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® |