| 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 |
| 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 |
| 10.01.03 |
Formulary
|
|
Bimekizumab Bimzelx® |
| 04.07.04.02 |
Formulary
|
|
Botulinum Toxin Type A botox® |
| 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 ® |
| 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 |
| 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® |
| 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® |
| 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® |
