NOTE: This list is subject to change as new drugs come to market or new decisions are made by our Pharmacy and Therapeutics Committee.

**This list does not guarantee coverage and is subject to change.**

  • Abrilada
  • Actemra SQ
  • Actimmune
  • adalimumab
  • Adbry
  • Adlyxin
  • Adrenaclick
  • Aimovig
  • Ajovy
  • alprostadil
  • Amjevita
  • Apidra
  • Apokyn
  • Arixtra
  • Avonex
  • Basaglar
  • Benlysta SQ
  • Besremi
  • Betaseron
  • Bimzelx
  • Bydureon
  • Byetta
  • calcitonin
  • Caverject
  • Cimzia
  • Copaxone
  • Cosentyx
  • cyanocobalamin
  • Cyltezo
  • Delestrogen
  • Depo-Estradiol
  • Depo-Testosterone
  • D.H.E. 45
  • dihydroergotamine
  • Dupixent
  • Edex
  • Emgality
  • Enbrel
  • enoxaparin
  • Enspryng
  • Entyvio Pen
  • epinephrine
  • EpiPen
  • estradiol valerate
  • Evrysdi
  • Evzio
  • Extavia
  • Fasenra Pen
  • fondaparinux
  • Forteo
  • Fragmin
  • Furoscix
  • Fuzeon
  • Gattex
  • Genotropin
  • glatiramer
  • Glatopa
  • Glucagen
  • glucagon
  • Gvoke
  • Hadlima
  • Hulio
  • Humalog*
  • Humatrope
  • Humira
  • Humulin*
  • hydroxyprogesterone
  • Hyrimoz
  • Idacio
  • Ilumya
  • Imitrex
  • Increlex
  • Intron-A
  • Kesimpta
  • Kevzara
  • Kineret
  • Kloxxado
  • Lantus
  • leuprolide (non-depot)
  • Levemir
  • liraglutide
  • Lovenox
  • Makena
  • methotrexate
  • Miacalcin
  • Mounjaro
  • Natpara
  • Ngenla
  • Norditropin
  • Novolin*
  • Novolog*
  • Nucala
  • Nutropin AQ
  • octreotide (non-LAR)
  • Omnitrope
  • Omvoh
  • Orencia SQ
  • Orladeyo
  • Otrexup
  • Ozempic
  • Palynziq
  • Pegasys
  • Plegridy
  • Praluent
  • progesterone in oil
  • Rasuvo
  • Rebif
  • Relistor
  • Repatha
  • Rivfloza
  • Saizen
  • Sandostatin (non-LAR)
  • Saxenda
  • Serostim
  • Signifor
  • Siliq
  • Simlandi
  • Simponi SQ
  • Skyrizi
  • Skytrofa
  • Sogroya
  • Soliqua
  • Somavert
  • Spevigo
  • Stelara
  • sumatriptan
  • SymlinPen
  • Takhzyro
  • Taltz
  • Tegsedi
  • teriparatide
  • testosterone cypionate
  • testosterone enanthate
  • Tezspire
  • Toujeo Solostar
  • Tremfya
  • Tresiba
  • Trulicity
  • Tyenne
  • Tymlos
  • Victoza
  • Voxzogo
  • Vyleesi
  • Wainua
  • Wezlana SQ
  • Winrevair
  • Xolair prefilled syringe, auto-injector
  • Xultophy
  • Xyosted
  • Yuflyma
  • Yusimry
  • Zembrace Symtouch
  • Zilbrysq
  • Zimhi
  • Zomacton
  • Zorbtive
  • Zymfentra

*Includes all forms of the drug.

Reviewed by LJS/BNN on 7/29/24

Our Website Uses Cookies

This website uses cookies to give you the very best experience. Your continued use of this site is considered permission by you to use cookies in this manner. Please review our Privacy Commitment and Notice for terms of use, the types of cookies we use and more information about the data we collect. Please note, if you navigate from our website to a third-party site of any kind, that website has its own terms and conditions.