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® |
08.01.05 |
Formulary
|
 |
Avapritinib Ayvakyt® |
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® |
08.01.05 |
Formulary
|
 |
Belzutifan Welireg® |
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® |
04.07.03 |
Formulary
|
 |
Botulinum Toxin Type A Botox® |
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 |
09.01.03 |
Formulary
|
 |
Crovalimab Piasky® |
08.01.05 |
Formulary
|
 |
Dabrafenib Tafinlar® |
05.03.03.02 |
Formulary
|
 |
Daclatasvir |
08.02.04 |
Formulary
|
 |
Daclizumab Zinbryta® |
08.01.05 |
Formulary
|
 |
Dacomitinib Vizimpro® |
09.01.03 |
Formulary
|
 |
Danicopan Voydeya® |
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® |
01.09.01 |
Formulary
|
 |
Elafibranor Iqirvo® |
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® |
04.12 |
Formulary
|
 |
Eplontersen Wainzua ® |
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 |
08.01.05 |
Formulary
|
 |
Fedratinib |
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® |
08.01.05 |
Formulary
|
 |
Quizartinib Vanflyta® |
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 |
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 |
08.01.05 |
Formulary
|
 |
Teclistamab Tecvayli® |
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® |
08.02.03 |
Formulary
|
 |
Ublituximab Briumvi® |
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 |