08.01.05 |
Formulary
|
 |
Arsenic Trioxide Trisenox® |
08.02.04 |
Formulary
|
 |
Axicabtagene ciloleucel Yescarta® |
08.01.05 |
Formulary
|
 |
Brentuximab vedotin Adcetris® |
08.01.03 |
Formulary
|
 |
Cytarabine-Daunorubicin liposomal Vyxeos® |
08.01.05 |
Formulary
|
 |
Dabrafenib mesilate Tafinlar® |
08.02.04 |
Formulary
|
 |
Dimethyl fumarate Tecfidera® |
08.02.03 |
Formulary
|
 |
Gemtuzumab ozogamicin Mylotarg® |
05.03.03.02 |
Restricted Use
|
 |
Glecaprevir - pibrentasvir Maviret® |
08.02.03 |
Formulary
|
 |
Inotuzumab ozogamicin Besponsa® |
03.07 |
Formulary
|
 |
Lumacaftor with ivacaftor Orkambi® |
03.07 |
Formulary
|
 |
Mannitol Dry Powder Bronchitol ® |
08.01.05 |
Formulary
|
 |
Paclitaxel - Albumin Bound Formulation Abraxane® |
08.02.04 |
Formulary
|
 |
Peginterferon Beta-1a Plegridy® |
08.02.03 |
Formulary
|
 |
Polatuzumab vedotin Polivy® |
05.03.03.02 |
Restricted Use
|
 |
Sofosbuvir-velpatasvir-voxilaprevir |
08.01.05 |
Formulary
|
 |
Talimogene laherparepvec Imlygic® |
08.01.05 |
Formulary
|
 |
Tisagenlecleucel Kymriah® |
08.01.03 |
Formulary
|
 |
Trifluridine tipiracil Lonsurf® |