Pharmacy Policies
-
A
- ADAMTS13, recombinant-krhn (Adzynma)
- Abatacept (Orencia®) for Injection for Intravenous Use
- Agalsidase beta (Fabrazyme®) and pegunigalsidase alfa-iwxj (Elfabrio)
- Alemtuzumab (Lemtrada)
- Algucosidase alfa (Lumizyme) Avalglucosidase alfa-ngpt (Nexvlazyme)
- Alpha 1-Antitrypsin Therapy (Prolastin-C, Aralast NP, Glassia, Zemaira)
- Anifrolumab-fnia_(Saphnelo).pdf
- Anti-Emetic Agents
-
B
-
C
- CGM Policy
- Canakinumab (Ilaris)
- Cerliponase alfa (Brineura®)
- Coagulation Factors
- Collagenase clostridum histolyticum (Xiaflex), collengenase clostridium histolyticum-aaes (Qwo)
- Crizanlizumab-tmca (Adakveo®)
-
D
- Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®)
- Dofetilide (Tikosyn) Use in the Inpatient Setting
-
E
- Eculizumab_(Soliris)_and_Related_Biosimilars,_Ravulizumab-cwvz_(Ultomiris).pdf
- Edaravone (Radicava)
- Efgartigimod-alfa (VyvgartTM) and efgartgimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo)
- Emapalumab-lzsq (Gamifant)
- Enteral_Nutritional_Therapy.pdf
- Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g. Aldurazyme, Elaprase, Vimizim, Naglazyme, Mepsevil)
- Enzyme Replacement for the Treatment of Gaucher's Disease
- Eptinezumab-jjmr (Vyepti)
- Erythropoeisis Stimulating Agents (ESAs)
- Evinacumab-dgnb_(Evkeeza).pdf
- Exon Skipping for Duchenne Muscular Dystrophy (DMD)
-
F
-
G
-
I
- Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)
- Inebilizumab-cdon (Uplinza)
- Infliximab and Related Biosimilars
- Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®, Nucala®) and IL-5 Receptor Antagonist (e.g., Fasenra®)
- Intravenous_Ketamine_(Ketalar)_and_Intranasal_Esketamine_(Spravato).pdf
- Intravitreal Injection of VEGF Antagonists and Related Biosimilars
- Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists and Related Biosimilars
-
L
-
M
- Medicare Part B vs. Part D Crossover Drugs
- Mirikizumab-mrkz (Omvoh™) for Intravenous Use
- Monoclonal_Antibodies_Directed_Against_Amyloid_For_The_Treatment_of_Alzheimer_Disease_2.pdf
-
N
-
O
- Ocrezilumab (Ocrevus)
- Octreotide Acetate (Sandostatin® LAR Depot)
- Off-Label Coverage for Prescription Drugs and-or Biologics
- Omalizumab (Xolair®)
-
P
-
R
-
S
- Sebelipase alfa (Kanuma)
- Secukinumab (Cosentyx®) for Intravenous Use
- Spesolimab-sbzo_(Spevigo).pdf
- Sutimlimab-jome (Enjaymo)
-
T
- Teplizumab-mzwv (Tzield)
- Teprotumumab (Tepezza)
- Tezepelumab-ekko (Tezspire)
- Tildrakizumab-asmn (Ilumya)
- Tocilizumab (Actemra®) and Related Biosimilars for Intravenous Infusion and Subcutaneous Injection
- Treatment_of_Pulmonary_Artery_Hypertension_with_Intravenous,_Subcutaneous,_and_Inhaled_Pharmacologic_Agents.pdf
- Treatments for Complex Regional Pain Syndrome (CRPS)
- Triamcinolone Acetonide Extended-Release Injectable (Zilretta)
-
U
-
V