Section |
Status |
BlueTeq |
Name |
06.06.01 |
Formulary
|
 |
Abaloparatide |
10.01.03 |
Formulary
|
 |
Abatacept Orencia® |
13.05.03 |
Formulary
|
 |
Abrocitinib Cibinqo ® |
01.05.03 |
Formulary
|
 |
Adalimumab |
10.01.03 |
Formulary
|
 |
Adalimumab Biosimilars avaliable |
11.08.02 |
Formulary
|
 |
Adalimumab |
13.05.03 |
Formulary
|
 |
Adalimumab Biosimilars avaliable |
11.08.02 |
Formulary
|
 |
Aflibercept Eylea® |
02.12 |
Formulary
|
 |
Alirocumab Praluent® |
13.05.01 |
Formulary
|
 |
Alitretinoin Toctino® |
10.01.03 |
Formulary
|
 |
Apremilast |
13.05.03 |
Formulary
|
 |
Apremilast Otezla® |
04.07.04.02 |
Formulary
|
 |
Atogepant Aquipta® |
09.01.04 |
Formulary
|
 |
Avatrombopag Doptelet® |
10.01.03 |
Formulary
|
 |
Baricitinib Olumiant® |
05.01.09 |
Formulary
|
 |
Bedaquiline |
11.08.02 |
Formulary
|
 |
Bevacizumab gamma |
10.01.03 |
Formulary
|
 |
Bimekizumab Bimzelx® |
13.05.03 |
Formulary
|
 |
Brodalumab Kyntheum® |
11.08.02 |
Formulary
|
 |
Brolucizumab Beovu® |
05.03.03 |
Formulary
|
 |
Bulevirtide HEPCLUDEX® |
06.06.02 |
Formulary
|
 |
Burosumab Crysvita® |
05.03.01 |
Formulary
|
 |
Cabotegravir Vocabria® |
10.01.03 |
Formulary
|
 |
Certolizumab Pegol Cimzia® |
09.01.03 |
Formulary
|
 |
Crovalimab Piasky® |
09.01.03 |
Formulary
|
 |
Danicopan |
05.01.09 |
Formulary
|
 |
Delamanid |
13.05.03 |
Formulary
|
 |
Deucravacitinib SOTYKTU |
11.04.01 |
Formulary
|
 |
Dexamethasone intravitreal implant Ozurdex® |
13.05.02 |
Formulary
|
 |
Dimethyl Fumarate Skilarence® |
13.05.03 |
Formulary
|
 |
Dupilumab Dupixent® |
05.03.03.02 |
Formulary
|
 |
Elbasvir with grazoprevir Zepatier® |
09.01.04 |
Formulary
|
 |
Eltrombopag Revolade® |
09.08.01 |
Formulary
|
 |
Eplontersen Wainzua® |
04.07.04.02 |
Formulary
|
 |
Eptinezumab Vyepti® |
04.07.04.02 |
Formulary
|
 |
Erenumab Aimovig® |
10.01.03 |
Formulary
|
 |
Etanercept Biosimilars avaliable |
13.05.03 |
Formulary
|
 |
Etanercept Biosimilars avaliable |
02.12 |
Formulary
|
 |
Evinacumab Evkeeza® |
02.12 |
Formulary
|
 |
Evolocumab Repatha® |
11.08.02 |
Formulary
|
 |
Faricimab Vabysmo ® |
04.08.01 |
Formulary
|
 |
Fenfluramine Fintepla® |
01.05.03 |
Formulary
|
 |
Filgotinib |
10.01.03 |
Formulary
|
 |
Filgotinib Jyseleca® |
11.04.01 |
Formulary
|
 |
Fluocinolone intravitreal implant Iluvien® |
09.01.04 |
Formulary
|
 |
Fostamatinib TAVLESSE ® |
05.03.01 |
Formulary
|
 |
Fostemsavir Rukobia® |
04.07.04.02 |
Formulary
|
 |
Fremanezumab Ajovy® |
04.07.04.02 |
Formulary
|
 |
Galcanezumab Emgality® |
05.03.03.02 |
Formulary
|
 |
Glecaprevir with pibrentasvir Maviret® |
01.05.03 |
Formulary
|
 |
Golimumab |
10.01.03 |
Formulary
|
 |
Golimumab Simponi® |
13.05.03 |
Formulary
|
 |
Guselkumab Tremfya® |
01.05.03 |
Formulary
|
 |
Infliximab |
08.01 |
Formulary
|
 |
Infliximab |
10.01.03 |
Formulary
|
 |
Infliximab Biosimilars avaliable |
13.05.03 |
Formulary
|
 |
Infliximab Biosimilars avaliable |
06.01.01.03 |
Formulary
|
 |
Insulin pumps |
09.01.03 |
Formulary
|
 |
Iptacopan |
03.07 |
Formulary
|
 |
Ivacaftor–Tezacaftor–Elexacaftor Kaftrio® |
10.01.03 |
Formulary
|
 |
Ixekizumab |
13.05.02 |
Formulary
|
 |
Ixekizumab Taltz® |
08.03.04.03 |
Formulary
|
 |
Lanreotide |
05.03.03.02 |
Formulary
|
 |
Ledipasvir and Sofosbuvir Harvoni® |
05.03.02.02 |
Formulary
|
 |
Letermovir Prevymis® |
04.09.01 |
Formulary
|
 |
Levodopa-Carbidopa- Entacapone Intestinal Gel (LECIG) |
04.09.01 |
Formulary
|
 |
Levodopa-Carbidopa Intestinal Gel (LCIG) |
03.07 |
Formulary
|
 |
Lumacaftor–Ivacaftor Orkambi® |
05.03.02.02 |
Formulary
|
 |
Maribavir Livtencity® |
03.04.02 |
Formulary
|
 |
Mepolizumab |
01.05.03 |
Formulary
|
 |
Mirikizumab |
13.05.03 |
Formulary
|
 |
Omalizumab |
01.05.03 |
Formulary
|
 |
Ozanimod |
08.02 |
Formulary
|
 |
Ozanimod Zeposia® |
05.03.05 |
Formulary
|
 |
Palivizumab Synagis® |
08.02.04 |
Formulary
|
 |
Peginterferon Alfa Pegasys® |
06.05 |
Formulary
|
 |
Pegvisomant |
05.01.09 |
Formulary
|
 |
Pretomanid |
11.08.02 |
Formulary
|
 |
Ranibizumab |
03.04.02 |
Formulary
|
 |
Reslizumab |
04.07.04.02 |
Formulary
|
 |
Rimegepant Vydura |
01.05.03 |
Formulary
|
 |
Risankizumab Skyrizi® |
10.01.03 |
Formulary
|
 |
Risankizumab Skyrizi® |
13.05.03 |
Formulary
|
 |
Risankizumab Skyrizi® |
13.05.03 |
Formulary
|
 |
Ritlecitinib |
08.02.03 |
Formulary
|
 |
Rituximab |
09.01.03 |
Formulary
|
 |
Rituximab |
09.01.04 |
Formulary
|
 |
Rituximab idiopathic thrombocytopenia in adults |
10.01.03 |
Formulary
|
 |
Rituximab (rheumatology) Biosimilars avaliable |
09.01.04 |
Formulary
|
 |
Romiplostim Nplate® |
08.02.04 |
Formulary
|
 |
Ropeginterferon Alfa-2b Besremi® |
10.01.03 |
Formulary
|
 |
Sarilumab Kevzara® |
10.01.03 |
Formulary
|
 |
Secukinumab |
13.05.03 |
Formulary
|
 |
Secukinumab Cosentyx® |
05.03.03.02 |
Formulary
|
 |
Sofosbuvir and Velpatasvir Epclusa®
|
05.03.03.02 |
Formulary
|
 |
Sofosbuvir with Velpatasvir and Voxilaprevir Vosevi® |
04.04 |
Formulary
|
 |
Solriamfetol hydrochloride Sunosi® |
06.05.01 |
Formulary
|
 |
Somatrogon Ngenla® |
04.12 |
Formulary
|
 |
Tafamidis |
03.07 |
Formulary
|
 |
Tezacaftor–Ivacaftor Symkevi® |
13.05.03 |
Formulary
|
 |
Tildrakizumab Ilumetri® |
10.01.03 |
Formulary
|
 |
Tocilizumab Biosimilars avaliable |
01.05.03 |
Formulary
|
 |
Tofacitinib |
10.01.03 |
Formulary
|
 |
Tofacitinib Xeljanz® |
06.05.02 |
Formulary
|
 |
Tolvaptan |
08.02.03 |
Formulary
|
 |
Ublituximab Briumvi® |
01.05.03 |
Formulary
|
 |
Upadacitinib Rinvoq ® |
10.01.03 |
Formulary
|
 |
Upadacitinib Rinvoq ® |
13.05.03 |
Formulary
|
 |
Upadacitinib Rinvoq ® |
01.05.03 |
Formulary
|
 |
Ustekinumab |
10.01.03 |
Formulary
|
 |
Ustekinumab |
13.05.03 |
Formulary
|
 |
Ustekinumab Stelara® |
08.01 |
Formulary
|
 |
Vedolizumab Entyvio® |
11.11 |
Formulary
|
 |
Voretigene Neparvovec Luxturna® |