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 |