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.
Current Pharmacy Policies
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 MyCare 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.