Report : A-Z HCD items in Formulary 26/01/2021 20:29:48

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Section Status HCD Name 05.03.01 Formulary Abacavir  05.03.01 Formulary Abacavir/lamivudine Kivexa® 05.03.01 Formulary Abacavir/lamivudine/zidovudine Tizivir® 06.06.02 Non Formulary Abaloparatide  10.01.03 Formulary Abatacept Orencia® 08.01.05 Formulary Abemaciclib Verzenios® 08.03.04.02 Formulary Abiraterone  01.05.03 Formulary Adalimumab/ adalimumab biosimilar Humira®, Imraldi®, Amgevita®) (Gastroenterology 10.01.03 Formulary Adalimumab/ adalimumab biosimilar Humira®, Imraldi®, Amgevita® ) (Rheumatology 11.04 Formulary Adalimumab/ adalimumab biosimilar Humira®, Imraldi®, Amgevita®) (Ophthalmology 13.05.03 Formulary Adalimumab/ adalimumab biosimilar Humira®, Imraldi®, Amgevita®) (dermatology 05.03.03.01 Formulary Adefovir Dipivoxil  08.01.05 Formulary Afatinib  11.08.02 Formulary Aflibercept   08.02.04 Non Formulary Aldesleukin Proleukin® 08.01.05 Formulary Alectinib Alecensa® 08.02.04 Formulary Alemtuzumab  13.05.01 Formulary Alitretinoin  02.05.01 Formulary Ambrisentan  10.02.01 Formulary Amifampridine base (3,4-diaminopyridine)  10.01.03 Formulary Anakinra Kineret® 08.02.02 Formulary Antithymocyte immunoglobulin (rabbit)   04.09.01 Formulary Apomorphine  10.01.03 Formulary Apremilast  13.05.03 Formulary Apremilast  08.01.05 Formulary Arsenic trioxide  10.02 Formulary Ataluren Translarna® 05.03.01 Formulary Atazanavir  05.03.01 Formulary Atazanavir sulfate/cobicistat Evotaz® 08.01.05 Formulary Atezolizumab  09.01.04 Formulary Avatrombopag Doptelet® 08.01.05 Formulary Avelumab Bavencio® 08.01.05 Formulary Axitinib  08.01.03 Formulary Azacitidine  05.01.02.03 Formulary Aztreonam  10.01.03 Formulary Baricitinib Olumiant® 08.02 Formulary Basiliximab Simulect® 08.01 Non Formulary Begelomab Begedina® 10.01.03 Formulary Belimumab Benlysta® 08.01.01 Formulary Bendamustine  03.04.02 Formulary Benralizumab Fasenra® 03.05.02 Formulary Beractant  09.08.01 Formulary Betaine  08.01.05 Formulary Bevacizumab Avastin® 11.08.02 Non Formulary Bevacizumab intravitreal inj  05.03.01 Restricted Use Bictegravir / emtricitabine / tenofovir-alafenamide Biktarvy ® 05.03.03.02 Non Formulary Boceprevir  08.01.05 Formulary Bortezomib  02.05.01 Formulary Bosentan Tracleer® 08.01.05 Formulary Bosutinib  01.07.04 Formulary Botulinum toxin type A  04.07.04.02 Formulary Botulinum Toxin Type A  04.09.03 Formulary Botulinum Toxin Type A  13.12 Formulary Botulinum toxin type A   08.01.05 Formulary Brentuximab vedotin  08.01.05 Formulary Brigatinib Alunbrig® 13.05.03 Formulary Brodalumab  09.08.01 Formulary Burosumab Crysvita® 03.04.03 Formulary C1 esterase inhibitor Cinryze® 03.04.03 Formulary C1 esterase inhibitor Berinert® 08.01.05 Formulary Cabazitaxel  08.01.05 Formulary Cabozantinib Cabometyx® 08.02.04 Non Formulary Canakinumab Ilaris® 05.02.04 Formulary Caspofungin  08.01.05 Formulary Ceritinib  10.01.03 Formulary Certolizumab Pegol Cimzia® 13.05.03 Formulary Certolizumab pegol Cimzia® 08.01.05 Formulary Cetuximab  08.02.02 Formulary Ciclosporin  05.03.02.02 Formulary Cidofovir   09.05.01.02 Formulary Cinacalcet Mimpara® 08.01.03 Formulary Cladribine  10.02 Formulary Cladribine Mavenclad® 08.01.03 Non Formulary Clofarabine Evoltra® 05.03.01 Formulary Cobicistat Tybost® 04.09.01 Formulary Co-Careldopa Duodopa® 05.01.07 Formulary Colistimethate   05.01.07 Formulary Colistimethate  03.04.03 Formulary Conestat alfa Ruconest® 08.01.05 Formulary Crizotinib  08.01.05 Formulary Dabrafenib  05.03.03.02 Formulary Daclatasvir   08.01.05 Formulary Dacomitinib  Vizimpro® 08.01.05 Formulary Daratumumab Darzalex® 09.01.03 Formulary Darbepoetin Alfa Aranesp® 05.03.01 Formulary Darunavir  05.03.01 Formulary Darunavir/cobicistat Rezolsta® 05.03.01 Formulary Darunavir/cobicistat/emtricitabine/tenofovir alafenamide fumarate  Symtuza® 05.03.03.02 Formulary Dasabuvir  08.01.05 Formulary Dasatinib  08.01.03 Non Formulary Decitabine Dacogen® 09.01.03 Formulary Deferasirox Exjade® 09.01.03 Formulary Deferiprone Ferriprox® 02.08.01 Formulary Defibrotide  09.01.03 Formulary Desferrioxamine mesilate  18 Formulary Desferrioxamine mesilate  11.04.01 Formulary Dexamethasone intravitreal implant Ozurdex® 08.01 Non Formulary Dexrazoxane Savene® 08.01 Formulary Dexrazoxane Cardioxane® 05.03.01 Formulary Didanosine  02.01.01 Formulary Digoxin specific antibody fragments Digifab® 18 Formulary Digoxin specific antibody fragments Digifab® 08.02.04 Formulary Dimethyl fumarate Tecfidera® 13.05.02 Formulary Dimethyl fumarate Skilarence® 08.01.05 Formulary Dinutuximab beta Qarziba® 05.03.01 Formulary Dolutegravir  03.07 Formulary Dornase Alfa  13.05.03 Formulary Dupilumab Dupixent®) (dermatology 08.01.05 Formulary Durvalumab Imfinzi® 09.01.03 Formulary Eculizumab Soliris® 05.03.01 Formulary Efavirenz  05.03.01 Formulary Efavirenz/emtricitabine/tenofovir disoproxil fumarate  Atripla® 09.01 Restricted Use Efmoroctocog alfa Elocta® 03.07 Restricted Use Elexacaftor/tezacaftor/ivacaftor Kaftrio® 09.01.04 Formulary Eltrombopag Revolade® 05.03.01 Formulary Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate  Genvoya® 05.03.01 Formulary Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate Stribild® 09.01.03 Formulary Emicizumab  05.03.01 Formulary Emtricitabine  05.03.01 Formulary Emtricitabine/rilpivirine/tenofovir alafenamide fumarate Odefsey® 05.03.01 Formulary Emtricitabine/rilpivirine/tenofovir disoproxil fumarate Eviplera® 05.03.01 Formulary Emtricitabine/tenofovir disoproxil fumarate  05.03.03.01 Formulary Entecavir  08.01.05 Formulary Entrectinib Rozlytrek® 08.03.04.02 Formulary Enzalutamide Xtandi® 09.01.03 Formulary Epoetin alfa Eprex® 09.01.03 Formulary Epoetin beta NeoRecormon® 02.08.01 Formulary Epoprostenol Flolan® 08.01.05 Formulary Eribulin  08.01.05 Formulary Erlotinib  02.04 Formulary Esmolol  10.01.03 Formulary Etanercept/etanercept biosimilar Enbrel®, Benepali®, Erelzi®) (Rheumatology 13.05.03 Formulary Etanercept/etanercept biosimilar Enbrel®, Benepali®, Erelzi®) (dermatology 05.03.01 Formulary Etravirine  08.01.05 Formulary Everolimus Votubia® 08.01.05 Formulary Everolimus Afinitor® 08.02.02 Non Formulary Everolimus Certican®) (Transplant 02.12 Formulary Evolocumab Repatha® 08.02.04 Non Formulary Fampridine  09.01.06 Formulary Filgrastim  08.02.04 Formulary Fingolimod  11.04.01 Formulary Fluocinolone acetonide Iluvien® 18 Formulary Fomepizole  05.03.01 Formulary Fosamprenavir  05.03.02.02 Formulary Foscarnet Sodium  04.07.04.02 Formulary Fremanezumab Ajovy® 04.07.04.02 Formulary Galcanezumab Emgality® 05.03.02.02 Formulary Ganciclovir  08.01.05 Formulary Gefitinib  08.01.05 Formulary Gilteritinib Xospata® 08.02.04 Formulary Glatiramer acetate  01.05.03 Formulary Golimumab Simponi®) (Gastroenterology 10.01.03 Formulary Golimumab Simponi®) (Rheumatology 13.05.03 Formulary Guselkumab  09.08.02 Formulary Haem Arginate  08.01.05 Formulary Ibrutinib Imbruvica® 03.04.03 Formulary Icatibant Firazyr® 11.08 Formulary Idebenone Raxone® 08.01.05 Formulary Idelalisib  02.05.01 Formulary Iloprost 100micrograms/ml  08.01.05 Formulary Imatinib  01.05.03 Formulary Infliximab Remicade®)(Gastroenterology 01.05.03 Formulary Infliximab biosimilar Remsima®, Inflectra®, Flixabi®) (Gastroenterology 10.01.03 Formulary Infliximab/infliximab biosimilar rheumatology 13.05.03 Formulary Infliximab/infliximab biosimilar dermatology 09.08.01 Formulary Inotersen Tegsedi® 08.01.05 Formulary Inotuzumab ozogamicin Besponsa® 05.03.03 Formulary Interferon alfa  08.02.04 Formulary Interferon Alfa  08.02.04 Formulary Interferon Beta  08.01.05 Formulary Ipilimumab  05.02.01 Formulary Isavuconazole Cresemba® 03.07 Restricted Use Ivacaftor Kalydeco® 08.01.05 Formulary Ixazomib Ninlaro® 10.01.03 Formulary Ixekizumab Taltz® 13.05.03 Formulary Ixekizumab Taltz® 05.03.01 Formulary Lamivudine  05.03.01 Formulary Lamivudine/abacavir/dolutegravir Triumeq® 03.04.03 Formulary Lanadelumab 300mg  Takhzyro® 08.03.04.03 Formulary Lanreotide Somatuline Autogel® 08.01.05 Non Formulary Lapatinib Tyverb® 08.01.05 Formulary Larotrectinib Vitrakvi® 05.03.03.02 Formulary Ledipasvir with sofosbuvir Harvoni® 08.02.04 Formulary Lenalidomide  Revlimid® 09.01.06 Non Formulary Lenograstim Granocyte® 09.08.01 Formulary Levocarnitine  08.01.05 Formulary Liposomal daunorubicin-cytarabine Vyxeos® 02.12 Formulary Lomitapide Lojuxta®▼ 05.03.01 Formulary Lopinavir/ritonavir Kaletra® 08.01.05 Formulary Lorlatinib Lorviqua® 03.07 Restricted Use Lumacaftor/ivacaftor Orkambi® 09.01.04 Formulary Lusutrombopag Mulpleo® 08.01.05 Formulary Lutetium (177Lu) oxodotreotride  02.05.01 Formulary Macitentan Opsumit ® 03.07 Formulary Mannitol inhalation  05.03.01 Formulary Maraviroc Celsentri® 03.04.02 Formulary Mepolizumab Nucala® 09.08.01 Formulary Mercaptamine Cystagon® 11.08 Formulary Mercaptamine (cysteamine)   11.08 Non Formulary Mercaptamine (cysteamine)  Cystadrops® 09.01.03 Non Formulary Methoxy Polyethylene Glycol-Epoetin Beta Mircera® 10.02.02 Formulary Mexiletine Namuscla® 05.02.04 Formulary Micafungin  08.01.05 Formulary Midostaurin  08.02.01 Formulary Mycophenolate mofetil  08.02.04 Formulary Natalizumab  08.01.05 Non Formulary Necitumumab Portrazza® 08.01.03 Non Formulary Nelarabine Atriance® 08.01.05 Formulary Neratinib Nerlynx® 05.03.01 Formulary Nevirapine  08.01.05 Formulary Nilotinib  08.01.05 Formulary Nintedanib  08.01.05 Formulary Niraparib  08.01.05 Formulary Nivolumab Opdivo® 14.05.01 Formulary Normal immunoglobulin for Intravenous use  14.05.01 Formulary Normal immunoglobulin for Subcutaneous use  10.02 Formulary Nusinersen Spinraza ® 01.09.01 Formulary Obeticholic acid Ocaliva® 08.02.03 Formulary Obinutuzumab  08.02.04 Formulary Ocrelizumab Ocrevus® 11.08.02 Formulary Ocriplasmin Jetrea® 08.03.04.03 Formulary Octreotide Sandostatin Lar® 08.03.04.03 Formulary Octreotide  08.02.03 Formulary Ofatumumab  08.01.05 Formulary Olaparib Lynparza® 03.04.02 Formulary Omalizumab Xolair® 05.03.03.02 Formulary Ombitasvir/ paritaprevir/ ritonavir Viekirax® 08.01.05 Formulary Osimertinib  08.01.05 Formulary Paclitaxel - Albumin Bound   08.01.05 Formulary Palbociclib Ibrance® 05.03.05 Formulary Palivizumab Synagis® 08.01.05 Formulary Panitumumab  08.01.05 Formulary Panobinostat  08.01.05 Formulary Pazopanib  11.08.02 Non Formulary Pegaptanib intravitreal inj Macugen® 08.01.05 Formulary Pegaspargase Oncaspar® 09.01.06 Formulary Pegfilgrastim  05.03.03 Formulary Peginterferon alfa-2a Pegasys® 08.02.04 Formulary Peginterferon Alfa-2a Pegasys® 05.03.03 Formulary Peginterferon Alfa-2b ViraferonPeg® 08.02.04 Formulary Peginterferon Alfa-2b ViraferonPeg® 08.02.04 Formulary Peginterferon Beta-1a Plegridy® 06.05.01 Formulary Pegvisomant Somavert® 08.01.05 Formulary Pembrolizumab Keytruda® 08.01.03 Formulary Pemetrexed  08.01.05 Formulary Pertuzumab  03.11 Formulary Pirfenidone  04.04 Formulary Pitolisant Wakix® 08.01.02 Formulary Pixantrone  09.01.07 Formulary Plerixafor  08.01.05 Formulary Polatuzumab vedotin Polivy® 08.02.04 Formulary Pomalidomide Imnovid® 08.01.05 Formulary Ponatinib  03.05.02 Formulary Poractant Alfa  05.02.01 Formulary Posaconazole   08.03.04.02 Formulary Radium-223 dichloride  05.03.01 Formulary Raltegravir  08.01.05 Non Formulary Ramucirumab Cyramza® 11.08.02 Formulary Ranibizumab  10.01.04 Formulary Rasburicase Fastertec® 08.01.05 Formulary Regorafenib Stivarga® 03.04.02 Formulary Reslizumab  05.03.03.02 Formulary Ribavirin  05.03.05 Formulary Ribavirin  08.01.05 Formulary Ribociclib Kisqali® 05.03.01 Formulary Rilpivirine hydrochloride  04.09.03 Formulary Riluzole Rilutek® 02.05.01 Non Formulary Riociguat Adempas® 10.02 Formulary Risdiplam  05.03.01 Formulary Ritonavir  08.02.03 Formulary Rituximab/ rituximab biosimilar MabThera®, Rixathon®, Truxima®) (Haematology 10.01.03 Formulary Rituximab/rituximab biosimilar MabThera®, Rixathon®, Truxima®) (Rheumatology & Other 09.01.04 Formulary Romiplostim Nplate® 08.01.05 Formulary Rucaparib Rubraca® 08.01.05 Formulary Ruxolitinib Jakavi® 05.03.01 Formulary Saquinavir  10.01.03 Formulary Sarilumab Kevzara® 10.01.03 Formulary Secukinumab Cosentyx®) (Rheumatology 13.05.03 Formulary Secukinumab Cosentyx®) (dermatology 09.05.02.02 Formulary Sevelamer Carbonate  09.05.02.02 Formulary Sevelamer Hydrochloride  Renagel® 02.05.01 Formulary Sildenafil Revatio® 05.03.03.02 Formulary Simeprevir  08.02.02 Formulary Sirolimus  04.04 Formulary Sodium Oxybate Xyrem® 09.08.01 Formulary Sodium Phenylbutyrate  05.03.03.02 Formulary Sofosbuvir  05.03.03.02 Formulary Sofosbuvir with velpatasvir Epclusa® 05.03.03.02 Formulary Sofosbuvir/velpatasvir/voxilaprevir Vosevi 06.05.01 Formulary Somatropin  08.01.05 Formulary Sorafenib  05.03.01 Formulary Stavudine  08.01.05 Formulary Streptozocin  08.01.05 Formulary Sunitinib  02.14 Formulary Tafamidis Vyndaqel 08.01.05 Formulary Talimogene laherparepvec Imlygic® 01.04.02 Non Formulary Teduglutide Revestive® 05.03.03.02 Non Formulary Telaprevir  08.01.05 Formulary Temozolomide  08.01.05 Non Formulary Temsirolimus Torisel® 05.03.01 Formulary Tenofovir disoproxil fumarate  08.02.04 Formulary Teriflunomide  06.06.01 Formulary Teriparatide  03.07 Restricted Use Tezacaftor/ivacaftor Symkevi® 08.02.04 Formulary Thalidomide  13.05.03 Formulary Tildrakizumab Ilumetri® 08.01.05 Formulary Tivozanib  05.01.04 Formulary Tobramycin  05.01.04 Formulary Tobramycin  10.01.03 Formulary Tocilizumab RoActemra® 01.05.03 Formulary Tofacitinib XELJANZ® 10.01.03 Formulary Tofacitinib XELJANZ® 06.05.02 Formulary Tolvaptan Jinarc® 08.01.05 Formulary Trabectedin  08.01.05 Formulary Trametinib  08.01.05 Formulary Trastuzumab  08.01.05 Formulary Trastuzumab emtansine  08.01.03 Formulary Trifluridine and tipiracil  01.05.03 Formulary Ustekinumab Stelara®) (Gastroenterology 13.05.03 Formulary Ustekinumab Stelara®) (dermatology 05.03.02.02 Formulary Valganciclovir  08.01.05 Non Formulary Vandetanib Caprelsa® 01.05.03 Formulary Vedolizumab Entyvio® 08.01.05 Formulary Vemurafenib  11.08.02 Formulary Verteporfin  Visudyne® 09.01 Non Formulary Vonicog alfa Veyvondi ® 05.02.01 Formulary Voriconazole  08.01.05 Non Formulary Vosaroxin Qinprezo 05.03.01 Formulary Zidovudine  05.03.01 Formulary Zidovudine/lamivudine

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