Highmark Health Options
Specialty Drug List
CURRENT AS OF 11/1/2020
Notes
Drug Name Notes
*Adenosine Deaminase Scid Treatment - Agents***
Revcovi
*Als Agents - Miscellaneous***
Radicava
*Amino Acids***
Endari
*Aminoglycosides*
Arikayce
Bethkis
Kitabis Pak
Tobi
Tobi Podhaler
Tobramycin
Tobramycin Sulfate
*Aminolevulinate Synthase 1-Directed Sirna***
Givlaari
*Analgesics - Anti-Inflammatory*
Actemra
Actemra ACTPen
Arcalyst
Enbrel
Enbrel Mini
Enbrel SureClick
Humira
Humira Pediatric Crohns Start
Humira Pen
Humira Pen-CD/UC/HS Starter
Humira Pen-Ps/UV/Adol HS Start
Ilaris
1
Drug Name Notes
Ilaris (150mg Delivered)
Kevzara
Kineret
Olumiant
Orencia
Orencia ClickJect
Otrexup
Rasuvo
Rinvoq
Simponi
Simponi Aria
Xeljanz
Xeljanz XR
*Analgesics - Nonnarcotic*
CloNIDine HCl (Analgesia)
Duraclon
Prialt
*Androgens-Anabolic*
Aveed
Testopel
*Antiasthmatic And Bronchodilator Agents*
Xolair
*Anticonvulsants*
Fintepla
Sabril
Vigabatrin
Vigadrone
*Antidepressants*
Emsam
*Antidiabetics*
Korlym
*Antidiarrheals*
Mytesi
*Antidotes And Specific Antagonists*
Praxbind
2
Drug Name Notes
Vistogard
*Antidotes*
Deferasirox
Exjade
Ferriprox
Ferriprox Twice-A-Day
Jadenu
Jadenu Sprinkle
Praxbind
Vistogard
*Antiemetics*
Akynzeo
Cinvanti
Palonosetron HCl
Sustol
*Antifungals*
AmBisome
Cancidas
Caspofungin Acetate
Micafungin Sodium
Mycamine
*Antihemophilic Products - Monoclonal Antibodies***
Hemlibra
*Antihyperlipidemics*
Juxtapid
Kynamro
*Anti-Infective Agents - Misc.*
Colistimethate Sodium
Colistimethate Sodium (CBA)
Coly-Mycin M
Cubicin
Cubicin RF
DAPTOmycin
Ertapenem Sodium
Impavido
INVanz
3
Drug Name Notes
Sivextro
Tigecycline
Tygacil
*Antimalarials*
Daraprim
Pyrimethamine
*Antimyasthenic Agents*
Firdapse
Ruzurgi
*Antimyasthenic/Cholinergic Agents*
Firdapse
Ruzurgi
*Antimycobacterial Agents*
Pretomanid
Sirturo
*Antineoplastic - Bcl-2 Inhibitors***
Venclexta
*Antineoplastic - Fgfr Kinase Inhibitors***
Balversa
Pemazyre
*Antineoplastic - Methyltransferase Inhibitors***
Tazverik
*Antineoplastic - Tropomyosin Receptor Kinase Inhibitors***
Rozlytrek
Vitrakvi
*Antineoplastic - Xpo1 Inhibitors***
Xpovio (100 MG Once Weekly)
Xpovio (40 MG Once Weekly)
Xpovio (40 MG Twice Weekly)
Xpovio (60 MG Once Weekly)
Xpovio (60 MG Twice Weekly)
Xpovio (80 MG Once Weekly)
Xpovio (80 MG Twice Weekly)
4
Drug Name Notes
*Antineoplastics And Adjunctive Therapies*
Abiraterone Acetate
Abraxane
Actimmune
Adcetris
Adriamycin Intravenous Solution
Adriamycin Intravenous Solution Reconstituted 10 MG
Adriamycin Intravenous Solution Reconstituted 50 MG
Adrucil
Afinitor
Alecensa
Alferon N
Alimta
Alkeran
Alunbrig
Arranon
Arsenic Trioxide
Arzerra
Asparlas
Avastin
Ayvakit
AzaCITIDine
Azedra Dosimetric
Azedra Therapeutic
Bavencio
Beleodaq
Belrapzo
Bendamustine HCl
Bendeka
Besponsa
Bexarotene
BiCNU
Blenrep
Bleomycin Sulfate
Bortezomib
Bosulif
5
Drug Name Notes
Braftovi
Brukinsa
Busulfan
Busulfex
Cabometyx
Calquence
Camptosar
Capecitabine
Caprelsa
CARBOplatin
Carmustine
CISplatin
Cladribine
Clofarabine
Clolar
Cometriq (100 mg Daily Dose)
Cometriq (140 mg Daily Dose)
Cometriq (60 mg Daily Dose)
Cosmegen
Cotellic
Cyclophosphamide
Cytarabine
Cytarabine (PF)
Dacarbazine
Dacogen
DACTINomycin
Darzalex
Darzalex Faspro
DAUNOrubicin HCl
DaunoXome
Daurismo
Decitabine
DepoCyt
Dexrazoxane
Dexrazoxane HCl
Docefrez
6
Drug Name Notes
DOCEtaxel
DOCEtaxel (Non-Alcohol)
Doxil
DOXOrubicin HCl
DOXOrubicin HCl Liposomal
Eligard
Ellence
Elzonris
Empliciti
Enhertu
EpiRUBicin HCl
Erbitux
Erivedge
Erleada
Erlotinib HCl
Erwinaze
Ethyol
Etoposide
Everolimus
Evomela
Fareston
Farydak
Faslodex
Firmagon
Firmagon (240 MG Dose)
Floxuridine
Fludarabine Phosphate
Fluorouracil
Folotyn
Fulvestrant
Fusilev
Gavreto
Gazyva
Gemcitabine HCl
Gemzar
Gilotrif
7
Drug Name Notes
Gleevec
Gleostine
Halaven
Herceptin
Herceptin Hylecta
Herzuma
Hycamtin
Iclusig
Idamycin PFS
IDArubicin HCl
Ifex
Ifosfamide
Imatinib Mesylate
Imbruvica
Imfinzi
Infugem
Inlyta
Inqovi
Inrebic
Intron A
Irinotecan HCl
Istodax (Overfill)
Ixempra Kit
Jakafi
Jelmyto
Jevtana
Kadcyla
Kanjinti
Kepivance
Keytruda
Khapzory
Kisqali Femara (400 MG Dose)
Kisqali Femara (600 MG Dose)
Kisqali Femara(200 MG Dose)
Koselugo
Kymriah
8
Drug Name Notes
Kyprolis
Lartruvo
Lenvima (12 MG Daily Dose)
Lenvima (4 MG Daily Dose)
Leucovorin Calcium
Leuprolide Acetate
LEVOleucovorin Calcium
LEVOleucovorin Calcium PF
Libtayo
Lipodox 50
Lonsurf
Lorbrena
Lumoxiti
Lupron Depot (1-Month)
Lupron Depot (3-Month)
Lupron Depot (4-Month)
Lupron Depot (6-Month)
Lutathera
Lysodren
Marqibo
Matulane
Mekinist
Mektovi
Melphalan
Melphalan HCl
Mesna
Mesnex
MitoMYcin
Mitoxantrone HCl
Monjuvi
Mustargen
Mutamycin
Mvasi
Mylotarg
Navelbine
Nerlynx
9
Drug Name Notes
NexAVAR
Ninlaro
Nipent
Nubeqa
Odomzo
Ogivri
Oncaspar
Onivyde
Ontruzant
Onureg
Opdivo
Oxaliplatin
PACLitaxel
Padcev
Paraplatin
Perjeta
Phesgo
Photofrin
Polivy
Pomalyst
Portrazza
Poteligeo
Proleukin
Provenge
Purixan
Qinlock
Retevmo
Rituxan
Rituxan Hycela
romiDEPsin
Ruxience
Rydapt
Sarclisa
Sprycel
Stivarga
Sutent
10
Drug Name Notes
Sylatron
Synribo
Tabrecta
Tafinlar
Tagrisso
Tarceva
Targretin
Tasigna
Taxotere
Tecartus
Tecentriq
Temodar
Temozolomide
Temsirolimus
Teniposide
Tepadina
TheraCys
Thiotepa
Tice BCG
Toposar
Topotecan HCl
Toremifene Citrate
Torisel
Totect
Trazimera
Treanda
Trelstar Mixject
Tretinoin
Trisenox
Trodelvy
Truxima
Tukysa
Turalio
Tykerb
Uvadex
Valrubicin
11
Drug Name Notes
Valstar
Vantas
Vectibix
Velcade
Vidaza
VinBLAStine Sulfate
Vincasar PFS
vinCRIStine Sulfate
Vinorelbine Tartrate
Vizimpro
Voraxaze
Votrient
Vyxeos
Xalkori
Xatmep
Xeloda
Xofigo
Xospata
Xtandi
Yervoy
Yescarta
Yonsa
Zaltrap
Zanosar
Zelboraf
Zepzelca
Zinecard
Zirabev
Zoladex
Zolinza
Zykadia
Zytiga
*Antiparkinson Agents*
Apokyn
Inbrija
Kynmobi
12
Drug Name Notes
*Antipsychotics/Antimanic Agents*
Abilify Maintena
Aristada
Aristada Initio
FluPHENAZine Decanoate
Haldol Decanoate
Haloperidol Decanoate
Invega Sustenna
Invega Trinza
Nuplazid
Perseris
RisperDAL Consta
ZyPREXA Relprevv
*Antiretrovirals - Cd4-Directed Post-Attachment Inhibitor***
Trogarzo
*Antiretrovirals - Gp120-Directed Attachment Inhibitor***
Rukobia
*Antiretrovirals Adjuvants***
Tybost
*Antisense Oligonucleotide (Aso) Inhibitor Agents***
Tegsedi
*Antivirals*
Abacavir Sulfate
Abacavir Sulfate-lamiVUDine
Abacavir-Lamivudine-Zidovudine
Adefovir Dipivoxil
Aptivus
Atazanavir Sulfate
Atripla
Baraclude
Biktarvy
Cimduo
Combivir
Complera
Crixivan
13
Drug Name Notes
Cytovene
Daklinza
Delstrigo
Descovy
Didanosine
Dovato
Edurant
Efavirenz
Emtriva
Entecavir
Epivir
Epivir HBV
Epzicom
Evotaz
Fosamprenavir Calcium
Fuzeon
Ganciclovir Sodium
Genvoya
Hepsera
Intelence
Invirase
Isentress
Isentress HD
Juluca
Kaletra
LamiVUDine
lamiVUDine-Zidovudine
Lexiva
Lopinavir-Ritonavir
Moderiba
Moderiba (1200 MG Pack)
Moderiba (600 MG Pack)
Moderiba (800 MG Pack)
Nevirapine
Nevirapine ER
Norvir
14
Drug Name Notes
Odefsey
Olysio
Pegasys
Pegasys ProClick
PegIntron
Peg-Intron
Peg-Intron Redipen
Peg-Intron Redipen Pak 4
Pifeltro
Prevymis
Prezcobix
Prezista
Rebetol
Rescriptor
Retrovir
Reyataz
RibaPak
Ribasphere
Ribasphere RibaPak
Ribasphere RibaPak (1000 Pack)
Ribasphere Ribapak (1200 Pack)
Ribasphere RibaPak (600 Pack)
Ribasphere RibaPak (800 Pack)
RibaTab
Ribavirin
Ritonavir
Selzentry
Sovaldi
Stavudine
Stribild
Sustiva
Symfi
Symfi Lo
Symtuza
Temixys
Tenofovir Disoproxil Fumarate
15
Drug Name Notes
Tivicay
Tivicay PD
Triumeq
Trizivir
Truvada
Tyzeka
Vemlidy
Victrelis
Videx
Videx EC
Viracept
Viramune
Viramune XR
Virazole
Viread
Vitekta
Zerit
Ziagen
Zidovudine
*Anti-Von Willebrand Factor Agents***
Cablivi
*Assorted Classes*
Astagraf XL
Atgam
Azasan
azaTHIOprine
AzaTHIOprine Sodium
Benlysta
CellCept
CellCept Intravenous
Clovique
Cuprimine
CycloSPORINE
CycloSPORINE Modified
Depen Titratabs
D-Penamine
16
Drug Name Notes
Enspryng
Envarsus XR
Everolimus
Gamifant
Gengraf
Imuran
Mycophenolate Mofetil
Mycophenolate Mofetil HCl
Mycophenolate Sodium
Myfortic
Neoral
Nulojix
penicillAMINE
Prograf
Rapamune
Revlimid
SandIMMUNE
Sirolimus
Solesta
Syprine
Tacrolimus
Thalomid
Thymoglobulin
Trientine HCl
Uplizna
Varithena
Veltassa
Xiaflex
Zortress
*Atopic Dermatitis - Monoclonal Antibodies***
Dupixent
*Beta Blockers*
Hemangeol
*Bile Acid Synthesis Disorder Agents***
Cholbam
17
Drug Name Notes
*Biologicals Misc*
Adagen
*Cardiovascular Agents - Misc.*
Adcirca
Adempas
Alyq
Ambrisentan
Bosentan
Epoprostenol Sodium
Flolan
Letairis
Opsumit
Orenitram
Revatio
Sildenafil Citrate
Tadalafil (PAH)
Tracleer
Tyvaso
Tyvaso Refill
Tyvaso Starter
Veletri
*Cephalosporin Combinations***
Avycaz
Zerbaxa
*Cephalosporins*
Teflaro
*Chemicals*
5-Fluorouracil
Cyclophosphamide
CycloSPORINE
CycloSPORINE A
Etoposide
Floxuridine
Fluorouracil
FluPHENAZine Decanoate
Haloperidol Decanoate
18
Drug Name Notes
Leuprolide Acetate
Mitomycin
Sirolimus
Tacrolimus
Thiotepa
Tobramycin
*Corticosteroids*
Emflaza
Zilretta
*Cyclin-Dependent Kinases (Cdk) Inhibitors***
Ibrance
Kisqali (200 MG Dose)
Kisqali (400 MG Dose)
Kisqali (600 MG Dose)
Kisqali 200 Dose
Kisqali 400 Dose
Kisqali 600 Dose
Verzenio
*Cystic Fibrosis Agent - Combinations***
Orkambi
Symdeko
Trikafta
*Dermatologicals*
8-Mop
Acitretin
Botox Cosmetic
Cosentyx
Cosentyx (300 MG Dose)
Cosentyx Sensoready (300 MG)
Cosentyx Sensoready Pen
Durolane
Ilumya
Methoxsalen
Methoxsalen Rapid
Oxsoralen Ultra
Perlane
19
Drug Name Notes
Qutenza
Qutenza (2 Patch)
Refissa
Restylane
Siliq
Skyrizi (150 MG Dose)
Soriatane
Stelara
Taltz
Targretin
Tremfya
Tretinoin (Emollient)
Valchlor
*Diagnostic Products*
Acthrel
Macrilen
Thyrogen
*Digestive Aids*
Sucraid
*Diuretics*
Keveyis
*Endocrine And Metabolic Agents - Misc.*
Acthar
Aldurazyme
Buphenyl
Bynfezia Pen
Calcitonin (Salmon)
Cinacalcet HCl
Cystadane
DDAVP
DDAVP Rhinal Tube
Desmopressin Acetate Spray
Egrifta
Egrifta SV
Elaprase
Fabrazyme
20
Drug Name Notes
Fensolvi (6 Month)
Forteo
Galafold
Genotropin
Genotropin MiniQuick
Humatrope
Increlex
Ipamorelin Acetate
Jynarque
Kuvan
Lumizyme
Lupron Depot-Ped (1-Month)
Lupron Depot-Ped (3-Month)
Miacalcin
Mycapssa
Naglazyme
Natpara
Nitisinone
Nityr
Nocdurna
Norditropin FlexPro
Nutropin AQ NuSpin 10
Nutropin AQ NuSpin 20
Nutropin AQ NuSpin 5
Octreotide Acetate
Omnitrope
Orfadin
Palynziq
Pamidronate Disodium
Paricalcitol
Prolia
Ravicti
Rayaldee
Reclast
Saizen
Saizen Click.Easy
21
Drug Name Notes
Saizenprep
Samsca
SandoSTATIN
SandoSTATIN LAR Depot
Sensipar
Serostim
Signifor
Signifor LAR
Sodium Phenylbutyrate
Somatuline Depot
Somavert
Supprelin LA
Synarel
Teriparatide (Recombinant)
Tolvaptan
Triptodur
Tymlos
Xgeva
Zemplar
Zoledronic Acid
Zomacton
Zometa
Zorbtive
*Erythroid Maturation Agents***
Reblozyl
*Farnesoid X Receptor (Fxr) Agonists***
Ocaliva
*Gastrointestinal Agents - Misc.*
Avsola
Chenodal
Cimzia
Cimzia Prefilled
Cimzia Starter Kit
Entereg
Gattex
Inflectra
22
Drug Name Notes
Relistor
Remicade
Renflexis
*Genitourinary Agents - Miscellaneous*
Procysbi
Thiola
Thiola EC
*Gout Agents*
Krystexxa
*Growth Hormone Releasing Hormones (Ghrh) Combinations***
GHRP2-GHRP6-Sermorelin
GHRP2-Sermorelin
*Hematological Agents - Misc.*
Advate
Adynovate
Afstyla
Alphanate/VWF Complex/Human
AlphaNine SD
Alprolix
Bebulin
BeneFIX
Berinert
Cathflo Activase
Cinryze
Coagadex
Corifact
Eloctate
Esperoct
Feiba
Feiba NF
Feiba VH Immuno
Fibryga
Firazyr
Haegarda
Helixate FS
23
Drug Name Notes
Hemofil M
Humate-P
Icatibant Acetate
Idelvion
Ixinity
Jivi
Kalbitor
Kcentra
Koate
Koate-DVI
Kogenate FS
Kogenate FS Bio-Set
Kovaltry
Monoclate-P
Mononine
Novoeight
NovoSeven RT
Nuwiq
Obizur
Panhematin
Profilnine
Profilnine SD
Rebinyn
Recombinate
Retavase
Retavase Half-Kit
RiaSTAP
Rixubis
Ruconest
Sevenfact
Soliris
Tretten
Ultomiris
Vonvendi
Wilate
Xyntha
24
Drug Name Notes
Xyntha Solofuse
*Hematopoietic Agents*
Aranesp (Albumin Free)
Cerdelga
Cerezyme
Doptelet
Elelyso
Epogen
Fulphila
Granix
Injectafer
Leukine
Miglustat
Mircera
Mozobil
Mulpleta
Neulasta
Neulasta Onpro
Neumega
Neupogen
Nivestym
Nplate
Procrit
Promacta
Retacrit
Siklos
Udenyca
Vpriv
Zarxio
Zavesca
Ziextenzo
*Hemoglobin S (Hbs) Polymerization Inhibitors***
Oxbryta
*Hemostatics*
Cyklokapron
Tranexamic Acid
25
Drug Name Notes
*Hepatitis C Agent - Combinations***
Epclusa
Harvoni
Ledipasvir-Sofosbuvir
Mavyret
Sofosbuvir-Velpatasvir
Technivie
Viekira Pak
Viekira XR
Vosevi
Zepatier
*Hereditary Orotic Aciduria Treatment - Agents**
Xuriden
*Hypnotics*
Hetlioz
*Hypophosphatasia (Hpp) Agents***
Strensiq
*Insulin-Like Growth Factor-1 Receptor Inhibitors(Igf-1R)***
Tepezza
*Integrin Receptor Antagonists***
Entyvio
*Interleukin Antagonists***
Stelara
*Interleukin-5 Antagonists (Igg1 Kappa)***
Fasenra
Fasenra Pen
Nucala
*Interleukin-5 Antagonists (Igg4 Kappa)***
Cinqair
*Interleukin-6 (Il-6) Antagonists***
Sylvant
*Isocitrate Dehydrogenase-1 (Idh1) Inhibitors***
Tibsovo
26
Drug Name Notes
*Isocitrate Dehydrogenase-2 (Idh2) Inhibitors***
IDHIFA
*Leptin Analogues***
Myalept
*Lhrh/Gnrh Agonist Analog Combinations***
Lupaneta Pack
*Lysosomal Acid Lipase (Lal) Deficiency - Agents***
Kanuma
*Macrolides*
Dificid
*Migraine Products*
Zecuity
*Mixed Allergenic Extracts***
Oralair
*Monobactams***
Azactam
Aztreonam
Cayston
*Mouth/Throat/Dental Agents*
MuGard
*Mucopolysaccharidosis Iv (Mps Iv) - Agents***
Vimizim
*Mucopolysaccharidosis Vii (Mps Vii) - Agents***
Mepsevii
*Multiple Sclerosis Agents - Antimetabolites***
Mavenclad (10 Tabs)
Mavenclad (4 Tabs)
Mavenclad (5 Tabs)
Mavenclad (6 Tabs)
Mavenclad (7 Tabs)
Mavenclad (8 Tabs)
Mavenclad (9 Tabs)
*Muscular Dystrophy Agents***
Exondys 51
Viltepso
27
Drug Name Notes
Vyondys 53
*Musculoskeletal Therapy Agents*
Baclofen
Durolane
Euflexxa
Gablofen
Gel-One
Gelsyn-3
GenVisc 850
Hyalgan
Hymovis
Lioresal
Monovisc
OrthoVisc
Sodium Hyaluronate
Supartz FX
Synvisc
Synvisc One
Triluron
TriVisc
Visco-3
*Neurogenic Orthostatic Hypotension (Noh) - Agents***
Northera
*Neuromuscular Agents*
Botox
Dysport
Myobloc
Rilutek
Riluzole
Tiglutik
Xeomin
*Nutrients*
Dojolvi
*Oncolytic Viral Agents - Hsv1***
Imlygic
28
Drug Name Notes
*Ophthalmic Agents*
Beovu
Bevacizumab
Cystadrops
Cystaran
Eylea
Iluvien
Jetrea
Lucentis
Macugen
Ozurdex
Retisert
Visudyne
*Ophthalmic Gene Therapy***
Luxturna
*Ophthalmic Nerve Growth Factors***
Oxervate
*Passive Immunizing Agents - Combinations***
Hyqvia
*Passive Immunizing Agents*
Asceniv
Bivigam
Carimune NF
Cutaquig
Cuvitru
Flebogamma DIF
GamaSTAN
GamaSTAN S/D
Gammagard
Gammagard S/D Less IgA
Gammaked
Gammaplex
Gamunex-C
Hizentra
HyperRHO S/D
MICRhoGAM Ultra-Filtered Plus
29
Drug Name Notes
Octagam
Panzyga
Privigen
RhoGAM Ultra-Filtered Plus
Rhophylac
Synagis
WinRho SDF
Xembify
*Pcsk9 Inhibitors***
Praluent
Repatha
Repatha Pushtronex System
Repatha SureClick
*Phosphatidylinositol 3-Kinase (Pi3k) Inhibitors***
Aliqopa
Copiktra
Piqray (200 MG Daily Dose)
Piqray (250 MG Daily Dose)
Piqray (300 MG Daily Dose)
Zydelig
*Phosphodiesterase 4 (Pde4) Inhibitors***
Otezla
*Plasma Kallikrein Inhibitors - Monoclonal Antibodies***
Takhzyro
*Poly (Adp-Ribose) Polymerase (Parp) Inhibitors**
Lynparza
Rubraca
Talzenna
Zejula
*Poly (Adp-Ribose) Polymerase (Parp) Inhibitors***
Lynparza
Rubraca
Talzenna
Zejula
*Potassium Removing Agents***
Veltassa
30
Drug Name Notes
*Progestins*
HYDROXYprogesterone Caproate
Makena
*Psychotherapeutic And Neurological Agents - Misc.*
Ampyra
Aubagio
Austedo
Avonex
Avonex Pen
Avonex Prefilled
Bafiertam
Betaseron
Copaxone
Dalfampridine ER
Extavia
Gilenya
Glatiramer Acetate
Glatopa
Ingrezza
Kesimpta
Lemtrada
Mayzent
Ocrevus
Plegridy
Plegridy Starter Pack
Rebif
Rebif Rebidose
Rebif Rebidose Titration Pack
Rebif Titration Pack
Tecfidera
Tetrabenazine
Tysabri
Vumerity
Vumerity (Starter)
Xenazine
Xyrem
31
Drug Name Notes
Zeposia
Zeposia 7-Day Starter Pack
Zeposia Starter Kit
Zinbryta
*Pulmonary Fibrosis Agents - Kinase Inhibitors***
Ofev
*Pulmonary Fibrosis Agents***
Esbriet
*Pulmonary Hypertension - Prostacyclin Receptor Agonist***
Uptravi
*Respiratory Agents - Misc.*
Aralast
Aralast NP
Glassia
Kalydeco
Prolastin-C
Pulmozyme
Zemaira
*Sclerostin Inhibitors***
Evenity
*Small Interfering Ribonucleic Acid (Sirna) Agents***
Onpattro
*Spinal Muscular Atrophy-Antisense Oligonucleotides***
Spinraza
*Spinal Muscular Atrophy-Gene Therapy Agents***
Zolgensma 10.1-10.5 kg
Zolgensma 10.6-11.0 kg
Zolgensma 11.1-11.5 kg
Zolgensma 11.6-12.0 kg
Zolgensma 12.1-12.5 kg
Zolgensma 12.6-13.0 kg
Zolgensma 13.1-13.5 kg
Zolgensma 2.6-3.0 kg
Zolgensma 3.1-3.5 kg
32
Drug Name Notes
Zolgensma 3.6-4.0 kg
Zolgensma 4.1-4.5 kg
Zolgensma 4.6-5.0 kg
Zolgensma 5.1-5.5 kg
Zolgensma 5.6-6.0 kg
Zolgensma 6.1-6.5 kg
Zolgensma 6.6-7.0 kg
Zolgensma 7.1-7.5 kg
Zolgensma 7.6-8.0 kg
Zolgensma 8.1-8.5 kg
Zolgensma 8.6-9.0 kg
Zolgensma 9.1-9.5 kg
Zolgensma 9.6-10.0 kg
*Spinal Muscular Atrophy-Smn2 Splicing Modifiers***
Evrysdi
*Spleen Tyrosine Kinase (Syk) Inhibitors***
Tavalisse
*Tetrahydroisoquinolines***
Yondelis
*Thrombolytic Agent - Misc***
Defitelio
*Transthyretin Stabilizers***
Vyndamax
Vyndaqel
*Tripeptidyl Peptidase 1 Deficiency Treatment - Agents***
Brineura
*Tryptophan Hydroxylase Inhibitors***
Xermelo
*Vaccines*
BCG Vaccine
*X-Linked Hypophosphatemia (Xlh) Treatment - Agents***
Crysvita
33
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