Pharmacy Policies
These pharmacy policies apply to Medicare Advantage plans and the MyCare Ohio (Medicare-Medicaid) plan.
The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.
A
- Abecma® (idecabtagene vicleucel intravenous infusion – Bristol-Myers Squibb and bluebird bio)
- Abraxane (paclitaxel albumin-bound suspension, intravenous infusion – Celgene, generic)
- Actemra® (tocilizumab intravenous infusion – Genentech/Roche)
- Acthar® Gel (repository corticotropin intramuscular and subcutaneous injection – Mallinckrodt)
- Adakveo® (crizanlizumab-tmca intravenous infusion– Novartis)
- Adcetris® (brentuximab intravenous infusion – Seattle Genetics)
- Adstiladrin® (nadofaragene firadenovec-vncg intravesical suspension – Ferring)
- Aduhelm® (aducanumab-avwa intravenous infusion – Biogen/Eisai)
- Advate® (Antihemophilic Factor intravenous infusion – Baxalta/Takeda)
- Adynovate® (Antihemophilic Factor PEGylated intravenous infusion – Baxalta/Takeda)
- Adzynma™ (ADAMTS13 recombinant-krhn intravenous infusion − Takeda)
- Afstyla® (Antihemophilic Factor single chain intravenous infusion – CSL Behring)
- Aldurazyme® (laronidase intravenous infusion – Genzyme)
- Alimta (pemetrexed intravenous infusion – Eli Lilly, generics)
- Aliqopa® (copanlisib intravenous infusion – Bayer)
- Alphanate (Antihemophilic Factor/von Willebrand Factor Complex [human] intravenous infusion – Grifols)
- AlphaNine SD (Coagulation Factor IX [plasma-derived] intravenous infusion – Grifols)
- Alprolix® (Coagulation Factor IX [recombinant] Fc fusion protein intravenous infusion – Bioverativ/Sanofi)
- Altuviiio™ (antihemophilic factor [recombinant] Fc-VWF-XTEN fusion protein-ehtl intravenous infusion − Bioverativ/Sanofi)
- Alyglo™ (immune globulin intravenous solution-stwk – GC Biopharma)
- Alymsys® (bevacizumab-maly intravenous infusion – Amneal)
- Amondys 45™ (casimersen intravenous infusion – Sarepta)
- Amtagvi™ (lifileucel intravenous infusion – Iovance Biotherapeutics)
- Amvuttra™ (vutrisiran subcutaneous injection − Alnyam)
- Anktiva® (nogapendekin alfa inbakicept-pmln intravesical solution – ImmunityBio)
- Aphexda™ (motixafortide subcutaneous injection – BioLineRx)
- Apretude (cabotegravir intramuscular injection – ViiV)
- Aralast NP® (alpha1-proteinase inhibitor [human] intravenous infusion – Shire), Glassia® (alpha1-proteinase inhibitor [human] intravenous infusion – Shire), Prolastin®-C and Prolastin®-C Liquid (alpha1-proteinase inhibitor [human] intravenous infusion – Grifols Therapeutics), Zemaira® (alpha1-proteinase inhibitor [human] intravenous infusion – CSL Behring)
- Aranesp® (darbepoetin alfa intravenous or subcutaneous injection − Amgen)
- Aranesp® (darbepoetin alfa intravenous or subcutaneous injection − Amgen)
- Asceniv™ (immune globulin intravenous solution-sira – ADMA Biologics)
- Asparlas® (calaspargase pegol-mknl intravenous infusion – Servier)
- Atgam® (lymphocyte immune globulin, anti-thymocyte globulin [equine] intravenous infusion – Pfizer)
- Aucatzyl® (obecabtagene autoleucel intravenous infusion – Autolus)
- Avastin® (bevacizumab intravenous infusion – Genentech)
- Aveed™ (testosterone undecanoate intramuscular injection – Endo)
- Avsola™ (infliximab-axxq intravenous infusion – Amgen)
- Azmiro™ (testosterone cypionate intramuscular injection – Azurity)
B
- Bavencio® (avelumab intravenous infusion – EMD Serono)
- Beleodaq® (belinostat intravenous infusion – Spectrum)
- Belrapzo® (bendamustine intravenous infusion – Eagle)
- Bendamustine intravenous infusion – various manufacturers
- Bendeka® (bendamustine intravenous infusion – Teva)
- BeneFIX (Coagulation Factor IX [recombinant] intravenous infusion – Wyeth/Pfizer)
- Benlysta® (belimumab intravenous infusion – GlaxoSmithKline)
- Beovu® (brolucizumab intravitreal injection – Novartis)
- Beqvez™ (fidanacogene elaparvovec-dzkt intravenous infusion − Pfizer)
- Berinert® (C1 esterase inhibitor [human] intravenous infusion − CSL Behring)
- Besponsa® (inotuzumab ozogamicin intravenous infusion – Pfizer)
- Bivigam® (immune globulin intravenous solution – AMDA Biologics)
- Bizengri® (zenocutuzumab-zbco intravenous infusion −Merus/Partner)
- Bkemv™ (eculizumab-aeeb intravenous infusion – Amgen)
- Blenrep™ (belantamab mafodotin-blmf intravenous infusion – GlaxoSmithKline)
- Blincyto® (blinatumomab intravenous infusion – Amgen)
- Boruzu® (bortezomib intravenous or subcutaneous injection – Amneal Pharmaceuticals)
- Botox® (onabotulinumtoxinA injection – Allergan/AbbVie)
- Breyanzi® (lisocabtagene maraleucel intravenous infusion – Juno Therapeutics)
- Brineura® (cerliponase alfa intraventricular infusion – BioMarin)
- Briumvi® (ublituximab-xiiy intravenous infusion – TG Therapeutics)
- Byooviz™ (ranibizumab-nuna intravitreal injection – Biogen)
C
- Cabenuva® (cabotegravir extended-release intramuscular injection; rilpivirine extended-release intramuscular injection, co-packaged – ViiV/GlaxoSmithKline)
- Cablivi® (caplacizumab-yhdp intravenous infusion and subcutaneous injection – Genzyme/Sanofi)
- Camcevi™ (leuprolide subcutaneous injection – Accord BioPharma)
- Carmustine intravenous infusion (BICNU® – Avet, generics)
- Carvykti® (ciltacabtagene autoleucel intravenous infusion – Janssen Biotech)
- Casgevy™ (exagamglogene autotemcel intravenous infusion – Vertex/CRISPR Therapeutics)
- Ceprotin® (protein C concentrate [human] intravenous infusion – Takeda)
- Cerezyme® (imiglucerase intravenous infusion – Genzyme)
- Cimerli™ (ranibizumab-eqrn intravitreal injection – Coherus)
- Cimzia® (certolizumab pegol subcutaneous injection [lyophilized powder or solution] – UCB)
- Cinqair® (reslizumab intravenous infusion − Teva Respiratory)
- Cinryze® (C1 esterase inhibitor [human] intravenous infusion − Takeda)
- Coagadex® (coagulation Factor X [human] intravenous infusion – BPL)
- Columvi™ (glofitamab-gxbm intravenous infusion – Genentech)
- Corifact® (Factor XIII Concentrate [human] intravenous infusion – CSL Behring)
- Cosela™ (trilaciclib intravenous infusion – G1 Therapeutics)
- Cosentyx® (secukinumab intravenous infusion – Novartis)
- Crysvita® (burosumab-twza subcutaneous injection – Ultragenyx/Kyowa)
- Cutaquig® (immune globulin 16.5% subcutaneous solution – Octapharma/Pfizer)
- Cuvitru™ (immune globulin 20% subcutaneous solution – Takeda)
- Cyramza® (ramucirumab intravenous infusion – Eli Lilly)
- Cytogam® (human cytomegalovirus immune globulin intravenous infusion – Kamada)
D
- Dacogen® (decitabine intravenous infusion – Otsuka, generic)
- Danyelza® (naxitamab-gqgk intravenous infusion – Y-mAbs Therapeutics)
- Darzalex Faspro® (daratumumab and hyaluronidase-fihj subcutaneous injection – Janssen)
- Darzalex™ (daratumumab intravenous infusion – Janssen Biotech)
- Datroway® (datopotamab deruxtecan-dlnk intravenous infusion – Daiichi Sankyo)
- Daxxify® (daxibotulinumtoxinA-lanm injection – Revance)
- Depo®-Testosterone (testosterone cypionate intramuscular injection – Pfizer, generic)
- Durolane® (sodium hyaluronate injection – Bioventus)
- Durysta® (bimatoprost implant, for intracameral administration – Allergan)
- Dysport® (abobotulinumtoxinA injection – Ipsen/Galderma)
E
- Elahere® (mirvetuximab soravtansine-gynx intravenous infusion − ImmunoGen)
- Elaprase® (idursulfase intravenous infusion – Takeda)
- Elelyso® (taliglucerase intravenous infusion – Pfizer)
- Elevidys® (delandistrogene moxeparvovec-rokl intravenous infusion – Sarepta)
- Elfabrio® (pegunigalsidase alfa intravenous infusion – Chiesi)
- Eligard® (leuprolide acetate subcutaneous injection – Tolmar)
- Eloctate® (Antihemophilic Factor Fc fusion protein intravenous infusion – Bioverativ/Sanofi)
- Elrexfio™ (elranatamab-bcmm subcutaneous injection – Pfizer)
- Elzonris™ (tagraxofusp-erzs intravenous infusion – Stemline)
- Empliciti® (elotuzumab intravenous infusion – Bristol-Myers Squibb)
- Emrelis® (telisotuzumab vedotin-tllv intravenous infusion – AbbVie)
- Encelto™ (revakinagene taroretcel-lwey intravitreal implant – Neurotech)
- Enhertu® (fam-trastuzumab deruxtecan-nxki intravenous infusion – Daiichi Sankyo and AstraZeneca)
- Enjaymo® (sutimlimab-jome intravenous infusion – Bioverativ/Sanofi)
- Entyvio® (vedolizumab intravenous infusion – Takeda)
- Epkinly™ (epcoritamab-bysp subcutaneous injection – Genmab)
- Epogen® (epoetin alfa intravenous or subcutaneous injection − Amgen), Procrit® (epoetin alfa intravenous or subcutaneous injection – Janssen)
- Epysqli® eculizumab-aagh intravenous infusion – Samsung Bioepis)
- Erbitux® (cetuximab intravenous infusion – ImClone/Eli Lilly)
- Esperoct® (Antihemophilic factor glycopegylated intravenous infusion – Novo Nordisk)
- Euflexxa® (sodium hyaluronate injection – Ferring)
- Evenity® (romosozumab-aqqg subcutaneous injection – Amgen)
- Evkeeza® (evinacumab-dgnb intravenous infusion – Regeneron)
- Evusheld™ (tixagevimab intramuscular injection and cilgavimab intramuscular injection − AstraZeneca)
- Exondys 51™ (eteplirsen intravenous infusion – Sarepta)
- Eylea® (aflibercept intravitreal injection – Regeneron)
- Eylea® HD (aflibercept intravitreal injection – Regeneron)
F
- Fabrazyme® (agalsidase intravenous infusion – Genzyme)
- Fasenra® (benralizumab subcutaneous injection – AstraZeneca)
- Faslodex® (fulvestrant intramuscular injection – AstraZeneca; generic)
- Fensolvi® (leuprolide acetate subcutaneous injection, extended-release – Tolmar)
- Feraheme® (ferumoxytol intravenous infusion – AMAG, generic)
- Ferrlecit® (sodium ferric gluconate complex in sucrose intravenous infusion – sanofiaventis, generic)
- Fibryga® (fibrinogen [human] intravenous injection – Octapharma)
- Firazyr® (icatibant subcutaneous injection − Takeda, generic), Sajazir™ (icatibant subcutaneous injection – Cycle)
- Firmagon® (degarelix subcutaneous injection – Ferring)
- Flebogamma® DIF (immune globulin intravenous solution – Grifols)
- Flolan® (epoprostenol intravenous infusion – GlaxoSmithKline, generic), Veletri® (epoprostenol intravenous infusion – Actelion)
- Folotyn® (pralatrexate intravenous infusion – Spectrum, generic)
- Fulphila® (pegfilgrastim-jmdb subcutaneous injection − Mylan)
- Fusilev® (levoleucovorin intravenous infusion – Spectrum)
- Fyarro® (sirolimus protein-bound particles [albumin bound] intravenous infusion – Aadi Bioscience)
- Fylnetra® (pegfilgrastim-pbbk subcutaneous injection − Kashiv)
G
- Gamifant® (emapalumab-lzsg intravenous infusion – Sobi)
- Gammagard® Liquid (immune globulin solution – Baxalta [Takeda])
- Gammagard® S/D < 1 mcg/mL in 5% solution (immune globulin intravenous solution – Baxalta [Takeda])
- Gammaked™ (immune globulin solution caprylate/chromatography purified – Kedrion), Gamunex®-C (immune globulin solution caprylate/chromatography purified – Grifols)
- Gammaplex® (immune globulin intravenous solution – Bio Products Laboratory/Kedrion)
- Gazyva® (obinutuzumab intravenous infusion – Genentech)
- Gel-One® (sodium hyaluronate injection – Seikagaku/Zimmer)
- Gelsyn-3™ (sodium hyaluronate injection – Bioventus)
- GenVisc® 850 (sodium hyaluronate injection – OrthogenRx)
- Givlaari™ (givosiran subcutaneous injection – Alnylam)
- Glassia® (alpha1-proteinase inhibitor [human] intravenous infusion – Shire)
- Grafapex™ (treosulfan intravenous infusion – Medexus)
- Granix® (tbo-filgrastim subcutaneous injection − Teva)
H
- Haegarda® (C1 esterase inhibitor [human] subcutaneous injection − CSL Behring)
- Halaven® (eribulin mesylate intravenous infusion – Eisai)
- Hemgenix® (etranacogene dezaparvovec-drlb intravenous infusion − CSL Behring and uniQure)
- Hemlibra® (emicizumab-kxwh subcutaneous injection – Genentech/Roche/Chugai)
- Hemofil M (Antihemophilic Factor intravenous infusion – Baxalta/Takeda)
- Hemophilia – FEIBA® (anti-inhibitor coagulant complex intravenous infusion – Baxalta/Takeda)
- Herceptin Hylecta™ (trastuzumab and hyaluronidase-oysk subcutaneous injection – Genentech)
- Herceptin® (trastuzumab intravenous infusion – Genentech)
- Hercessi™ (trastuzumab-strf intravenous infusion – Accord BioPharma)
- Herzuma® (trastuzumab-pkrb intravenous infusion – Celltrion)
- Hizentra® (immune globulin 20% subcutaneous solution – CSL Behring)
- Humate-P (Antihemophilic Factor/von Willebrand Factor Complex intravenous infusion – CSL Behring)
- Hyalgan (sodium hyaluronate injection − Fidia/Sanofi)
- Hycamtin® (topotecan intravenous infusion – Novartis, generics)
- Hymovis (high molecular weight viscoelastic hyaluronan injection – Fidia)
- HyQvia® (immune globulin 10% subcutaneous solution with recombinant human hyaluronidase – Baxalta [Takeda])
I
- Idelvion (Coagulation Factor IX [recombinant] albumin fusion protein intravenous infusion – CSL Behring)
- iDose® TR(travoprost implant, for intracameral administration – Glaukos)
- Ilaris® (canakinumab subcutaneous injection – Novartis)
- Ilumya® (tildrakizumab-asmn subcutaneous injection – Sun)
- Imaavy™ (nipocalimab-aahu intravenous infusion – Johnson & Johnson)
- Imcivree® (setmelanotide subcutaneous injection – Rhythm)
- Imdelltra™ (tarlatamab-dlle intravenous infusion – Amgen)
- Imfinzi® (durvalumab intravenous infusion – AstraZeneca)
- Imjudo® (tremelimumab-actl intravenous infusion – AstraZeneca)
- Imlygic® (talimogene laherparepvec intralesional injection – Amgen)
- INFeD® (iron dextran intravenous or intramuscular injection – Allergan)
- Inflectra® (infliximab-dyyb intravenous infusion – Hospira/Pfizer)
- Infliximab intravenous infusion – Janssen/Johnson & Johnson
- Injectafer® (ferric carboxymaltose intravenous infusion or slow injection – American Regent)
- Istodax® (romidepsin intravenous infusion – Celgene, generic)
- Ixempra® (ixabepilone intravenous infusion – R-Pharm US)
- Ixinity (Coagulation Factor IX [recombinant] intravenous infusion – Medexus)
- Izervay™ (avacincaptad pegol intravitreal injection – Iveric)
J
- Jelmyto® (mitomycin solution for pyelocalyceal administration – UroGen)
- Jemperli™ (dostarlimab intravenous infusion – GlaxoSmithKline)
- Jevtana® (cabazitaxel intravenous infusion – Sanofi-Aventis)
- Jivi® (Antihemophilic Factor PEGylated-aucl intravenous infusion – Bayer HealthCare)
- Jubbonti® (denosumab-bbdz subcutaneous injection – Sandoz)
K
- Kadcyla (ado-trastuzumab emtansine intravenous infusion – Genentech)
- Kalbitor® (ecallantide subcutaneous injection – Takeda)
- Kanjinti™ (trastuzumab-anns intravenous infusion – Amgen)
- Kanuma® (sebelipase alfa intravenous infusion – Alexion)
- Kebilidi® (eladocagene exuparvovec-tneq suspension for intraputaminal infusion − PTC Therapeutics)
- Keytruda® (pembrolizumab intravenous infusion – Merck)
- Khapzory™ (levoleucovorin intravenous infusion – Spectrum)
- Kimmtrak® (tebentafusp-tebn intravenous infusion – Immunocore)
- Kisunla™ (donanemab-azbt intravenous infusion − Lilly)
- Koāte (Antihemophilic Factor intravenous infusion – Grifols/Kedrion Biopharma)
- Kogenate® FS (Antihemophilic Factor intravenous infusion – Bayer HealthCare)
- Kovaltry® (Antihemophilic Factor intravenous infusion – Bayer HealthCare)
- Krystexxa® (pegloticase intravenous infusion – Horizon)
- Kymriah (tisagenlecleucel intravenous infusion – Novartis Oncology)
- Kyprolis® (carfilzomib intravenous infusion – Amgen/Onyx)
L
- Lamzede® (velmanase alfa-tycv intravenous infusion − Chiesi)
- Lanreotide subcutaneous injection – Cipla
- Lemtrada® (alemtuzumab intravenous infusion – Genzyme)
- Lenmeldy™ (atidarsagene autotemcel intravenous infusion − Orchard)
- Leqembi® (lecanemab-irmb intravenous infusion – Eisai/Biogen)
- Leqvio® (inclisiran subcutaneous injection – Novartis)
- Leukine® (sargramostim intravenous or subcutaneous injection – Partner Therapeutics)
- Leuprolide Depot (leuprolide acetate 22.5 mg for depot suspension [formerly Lutrate Depot] – Cipla USA)
- Levoleucovorin intravenous infusion – various manufacturers
- Libtayo® (cemiplimab-rwlc intravenous infusion – Regeneron/Sanofi-Genzyme)
- Loqtorzi™ (toripalimab intravenous infusion – Coherus BioSciences)
- Lucentis® (ranibizumab intravitreal injection – Genentech)
- Lumizyme® (alglucosidase intravenous infusion – Genzyme)
- Lunsumio™ (mosunetuzumab-axgb intravenous infusion – Genentech)
- Lupron Depot-Ped® (leuprolide acetate depot intramuscular injection – AbbVie)
- Lupron Depot® (leuprolide acetate suspension for intramuscular injection – AbbVie)
- Lutathera® (lutetium Lu 177 dotatate intravenous infusion – Advanced Accelerator Applications USA)
- Luxturna ® (voretigene neparvovec-rzyl subretinal injection – Spark Therapeutics)
- Lyfgenia® (lovotibeglogene autotemcel intravenous infusion – bluebird bio)
- Lymphir™ (denileukin diftitox-cxdl intravenous infusion – Citius)
M
- Margenza® (margetuximab-cmkb intravenous infusion – MacroGenics)
- Mepsevii® (vestronidase alfa-vjbk intravenous infusion – Ultragenyx)
- Mircera® (methoxy polyethylene glycol-epoetin beta intravenous or subcutaneous injection – Vifor)
- Monjuvi® (tafasitamab-cxix intravenous infusion – MorphoSys/Incyte)
- Monoferric® (ferric derisomaltose intravenous infusion – Pharmacosmos)
- Monovisc™ (high molecular weight hyaluronan injection – Anika)
- Mvasi™ (bevacizumab-awwb intravenous infusion – Amgen)
- Mylotarg™ (gemtuzumab ozogamicin intravenous infusion – Pfizer)
- Myobloc® (rimabotulinumtoxinB injection − Solstice Neurosciences)
N
- Naglazyme® (galsulfase intravenous infusion – BioMarin)
- Neulasta® (pegfilgrastim subcutaneous injection − Amgen)
- Neupogen® (filgrastim intravenous or subcutaneous injection − Amgen)
- Nexviazyme® (avalglucosidase alfa-ngpt intravenous infusion – Genzyme)
- Niktimvo™ (axatilimab-csfr intravenous infusion − Incyte/Syndax)
- Nipent™ (pentostatin intravenous infusion – Hospira)
- Nivestym® (filgrastim intravenous or subcutaneous injection − Hospira/Pfizer)
- Novoeight® (Antihemophilic Factor intravenous infusion – Novo Nordisk)
- NovoSeven® RT (coagulation Factor VIIa [recombinant] intravenous infusion – Novo Nordisk)
- Nplate® (romiplostim subcutaneous injection – Amgen)
- Nucala® (mepolizumab subcutaneous injection – GlaxoSmithKline)
- Nulibry™ (fosdenopterin intravenous infusion – Origin Biosciences)
- Nulojix® (belatacept intravenous infusion – Bristol-Myers Squibb)
- Nuwiq® (Antihemophilic Factor intravenous infusion – Octapharma)
- Nypozi™ (filgrastim-txid intravenous or subcutaneous injection – Tanvex)
- Nyvepria™ (pegfilgrastim-apgf subcutaneous injection – Pfizer)
O
- Ocrevus Zunovo™ (ocrelizumab and hyaluronidase-ocsq subcutaneous injection – Genentech/Roche)
- Ocrevus® (ocrelizumab intravenous infusion – Genentech/Roche)
- Octagam® (immune globulin intravenous solution – Octapharma/Pfizer)
- Ogivri® (trastuzumab-dkst intravenous infusion – Mylan)
- Omisirge® (omidubicel-onlv intravenous infusion – Gamida)
- Omvoh® (mirikizumab-mrkz intravenous infusion – Eli Lilly)
- Onapgo™ (apomorphine subcutaneous injection – Supernus)
- Oncaspar® (pegaspargase intramuscular or intravenous injection – Servier)
- Onivyde® (irinotecan liposome intravenous infusion – Ipsen)
- Onpattro® (patisiran intravenous infusion – Alnylam)
- Ontruzant® (trastuzumab-dttb intravenous infusion – Merck)
- Opdivo Qvantig™ (nivolumab and hyaluronidase-nvhy subcutaneous injection – Bristol-Myers Squibb and Halozyme)
- Opdivo® (nivolumab intravenous infusion – Bristol-Myers Squibb)
- Opdualag™ (nivolumab and relatlimab-rmbw intravenous infusion – Bristol-Myers Squibb)
- Orencia® (abatacept intravenous infusion – Bristol-Myers Squibb)
- Orthovisc (high molecular weight hyaluronan injection –Anika)
- Otulfi™ (ustekinumab-aauz intravenous infusion – Formycon/Fresenius)
- Oxlumo™ (lumasiran subcutaneous injection – Alnylam)
P
- Padcev® (enfortumab vedotin-ejfv intravenous infusion – Astellas and Seagen)
- Palonosetron intravenous infusion (generic only)
- Panhematin® (hemin intravenous infusion − Recordati Rare Diseases)
- Panzyga® (immune globulin intravenous solution-ifas – Octapharma/Pfizer)
- Pavblu™ (aflibercept-ayyh intravitreal injection – Amgen)
- Pedmark® (sodium thiosulfate intravenous infusion – Fennec)
- Pemfexy™ (pemetrexed intravenous infusion – Eagle)
- Pemrydi RTU™ (pemetrexed disodium intravenous infusion – Amneal/Zydus)
- Perjeta® (pertuzumab intravenous infusion –Genentech)
- Phesgo® (pertuzumab, trastuzumab, and hyaluronidase-zzxf subcutaneous injection – Genentech)
- PiaSky® (crovalimab-akkz intravenous infusion or subcutaneous injection – Genentech)
- Pluvicto™ (lutetium Lu 177 vipivotide tetraxetan intravenous infusion – Advanced Accelerator Applications/Novartis)
- Polivy® (polatuzumab vedotin-piiq intravenous infusion – Genentech)
- Pombiliti® (cipaglucosidase alfa-atga intravenous infusion – Amicus)
- Portrazza® (necitumumab intravenous infusion – Eli Lilly)
- Posfrea™ (palonosetron intravenous infusion) – Avyxa)
- Poteligeo® (mogamulizumab-kpkc intravenous infusion – Kyowa Kirin)
- Privigen® (immune globulin intravenous solution – CSL Behring)
- Profilnine (Factor IX Complex [plasma-derived] intravenous infusion – Grifols)
- Proleukin® (aldesleukin intravenous infusion – Prometheus Laboratories)
- Prolia® (denosumab subcutaneous injection – Amgen)
- Provenge® (sipuleucel-T intravenous infusion – Dendreon)
- Purified Cortrophin™ Gel (repository corticotropin subcutaneous and intramuscular injection – ANI)
- Pyzchiva™ (ustekinumab-ttwe intravenous infusion – Sandoz/Samsung)
Q
R
- Radicava® (edaravone intravenous infusion – Mitsubishi Tanabe, generic)
- Radicava® (edaravone intravenous infusion – Mitsubishi Tanabe)
- Rebinyn® (Coagulation Factor IX [recombinant] glycoPEGylated intravenous infusion – NovoNordisk)
- Reblozyl® (luspatercept-aamt subcutaneous injection – Celgene/Bristol Myers Squibb)
- Reclast® (zoledronic acid intravenous infusion – Novartis, generic)
- Recombinate® (Antihemophilic Factor intravenous infusion – Baxalta/Takeda)
- Releuko® (filgrastim-ayow intravenous or subcutaneous injection − Amneal)
- Remicade® (infliximab intravenous infusion – Janssen/Johnson & Johnson)
- Remodulin® (treprostinil subcutaneous or intravenous infusion − United Therapeutics, generic)
- Renflexis® (infliximab-abda intravenous infusion – Samsung Bioepis/Organon)
- Retacrit® (epoetin alfa-epbx intravenous or subcutaneous injection – Pfizer)
- Revcovi® (elapegademase-lvlr intramuscular injection – Chiesi)
- Riabni™ (rituximab-arrx intravenous infusion – Amgen)
- RiaSTAP® (fibrinogen concentrate [human] intravenous injection – CSL Behring)
- Rituxan Hycela® (rituximab and hyaluronidase human subcutaneous injection – Biogen and Genentech/Roche)
- Rituxan® (rituximab intravenous infusion − Genentech)
- Rivfloza™ (nedosiran subcutaneous injection – Novo Nordisk)
- Rixubis® (Coagulation Factor IX [recombinant] intravenous infusion – Baxalta/Takeda)
- Roctavian® (valoctocogene roxaparvovec-rvox intravenous infusion – BioMarin)
- Rolvedon (eflapegrastim-xnst subcutaneous injection − Spectrum)
- Ruconest® (C1 esterase inhibitor [recombinant] intravenous infusion – Pharming)
- Ruxience® (rituximab-pvvr intravenous infusion – Pfizer)
- Rybrevant® (amivantamab-vmjw intravenous infusion – Janssen)
- Rylaze™ (asparaginase erwinia chrysanthemi [recombinant]-rywn intramuscular injection – Jazz)
- Ryoncil® (remestemcel-L-rknd intravenous infusion − Mesoblast)
- Ryplazim® (plasminogen, human-tvmh intravenous infusion – Prometic/Kedrion)
- Rystiggo® (rozanolixizumab-noli subcutaneous infusion – UCB)
- Rytelo® (imetelstat intravenous infusion – Geron)
- Ryzneuta (efbemalenograstim alfa-vuxw subcutaneous injection − Evive)
S
- Sandostatin® LAR Depot (octreotide acetate intramuscular injection – Novartis, generic)
- Saphnelo® (anifrolumab-fnia intravenous infusion – AstraZeneca)
- Sarclisa® (isatuximab-irfc intravenous infusion – Sanofi-Aventis)
- Scenesse® (afamelanotide subcutaneous implant – Clinuvel)
- Selarsdi™ (ustekinumab-aekn intravenous infusion – Alvotech/Teva)
- Sevenfact® (Factor VIIa [recombinant]-jncw intravenous infusion – LFB S.A./Hema Biologics)
- Signifor® LAR (pasireotide intramuscular injection – Recordati Rare Diseases)
- Simponi Aria® (golimumab intravenous infusion – Janssen)
- Skyrizi® (risankizumab-rzaa intravenous infusion – Abbvie)
- Skysona® (elivaldogene autotemcel intravenous infusion − Bluebird Bio)
- Sodium hyaluronate 1% injection – Teva
- Soliris® (eculizumab intravenous infusion – Alexion)
- Somatuline® Depot (lanreotide subcutaneous injection – Ipsen, generic)
- Spevigo® (spesolimab-sbzo intravenous infusion − Boehringer Ingelheim)
- Spinraza® (nusinersen intrathecal injection – Biogen)
- Spravato® (esketamine nasal spray – Janssen)
- Stelara® (ustekinumab intravenous infusion – Janssen Biotech)
- Steqeyma™ (ustekinumab-stba intravenous infusion – Celltrion)
- Stimufend® (pegfilgrastim-fpgk subcutaneous injection – Fresenius Kabi)
- Sunlenca® (lenacapavir subcutaneous injection − Gilead)
- Supartz FX™ (sodium hyaluronate injection − Seikagaku/Bioventus)
- Supprelin® LA (histrelin acetate subcutaneous implant – Endo)
- Susvimo™ (ranibizumab intravitreal injection via ocular implant – Genentech)
- Syfovre™ (pegcetacoplan intravitreal injection – Apellis)
- Sylvant® (siltuximab intravenous infusion – EUSA)
- Synagis® (palivizumab intramuscular injection – Sobi)
- SynoJoynt™ (sodium hyaluronate injection − Arthrex)
- Synvisc (hylan G-F 20 sodium hyaluronate injection – Genzyme/Sanofi), Synvisc-One® (hylan G-F 20 sodium hyaluronate injection – Genzyme/Sanofi)
T
- Takhzyro® (lanadelumab-flyo subcutaneous injection – Shire/Takeda)
- Talvey™ (talquetamab-tgvs subcutaneous injection – Janssen Biotech)
- Tecartus® (brexucabtagene autoleucel intravenous infusion – Kite Pharma)
- Tecelra® (afamitresgene autoleucel intravenous infusion – Adaptimmune)
- Tecentriq Hybreza™ (atezolizumab and hyaluronidase-tqjs subcutaneous injection – Genentech)
- Tecentriq® (atezolizumab intravenous infusion – Genentech/Roche)
- Tecvayli™ (teclistamab-cqyv subcutaneous injection – Janssen Biotech)
- Tegsedi® (inotersen subcutaneous injection – Ionis/Akcea Therapeutics)
- Temodar® (temozolomide intravenous infusion – Merck, generic)
- Tepadina® (thiotepa intravenous, intracavitary, or intravesical injection – Adienne and Amneal, generic)
- Tepezza™ (teprotumumab intravenous infusion – Horizon)
- Testopel® (testosterone subcutaneous pellet – Endo)
- testosterone enanthate intramuscular injection – Hikma, generic only
- Tevimbra® (tislelizumab-jsgr intravenous infusion – BeiGene)
- Tezspire® (tezepelumab-ekko subcutaneous injection − AstraZeneca/Amgen)
- Tivdak® (tisotumab vedotin-tftv intravenous infusion – Seagen and Genmab)
- Tofidence™ (tocilizumab-bavi intravenous infusion – Biogen)
- Torisel® (temsirolimus intravenous infusion – Wyeth)
- Trazimera™ (trastuzumab-qyyp intravenous infusion – Pfizer)
- Treanda® (bendamustine intravenous infusion – Cephalon)
- Trelstar® (triptorelin pamoate intramuscular injection – Verity)
- Tremfya® (guselkumab intravenous infusion – Janssen Biotech/Johnson & Johnson)
- Tretten® (coagulation Factor XIII A-Subunit [recombinant] intravenous infusion – NovoNordisk)
- Triluron™ (sodium hyaluronate injection – Fidia)
- Triptodur™ (triptorelin intramuscular injection, extended-release – Azurity)
- Trisenox® (arsenic trioxide intravenous infusion – Teva, generic)
- TriVisc™ (sodium hyaluronate injection – OrthogenRx)
- Trodelvy® (sacituzumab govitecan-hziy intravenous infusion – Gilead)
- Trogarzo® (ibalizumab-uiyk intravenous infusion – Theratechnologies)
- Truxima® (rituximab-abbs intravenous infusion – Celltrion/Teva)
- Tyenne® (tocilizumab-aazg intravenous infusion – Fresenius Kabi)
- Tysabri® (natalizumab intravenous infusion – Biogen)
- Tzield® (teplizumab-mzwv intravenous infusion – Provention/Sanofi)
U
- Udenyca® (pegfilgrastim-cbqv subcutaneous injection – Coherus)
- Ultomiris® (ravulizumab-cwvz intravenous infusion – Alexion)
- Unituxin® (dinutuximab intravenous infusion – United Therapeutics)
- Unloxcyt™ (cosibelimab-ipdl intravenous infusion – Checkpoint Therapeutics)
- Uplizna® (inebilizumab-cdon intravenous infusion – Amgen/Horizon)
- ustekinumab-ttwe intravenous infusion (Quallent)
V
- Vabysmo® (faricimab-svoa intravitreal injection − Genentech)
- Valstar® (valrubicin intravesical solution– Endo, generic)
- Vectibix® (panitumumab intravenous infusion – Amgen)
- Vegzelma™ (bevacizumab-adcd intravenous infusion – Celltrion)
- Veklury® (remdesivir intravenous infusion – Gilead)
- Velcade® (bortezomib intravenous or subcutaneous injection – Takeda, generic)
- Venofer® (iron sucrose intravenous infusion or slow injection – American Regent)
- Veopoz™ (pozelimab-bbfg intravenous infusion and subcutaneous injection − Regeneron)
- Viltepso™ (viltolarsen intravenous infusion – Nippon Shinyaku)
- Vimizim® (elosulfase alfa intravenous infusion – BioMarin)
- Visco-3™ (sodium hyaluronate injection – Seikagaku/Zimmer)
- Vivimusta® (bendamustine intravenous – Slayback, Latina)
- Vonvendi® (von Willebrand factor [recombinant] intravenous infusion – Baxalta)
- Vpriv® (velaglucerase intravenous infusion – Shire Human Genetic Therapies)
- Vyalev™ (foscarbidopa and foslevodopa subcutaneous injection – AbbVie)
- Vyepti® (eptinezumab-jjmr intravenous infusion – Lundbeck)
- Vyjuvek™ (beremagene geperpavec-svdt topical gel − Krystal Biotech)
- Vyloy® (zolbetuximab-clzb intravenous infusion – Astellas)
- Vyondys 53™ (golodirsen intravenous infusion – Sarepta)
- Vyvgart® (efgartigimod alfa-fcab intravenous infusion – Argenx)
- Vyvgart® Hytrulo (efgartigimod alfa and hyaluronidase-qvfc subcutaneous injection – Argenx/Halozyme)
- Vyxeos® (daunorubicin and cytarabine liposome intravenous infusion – Jazz)
W
X
- Xembify® (immune globulin 20% subcutaneous solution – Grifols)
- Xenpozyme™ (olipudase alfa-rpcp intravenous infusion − Genzyme)
- Xeomin® (incobotulinumtoxinA injection – Merz)
- Xgeva® (denosumab subcutaneous injection – Amgen)
- Xiaflex® (collagenase clostridium histolyticum intralesional injection – Endo)
- Xolair® (omalizumab subcutaneous injection − Genentech/Novartis)
- Xyntha®/Xyntha® Solofuse™ (Antihemophilic Factor intravenous infusion, plasma/albumin-free – Wyeth/Pfizer)
- Xyosted™ (testosterone enanthate subcutaneous injection – Antares)
Y
- Ycanth™ (cantharidin 0.7% topical solution − Verrica)
- Yervoy® (ipilimumab intravenous infusion – Bristol-Myers Squibb)
- Yescarta ® (axicabtagene ciloleucel intravenous infusion – Kite Pharma)
- Yesintek™ (ustekinumab-kfce intravenous infusion – Biocon)
- Yimmugo® (immune globulin intravenous solution-dira – Biotest (Grifols)
- Yondelis® (trabectedin intravenous infusion – Janssen)
Z
- Zaltrap® (ziv-aflibercept intravenous infusion – Regeneron/Sanofi-Aventis)
- Zarxio® (filgrastim-sndz intravenous or subcutaneous injection − Sandoz)
- Zepzelca™ (lurbinectedin intravenous infusion – Jazz)
- Ziextenzo™ (pegfilgrastim-bmez subcutaneous injection – Sandoz)
- Ziihera® (zanidatamab-hrii intravenous infusion – Jazz)
- Zilretta® (triamcinolone acetonide extended-release intraarticular injection – Pacira)
- Zirabev™ (bevacizumab-bvzr intravenous infusion – Pfizer)
- Zoladex® (goserelin acetate subcutaneous implant – TerSera Therapeutics)
- Zolgensma® (onasemnogene abeparvovec-xioi intravenous infusion – Novartis)
- Zometa® (zoledronic acid intravenous infusion – generic only)
- Zulresso ® (brexanolone intravenous infusion – Sage Therapeutics)
- Zynlonta® (loncastuximab tesirine-lpyl intravenous infusion – Teva)
- Zynteglo™ (betibeglogene autotemcel intravenous infusion − Bluebird Bio)
- Zynyz™ (retifanlimab-dlwr intravenous infusion – Incyte)
Cell and Gene Therapy Outcomes Tracking Program
CareSource Ohio Dual Advantage (D-SNP) partners with Audaire Health to capture and assess clinical benefits of Cell and Gene therapies. For more information, please refer to the CareSource Audaire Health™ Cell and Gene Therapy (CGT) Outcomes Tracking Program – Frequently Asked Questions for Providers. You can also find information about the program on our Updates & Announcements page.