epoetin alfa Eprex® |
09.01.03 |
Formulary
|
|
Epoetin beta NeoRecormon® |
02.05.01 |
Formulary
|
|
Epoprostenol |
02.08.01 |
Formulary
|
|
Epoprostenol |
04.07.04.02 |
Formulary
|
|
Eptinezumab Vyepti® |
20 |
Non Formulary
|
|
Eptotermin Alfa Osigraft® |
04.07.04.02 |
Formulary
|
|
Erenumab Aimovig® |
08.01.05 |
Formulary
|
|
Eribulin Halaven® |
10.01.03 |
Formulary
|
|
Etanercept |
13.05.03 |
Formulary
|
|
Etanercept Enbrel®, Benapali® & Erelzi® |
09.05.01.02 |
Formulary
|
|
Etelcalcetide Parsabiv® |
02.11 |
Formulary
|
|
Etranacogene dezaparvovec Hemgenix® |
01.05.03 |
Formulary
|
|
Etrasimod Velsipity® |
05.03.01 |
Formulary
|
|
Etravirine Intelence® |
02.12 |
Formulary
|
|
Evinacumab Evkeeza® |
02.12 |
Formulary
|
|
Evolocumab |
09.01 |
Formulary
|
|
Exagamglogene Autotemcel Casgevy® |
02.11 |
Formulary
|
|
Factor IX |
02.11 |
Formulary
|
|
Factor VIIa |
02.11 |
Formulary
|
|
Factor VIII |
02.11 |
Formulary
|
|
Factor VIII |
02.11 |
Formulary
|
|
Factor XIII |
04.08.01 |
Formulary
|
|
Fenfluramine Fintepla® |
05.01.07 |
Formulary
|
|
Fidaxomicin Dificlir® |
01.05.03 |
Formulary
|
|
Filgotinib Jyseleca® |
10.01.03 |
Formulary
|
|
Filgotinib Jyseleca® |
09.01.06 |
Formulary
|
|
Filgrastim (G-CSF) Neupogen®, Ratiograstim® |
08.02.04 |
Formulary
|
|
Fingolimod |
11.04.01 |
Formulary
|
|
Fluocinolone 190 microgram intravitreal implant |
16 |
Formulary
|
|
Fomepizole |
05.03.01 |
Formulary
|
|
Fosamprenavir |
05.03.02.02 |
Formulary
|
|
Foscarnet Sodium |
04.09.01 |
Formulary
|
|
Foslevidopa/foscarbidopa Produodopa® |
05.03.01 |
Formulary
|
|
Fostemsavir Rukobia® |
04.07.04.02 |
Formulary
|
|
Fremanezumab Ajovy® |
04.07.04.02 |
Formulary
|
|
Galcanezumab Emgality® |
05.03.02.02 |
Formulary
|
|
Ganciclovir |
08.01.05 |
Formulary
|
|
Gemtuzumab ozogamicin Mylotarg® |
08.01.05 |
Formulary
|
|
Gilteritinib Xospata® |
08.02.04 |
Formulary
|
|
Glatiramer Acetate |
05.03.03.02 |
Formulary
|
|
Glecaprevir & Pibrentasvir Maviret® |
08.01.05 |
Formulary
|
|
Glofitamab Columvi® |
01.05.03 |
Formulary
|
|
Golimumab |
10.01.03 |
Formulary
|
|
Golimumab Simponi® |
13.05.03 |
Formulary
|
|
Guselkumab Tremfya® |
11.08.02.04 |
Formulary
|
|
Holoclar® |
08.01.05 |
Formulary
|
|
Ibrutinib Imbruvica® |
03.04.03 |
Formulary
|
|
Icatibant Firazyr® |
08.01.05 |
Formulary
|
|
Idelalisib |
02.05.01 |
Formulary
|
|
Iloprost |
09.08.01 |
Formulary
|
|
Imiglucerase Cerezyme® |
08.01.05 |
Formulary
|
|
Imlifidase Idefirix® |
05.03.01 |
Formulary
|
|
Indinavir |
01.05.03 |
Formulary
|
|
Infliximab Remicade®, Inflectra®, Remsima® |
13.05.03 |
Formulary
|
|
Infliximab Remsima®, Inflectra®, Remicade® |
04.12 |
Formulary
|
|
Inotersen Tegsedi® |
08.01.05 |
Formulary
|
|
Inotuzumab ozogamicin Besponsa® |
08.02.04 |
Formulary
|
|
Interferon Alfa-2b Roferon-A® |
08.02.04 |
Formulary
|
|
Interferon Beta Avonex® |
08.02.04 |
Formulary
|
|
Interferon Beta Rebif® |
08.02.04 |
Formulary
|
|
Interferon Beta Betaferon® |
08.02.04 |
Formulary
|
|
Interferon beta Extavia® |
08.01.05 |
Formulary
|
|
Ipilimumab Yervoy® |
09.01.03 |
Formulary
|
|
Iptacopan Fabhalta® |
05.02.01 |
Formulary
|
|
Isavuconazole Cresemba® |
03.07 |
Formulary
|
|
Ivacaftor |
08.01.05 |
Formulary
|
|
Ivosidenib Tibsovo® |
10.01.03 |
Formulary
|
|
Ixekizumab Taltz® |
13.05.03 |
Formulary
|
|
Ixekizumab Taltz® |
05.03.03.01 |
Formulary
|
|
Lamivudine |
09.05.02.02 |
Formulary
|
|
Lanthanum Carbonate |
09.08.01 |
Formulary
|
|
Laronidase Aldurazyme® |
08.01.05 |
Formulary
|
|
Larotrectinib |
13.05.03 |
Formulary
|
|
Lebrikizumab Ebglyss® |
09.01.06 |
Formulary
|
|
Lenograstim (rHuG-CSF) Granocyte® |
08.01.05 |
Formulary
|
|
Lenvatinib Kisplyx® |
04.09.01 |
Formulary
|
|
Levidopa/carbidopa Intestinal Gel Duodopa® |
05.01.12 |
Formulary
|
|
Levofloxacin Nebuliser Solution Quinsair® |
08.01.05 |
Non Formulary
|
|
Lisocabtagene maraleucel |
08.01.05 |
Formulary
|
|
Loncastuximab tesirine Zynlonta® |
05.03.01 |
Formulary
|
|
Lopinavir and Ritonavir Kaletra® |
08.01.05 |
Formulary
|
|
Lorlatinib Lorviqua® |
03.07 |
Formulary
|
|
Lumacaftor and Ivacaftor Orkambi® |
02.05.01 |
Formulary
|
|
Macitentan |
03.07 |
Formulary
|
|
Mannitol inhalation Bronchitol ® |
05.03.01 |
Formulary
|
|
Maraviroc |
05.03.02.02 |
Formulary
|
|
Maribavir Livtencity® |
06.07.04 |
Formulary
|
|
Mecasermin Increlex® |
03.04.02 |
Formulary
|
|
Mepolizumab Nucala® |
09.08.01 |
Formulary
|
|
Mercaptamine |
11.08 |
Formulary
|
|
Mercaptamine hydrocholride |
09.01.03 |
Formulary
|
|
Methoxy Polyethylene Glycol-Epoetin Beta Mircera®, Pegzerepoetin® alfa |
06.08 |
Formulary
|
|
Metreleptin |
10.02 |
Formulary
|
|
Mexiletine Namuscla® |
05.02.04 |
Formulary
|
|
Micafungin |
01.05.03 |
Formulary
|
|
Mirikizumab Omvoh® |
08.01.05 |
Formulary
|
|
Mobocertinib |
08.01.05 |
Formulary
|
|
Mogamulizumab Poteligeo® |
08.01.05 |
Formulary
|
|
Momelotinib Omjjara® |
08.02.04 |
Formulary
|
|
Natalizumab |
08.01.03 |
Formulary
|
|
Nelarabine Atriance® |
05.03.01 |
Formulary
|
|
Nelfinavir |
08.01.05 |
Formulary
|
|
Neratinib Nerlynx® |
05.03.01 |
Formulary
|
|
Nevirapine |
03.11 |
Formulary
|
|
Nintedanib Ofev® |
08.01.05 |
Formulary
|
|
Niraparib Zejula® |
20 |
Non Formulary
|
|
Nitazoxanide |
08.01.05 |
Formulary
|
|
Nivolumab Opdivo® |
08.01.05 |
Formulary
|
|
Nivolumab-relatlimab Opdualag® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Gammunex® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Iqymune® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Intratect® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Cuvitru® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Gammanorm® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Octagam® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Subcuvia® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Privigen® |
14.05.01 |
Formulary
|
|
Normal Immunoglobulin Kiovig® |
14.05.01 |
Formulary
|
|
Normal immunoglobulin for Intramuscular use |
10.02 |
Formulary
|
|
Nusinersen Spinraza® |
01.09.01 |
Formulary
|
|
Obeticholic acid |
08.02.03 |
Formulary
|
|
Obinutuzumab |
08.02.03 |
Formulary
|
|
Ocrelizumab Ocrevus® |
11.08.02 |
Formulary
|
|
Ocriplasmin Jetrea® |
08.01.05 |
Formulary
|
|
Olaparib Lynparza® |
03.04.02 |
Formulary
|
|
Omalizumab Xolair® |
08.03.04.01 |
Formulary
|
|
Palbociclib Ibrance® |
05.03.05 |
Formulary
|
|
Palivizumab |
08.01.05 |
Formulary
|
|
Panitumumab Vectibix® |
08.01.05 |
Formulary
|
|
Panobinostat |
08.03.04.03 |
Formulary
|
|
Pasireotide Signifor® |
04.12 |
Formulary
|
|
Patisiran Onpattro® |
09.01.06 |
Formulary
|
|
Pegfilgrastim (G-CSF) |
08.02.04 |
Formulary
|
|
Peginterferon Beta-1a Plegridy® |
06.05.01 |
Formulary
|
|
Pegvisomant Somavert® |
08.01.05 |
Formulary
|
|
Pembrolizumab Keytruda® |
08.01.05 |
Formulary
|
|
Pertuzumab Perjeta® |
03.11 |
Formulary
|
|
Pirfenidone |
09.01.07 |
Formulary
|
|
Plerixafor Mozobil® |
08.01.05 |
Formulary
|
|
Polatuzumab vedotin Polivy® |
08.02.04 |
Formulary
|
|
Pomalidomide Imnovid® |
08.01.05 |
Formulary
|
|
Ponatinib Iclusig® |
08.02.04 |
Formulary
|
|
Ponesimod Ponvory® |
03.05.02 |
Formulary
|
|
Poractant Alfa |
05.02.01 |
Formulary
|
|
Posaconazole Noxafil® |
02.11 |
Formulary
|
|
Protein C Concentrate Ceprotin® |
02.11 |
Formulary
|
|
Prothrombin Complex Concentrate Octaplex® |
08.03.04.02 |
Formulary
|
|
Radium-223 dichloride |
05.03.01 |
Formulary
|
|
Raltegravir |
08.01.05 |
Formulary
|
|
Ramucirumab Cyramza® |
11.08.02 |
Formulary
|
|
Ranibizumab 10mg/1ml injection Lucentis® |
08.01.05 |
Formulary
|
|
Regorafenib Stivarga® |
03.04.02 |
Formulary
|
|
Reslizumab Cinquil® |
05.03.03.02 |
Formulary
|
|
Ribavirin |
08.03.04.01 |
Formulary
|
|
Ribociclib Kisqali® |
05.03.01 |
Formulary
|
|
Rilpivirine hydrochloride |
04.09.03 |
Formulary
|
|
Riluzole |
02.05.01 |
Formulary
|
|
Riociguat |
01.05.03 |
Formulary
|
|
Risankizumab Skyrizi® |
13.05.03 |
Formulary
|
|
Risankizumab Skyrizi® |
13.05.03 |
Formulary
|
|
Ritlecitinib Litfulo® |
05.03.01 |
Formulary
|
|
Ritonavir |
09.01.04 |
Formulary
|
|
Romiplostim |
08.01.05 |
Formulary
|
|
Sacituzumab govitecan Trodelvy® |
05.03.01 |
Formulary
|
|
Saquinavir |
10.01.03 |
Formulary
|
|
Sarilumab Kevzara® |
09.08.01 |
Formulary
|
|
Sebelipase alfa Kanuma® |
13.05.03 |
Formulary
|
|
Secukinumab Cosentyx® |
08.01.05 |
Formulary
|
|
Selinexor Nexpovio® |
08.01.05 |
Formulary
|
|
Selpercatinib |
08.01.05 |
Formulary
|
|
Selumetinib Koselugo® |
06.07 |
Formulary
|
|
Setmelanotide Imcivree® |
09.05.02.02 |
Formulary
|
|
Sevelamer Carbonate |
08.02.04 |
Formulary
|
|
Siponimod Mayzent® |
20 |
Non Formulary
|
|
Sipuleucel- T |
04.01.01 |
Formulary
|
|
Sodium Oxybate 500mg/1ml oral solution Xyrem® |
05.03.03.02 |
Formulary
|
|
Sofosbuvir Sovaldi® |
05.03.03.02 |
Formulary
|
|
Sofosbuvir & Ledipasvir Harvoni® |
05.03.03.02 |
Formulary
|
|
Sofosbuvir & velpatasvir Epclusa® |
05.03.03.02 |
Formulary
|
|
Sofosbuvir, Velpatasvir & Voxilaprevir Vosevi® |
06.05.01 |
Formulary
|
|
Somatrogon Ngenla® |
08.01.05 |
Formulary
|
|
Sorafenib Nexavar® |
05.03.01 |
Formulary
|
|
Stavudine |
09.05.02.02 |
Formulary
|
|
Sucroferric oxyhydroxide Velphoro® |
08.01.05 |
Formulary
|
|
Sunitinib Sutent® |
04.12 |
Formulary
|
|
Tafamidis Vyndaqel® |
08.01.05 |
Formulary
|
|
Talazoparib Talzenna® |
08.01.05 |
Formulary
|
|
Talimogene laherparepvec |
20 |
Non Formulary
|
|
Taribavirin |
01.04.02 |
Formulary
|
|
Teduglutide Revestive® |
08.01.05 |
Formulary
|
|
Temsirolimus Torisel® |
05.03.03.01 |
Formulary
|
|
Tenofovir Disproxil Viread® |
05.03.01 |
Formulary
|
|
Tenofovir Disproxil & Cobicistat & Elvitegravir & Emtricitabine |
05.03.01 |
Formulary
|
|
Tenofovir Disproxil & Efavirenz & Emtricitabine |
08.02 |
Formulary
|
|
Tepotinib Tepmetko® |
08.02.04 |
Formulary
|
|
Teriflunomide |
20 |
Non Formulary
|
|
TETRAHYDROBIOPTERIN Tablets 10 mg |
03.07 |
Formulary
|
|
Tezacaftor and ivacaftor Symkevi® |
03.07 |
Formulary
|
|
Tezacaftor with ivacaftor and elexacaftor Kaftrio® |
03.04.02 |
Formulary
|
|
Tezepelumab Tezspire® |
05.03.01 |
Formulary
|
|
Tipranavir |
08.01.05 |
Formulary
|
|
Tisagenlecleucel |
08.01.05 |
Non Formulary
|
|
Tisagenlecleucel |
05.01.04 |
Formulary
|
|
Tobramycin |
10.01.03 |
Formulary
|
|
Tofacitinib Xeljanz® |
06.05.02 |
Formulary
|
|
Tolvaptan |
13.05.03 |
Formulary
|
|
Tralokinumab Adtralza® |
08.01.05 |
Formulary
|
|
Trametinib |
08.01.05 |
Formulary
|
|
Trastuzumab emtansine Kadcyla® |
20 |
Non Formulary
|
|
Treprostinil |
09.08.01 |
Formulary
|
|
Trientine Dihydrochloride |
08.01.05 |
Formulary
|
|
Tucatinib Tukysa® |
01.05.03 |
Formulary
|
|
Upadacitinib Rinvoq® |
10.01.03 |
Formulary
|
|
Upadacitinib Rinvoq® |
13.05.03 |
Formulary
|
|
Upadacitinib Rinvoq® |
01.05.03 |
Formulary
|
|
Ustekinumab Stelara® |
13.05.03 |
Formulary
|
|
Ustekinumab Stelara® |
05.03.02.02 |
Formulary
|
|
Valganciclovir |
01.05.03 |
Formulary
|
|
Vedolizumab |
09.08.01 |
Formulary
|
|
Velmanase alfa Lamzede ® |
08.01.05 |
Formulary
|
|
Venetoclax Venclyxto® |
08.02.02 |
Formulary
|
|
Voclosporin Lupkynis® |
19 |
Formulary
|
|
Volanesorsen Waylivra® |
08.01.05 |
Formulary
|
|
Zanabrutinib Brukinsa |
08.01.05 |
Non Formulary
|
|
Zanubrutinib Brukinsa® |
08.01.05 |
Formulary
|
|
Zanubrutinib Brukinsa® |
05.03.01 |
Formulary
|
|
Zidovudine |
05.03.01 |
Formulary
|
|
Zidovudine & Lamivudine |