Section |
Status |
HCD |
Name |
05.03.01 |
Formulary
|
 |
Abacavir Ziagen® |
05.03.01 |
Formulary
|
 |
Abacavir and Lamivudine Kivexa® |
05.03.01 |
Formulary
|
 |
Abacavir and Lamivudine and Zidovudine Trizivir® |
10.01.03 |
Formulary
|
 |
Abatacept Orencia® |
08.03.04.02 |
Formulary
|
 |
Abiraterone Zytiga® |
01.05.03 |
Formulary
|
 |
Adalimumab |
10.01.03 |
Formulary
|
 |
Adalimumab Humira® |
13.05.03 |
Formulary
|
 |
Adalimumab |
05.03.03.01 |
Formulary
|
 |
Adefovir Dipivoxil Hepsera® |
11.08.02 |
Formulary
|
 |
Aflibercept |
08.01.05 |
Formulary
|
 |
Alectinib Alecensa® |
08.02.03 |
Formulary
|
 |
Alemtuzumab Lemtrada® |
02.14 |
Restricted Use
|
 |
Alirocumab Praluent® |
13.05.01 |
Formulary
|
 |
Alitretinoin Toctino® |
05.02 |
Formulary
|
 |
Amphotericin Abelcet ® AmBisome ® Fungizone ® |
10.01.03 |
Non Formulary
|
 |
Anakinra Kineret® |
05.02.04 |
Formulary
|
 |
Anidulafungin Ecalta® |
10.01.03 |
Formulary
|
 |
Apremilast (Ortezla® ) |
13.05.03 |
Formulary
|
 |
Apremilast Otezla® |
08.01.05 |
Formulary
|
 |
Arsenic Trioxide Trisenox® |
05.03.01 |
Formulary
|
 |
Atazanavir Reyataz® |
08.02.04 |
Formulary
|
 |
Atezolizumab (Tecentriq®) |
08.02.04 |
Formulary
|
 |
Avelumab (Bavencio®) |
08.02.04 |
Formulary
|
 |
Axicabtagene ciloleuce (Yescarta®) |
08.01.05 |
Formulary
|
 |
Axitinib Inlyta® |
08.01.03 |
Formulary
|
 |
Azacitidine Vidaza® |
10.01.03 |
Formulary
|
 |
Baricitinib (Olumiant®) |
08.02.02 |
Formulary
|
 |
Basiliximab Simulect® |
10.01 |
Formulary
|
 |
Belimumab Benlysta® |
08.01.01 |
Formulary
|
 |
Bendamustine |
03.05.02 |
Formulary
|
 |
Beractant Survanta® |
08.01.05 |
Formulary
|
 |
Bevacizumab Avastin® |
08.01.05 |
Formulary
|
 |
Bexarotene Targretin® |
08.02 |
Formulary
|
 |
Blinatumomab Blincyto® |
05.03.03.02 |
Formulary
|
 |
Boceprevir Victrelis® |
08.01.05 |
Formulary
|
 |
Bortezomib Velcade® |
08.01.05 |
Formulary
|
 |
Bosutinib Bosulif® |
04.07.04.02 |
Formulary
|
 |
Botulinum Toxin Type A botox® |
08.01.05 |
Formulary
|
 |
Brentuximab vedotin Adcetris® |
03.04.03 |
Formulary
|
 |
C1 Esterase Inhibitor Berinert® |
03.04.03 |
Non Formulary
|
 |
C1 esterase inhibitor Cinryze® |
08.01.05 |
Formulary
|
 |
Cabazitaxel Jevtana® |
08.01.05 |
Formulary
|
 |
Carfilzomib Kyprolis® |
05.02.04 |
Formulary
|
 |
Caspofungin Cancidas® |
08.01.05 |
Formulary
|
 |
Ceritinib Zykadia |
10.01.03 |
Formulary
|
 |
Certolizumab Pegol Cimzia® |
08.01.05 |
Formulary
|
 |
Cetuximab Erbitux® |
08.02.02 |
Formulary
|
 |
Ciclosporin |
09.05.01.02 |
Formulary
|
 |
Cinacalcet Mimpara® |
08.01.03 |
Formulary
|
 |
Cladribine Mavenclad® |
08.01.03 |
Formulary
|
 |
Cladribine |
08.01.03 |
Formulary
|
 |
Clofarabine Evoltra® |
05.03.01 |
Formulary
|
 |
Cobicistat Tybost® |
05.01.07 |
Formulary
|
 |
Colistimethate for nebulisation Colobreathe® |
05.01.07 |
Formulary
|
 |
Colistimethate for nebulisation Promixin® |
10.03.01 |
Formulary
|
 |
Collagenase Xiapex® |
03.04.03 |
Formulary
|
 |
Conestat Alfa Ruconest® |
08.01.05 |
Formulary
|
 |
Crizotinib Xalkori® |
08.01.05 |
Formulary
|
 |
Dabrafenib Tafinlar® |
05.03.03.02 |
Restricted Use
|
 |
Daclatasvir Daklinza® |
08.02.04 |
Formulary
|
 |
Daratumumab (Darzalex®) |
09.01.03 |
Formulary
|
 |
Darbepoetin Alfa Aranesp® |
05.03.03.02 |
Formulary
|
 |
Dasabuvir Exviera® |
08.01.05 |
Restricted Use
|
 |
Dasatinib Sprycel® |
20 |
Non Formulary
|
 |
DAUNORUBICIN saline pre-filled syringe |
20 |
Non Formulary
|
 |
DEFIBROTIDE Capsules 400 mg |
20 |
Non Formulary
|
 |
DEFIBROTIDE Injection 200 mg |
05.01.09 |
Non Formulary
|
 |
Delamanid Deltyba® |
09.01.03 |
Formulary
|
 |
Desferrioxamine Mesilate |
05.03.01 |
Formulary
|
 |
Didanosine Videx® |
02.01.01 |
Non Formulary
|
 |
Digoxin specific antibody fragments Digifab® |
18 |
Non Formulary
|
 |
Digoxin specific antibody fragments Digifab® |
08.02.04 |
Formulary
|
 |
Dimethyl fumarate Tecfidera® |
08.02.04 |
Formulary
|
 |
Dinutuximab (Qarziba®) |
08.01.05 |
Formulary
|
 |
Docetaxel Taxotere® |
05.03.01 |
Formulary
|
 |
Dolutegravir tivicay ® |
05.03.01 |
Formulary
|
 |
Dolutegravir, abacavir & lamivudine Triumeq® |
03.07 |
Formulary
|
 |
Dornase Alfa |
08.01.02 |
Formulary
|
 |
Doxorubicin Caelyx® |
08.02.04 |
Formulary
|
 |
Durvalumab (Imfinzi® ) |
05.03.01 |
Formulary
|
 |
Efavirenz Sustiva® |
09.01.04 |
Formulary
|
 |
Eltrombopag Revolade® |
05.03.01 |
Formulary
|
 |
Emtricitabine Emtriva® |
05.03.01 |
Formulary
|
 |
Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg Eviplera® |
05.03.03.01 |
Formulary
|
 |
Entecavir Baraclude® |
08.03.04.02 |
Formulary
|
 |
Enzalutamide Xtandi® |
09.01.03 |
Formulary
|
 |
Epoetin alfa Eprex® |
09.01.03 |
Formulary
|
 |
Epoetin beta NeoRecormon® |
20 |
Non Formulary
|
 |
Eptotermin Alfa Osigraft® |
08.01.05 |
Formulary
|
 |
Eribulin Halaven® |
08.01.05 |
Formulary
|
 |
Erlotinib Tarceva® |
08.01.05 |
Formulary
|
 |
Erlotinib Tarceva® |
10.01.03 |
Formulary
|
 |
Etanercept Enbrel® |
13.05.03 |
Formulary
|
 |
Etanercept |
05.03.01 |
Formulary
|
 |
Etravirine Intelence® |
08.01.05 |
Formulary
|
 |
Everolimus Votubia® |
08.01.05 |
Restricted Use
|
 |
Everolimus Afinitor® |
02.14 |
Restricted Use
|
 |
Evolocumab Repatha® |
02.11 |
Restricted Use
|
 |
Factor VIIa (Recombinant) Novo 7® |
08.02.04 |
Formulary
|
 |
Fingolimod |
11.04.01 |
Formulary
|
 |
Fluocinolone intravitreal implant Iluvien® |
18 |
Non Formulary
|
 |
Fomepizole |
05.03.01 |
Formulary
|
 |
Fosamprenavir Telzir® |
05.03.02.02 |
Formulary
|
 |
Ganciclovir Cymevene® |
08.01.05 |
Formulary
|
 |
Gefitinib Iressa® |
08.02.04 |
Formulary
|
 |
Glatiramer Acetate Copaxone® |
05.03.03.02 |
Formulary
|
 |
Glecaprevir and Pibrentasvir Maviret® |
18 |
Non Formulary
|
 |
Glucarpidase Carboxypeptidase |
01.05.03 |
Formulary
|
 |
Golimumab |
10.01.03 |
Formulary
|
 |
Golimumab Simponi® |
08.01.05 |
Formulary
|
 |
Ibrutinib Imbruvica® |
03.04.03 |
Formulary
|
 |
Icatibant Firazyr® |
02.05.01 |
Formulary
|
 |
Iloprost injection |
08.01.05 |
Formulary
|
 |
Imatinib Gilvec® |
08.02.04 |
Formulary
|
 |
Immunocellular therapy containing tisagenlecleucel, autologous T cells genetically modified ex vivo using a lentiviral vector encoding an anti-CD19 chimeric antigen receptor (CAR) (Kymriah®) |
01.05.03 |
Formulary
|
 |
Infliximab |
10.01.03 |
Formulary
|
 |
Infliximab |
13.05.03 |
Formulary
|
 |
Infliximab |
08.01 |
Formulary
|
 |
Inotuzumab ozogamicin Besponsa® |
08.02.04 |
Formulary
|
 |
Interferon Alfa |
08.02.04 |
Formulary
|
 |
Interferon Alfa Roferon-A® |
08.02.04 |
Formulary
|
 |
Interferon Beta Rebif® |
08.02.04 |
Formulary
|
 |
Interferon Beta Betaferon® |
08.02.04 |
Formulary
|
 |
Interferon Beta Avonex® |
08.02.04 |
Formulary
|
 |
Interferon beta Extavia® |
08.01.05 |
Formulary
|
 |
Ipilimumab Yervoy® |
08.01.05 |
Formulary
|
 |
Ixazomib Ninlaro® |
05.03.01 |
Formulary
|
 |
Lamivudine Epivir® |
05.03.01 |
Formulary
|
 |
Lamivudine Zeffix® |
08.03.04.03 |
Formulary
|
 |
Lanreotide |
05.03.03.02 |
Formulary
|
 |
Ledipasvir and Sofosbuvir Harvoni® |
08.02.04 |
Formulary
|
 |
Lenalidomide |
09.01.06 |
Formulary
|
 |
Lenograstim Granocyte® |
08.01.05 |
Formulary
|
 |
Lenvatinib Lenvima® and Kisplyx® |
05.03.01 |
Formulary
|
 |
Lopinavir and Ritonavir Kaletra® |
03.07 |
Formulary
|
 |
Mannitol inhalation Bronchitol ® |
05.03.01 |
Formulary
|
 |
Maraviroc Celsentri® |
08.01.05 |
Formulary
|
 |
Midostaurin Rydapt® |
08.02.01 |
Formulary
|
 |
Mycophenolate Mofetil |
08.02.04 |
Formulary
|
 |
Natalizumab Tysabri® |
08.01.03 |
Formulary
|
 |
Nelarabine Atriance® |
05.03.01 |
Formulary
|
 |
Nevirapine Viramune® |
08.01.05 |
Formulary
|
 |
Nilotinib Tasigna® |
03.11 |
Formulary
|
 |
Nintedanib Ofev® |
08.01.05 |
Formulary
|
 |
Nintedanib Vargatef ® |
08.02.04 |
Formulary
|
 |
Niraparib (Zejula®) |
20 |
Non Formulary
|
 |
Nitazoxanide |
08.02.04 |
Formulary
|
 |
Nivolumab Opdivo® |
14.05.01 |
Non Formulary
|
 |
Normal immunoglobulin for Intramuscular use |
14.05.01 |
Non Formulary
|
 |
Normal immunoglobulin for Intravenous use |
14.05.01 |
Non Formulary
|
 |
Normal immunoglobulin for Subcutaneous use |
08.02.03 |
Formulary
|
 |
Obinutuzumab Gazyvaro ® |
08.03.04.03 |
Formulary
|
 |
Octreotide Sandostatin Lar® |
08.03.04.03 |
Formulary
|
 |
Octreotide Sandostatin® |
08.02.03 |
Formulary
|
 |
Ofatumumab Arzerra® |
08.02.04 |
Formulary
|
 |
Olaparib Lynparza® |
08.01.05 |
Formulary
|
 |
Olaratumab Lartruvo® |
03.04.02 |
Formulary
|
 |
Omalizumab |
05.03.03.02 |
Formulary
|
 |
Ombitasvir/ paritaprevir/ ritonavir Viekirax® |
08.02.04 |
Formulary
|
 |
Osimertinib Tagrisso |
08.01.05 |
Formulary
|
 |
Paclitaxel - Albumin Bound Formulation Abraxane® |
05.03.05 |
Restricted Use
|
 |
Palivizumab Synagis® |
08.01.05 |
Formulary
|
 |
Panitumumab Vectibix® |
08.01.05 |
Formulary
|
 |
Panobinostat Farydak® |
08.01.05 |
Formulary
|
 |
Pazopanib Votrient® |
08.02.04 |
Formulary
|
 |
Peginterferon Alfa Pegasys® |
08.02.04 |
Formulary
|
 |
Peginterferon Alfa ViraferonPeg® |
08.02.04 |
Formulary
|
 |
Peginterferon Beta-1a Plegridy® |
08.01.05 |
Formulary
|
 |
Pembrolizumab Keytruda® |
08.01.03 |
Formulary
|
 |
Pemetrexed Alimta® |
08.02.04 |
Formulary
|
 |
Pemrolizumab Keytruda® |
08.01.05 |
Formulary
|
 |
Pertuzumab Perjeta® |
03.11 |
Formulary
|
 |
pirfenidone Esbriet® |
08.01.02 |
Formulary
|
 |
Pixantrone |
09.01.07 |
Formulary
|
 |
Plerixafor Mozobil® |
08.02.04 |
Formulary
|
 |
Pomalidomide Imnovid® |
08.01.05 |
Formulary
|
 |
Ponatinib Iclusig® |
03.05.02 |
Formulary
|
 |
Poractant Alfa Curosurf® |
08.03.04.02 |
Formulary
|
 |
Radium-223 dichloride |
05.03.01 |
Formulary
|
 |
Raltegravir Isentress ® |
08.01.03 |
Formulary
|
 |
Raltitrexed Tomudex® |
11.08.02 |
Formulary
|
 |
Ranibizumab Lucentis® |
10.01.04 |
Formulary
|
 |
Rasburicase Fastertec |
08.01.05 |
Formulary
|
 |
Regorafenib Stivarga® |
05.03.05 |
Formulary
|
 |
Ribavirin |
08.01.05 |
Formulary
|
 |
Ribociclib |
05.03.01 |
Formulary
|
 |
Rilpivirine hydrochloride Edurant® |
04.09.03 |
Formulary
|
 |
Riluzole Rilutek® |
05.03.01 |
Formulary
|
 |
Ritonavir Norvir® |
08.02.03 |
Formulary
|
 |
Rituximab MabThera®Truxima ® |
10.01.03 |
Formulary
|
 |
Rituximab (rheumatology) MabThera® |
09.01.04 |
Formulary
|
 |
Romiplostim Nplate® |
08.01.05 |
Formulary
|
 |
Ruxolitinib Jakavi® |
05.03.01 |
Formulary
|
 |
Saquinavir Invirase® |
10.01.03 |
Formulary
|
 |
Sarilumab (Kevzara®) |
10.01.03 |
Formulary
|
 |
Secukinumab |
13.05.03 |
Formulary
|
 |
Secukinumab |
20 |
Non Formulary
|
 |
Sipuleucel- T |
08.02.02 |
Formulary
|
 |
Sirolimus Rapamune® |
05.03.03.02 |
Formulary
|
 |
Sofosbuvir Sovaldi® |
05.03.03.02 |
Formulary
|
 |
Sofosbuvir, Velpatasvir and Voxilaprevir Vosevi® |
06.05.01 |
Formulary
|
 |
Somatropin Omnitrope® Humatrope® genotropin® and Zomacton® |
08.01.05 |
Formulary
|
 |
Sorafenib Nexavar® |
05.03.01 |
Formulary
|
 |
Stavudine Zerit® |
08.01.05 |
Formulary
|
 |
Sunitinib Sutent® |
08.02.04 |
Formulary
|
 |
Talimogene laherparepvac Imlygic® |
08.01.05 |
Formulary
|
 |
Talimogene laherparepvec Imlygic® |
20 |
Non Formulary
|
 |
Taribavirin |
05.03.03.02 |
Formulary
|
 |
Telaprevir Incivo® |
08.01.05 |
Formulary
|
 |
Temozolomide Temodal® |
08.01.05 |
Formulary
|
 |
Temsirolimus Torisel® |
05.03.01 |
Formulary
|
 |
Tenofovir 245mg, Efavirenz 600mg and Emtricitabine 200mg Atripla® |
05.03.01 |
Formulary
|
 |
Tenofovir alafenamide, elvitegravir, cobicistat & emtricitabine Genvoya® |
05.03.01 |
Formulary
|
 |
Tenofovir and Emtricitabine Truvada® |
05.03.01 |
Formulary
|
 |
Tenofovir Disproxil Viread® |
05.03.01 |
Restricted Use
|
 |
Tenofovir, cobicistat, elvitegravir & emtricitabine Stribild® |
08.02.04 |
Formulary
|
 |
Teriflunomide Aubagio® |
20 |
Non Formulary
|
 |
TETRAHYDROBIOPTERIN Tablets 10 mg |
08.02.04 |
Formulary
|
 |
Thalidomide Celgene® |
05.01.04 |
Formulary
|
 |
Tobramycin |
05.01.04 |
Formulary
|
 |
Tobramycin inhaler TOBI Podhaler® |
10.01.03 |
Formulary
|
 |
Tocilizumab RoActemra® |
10.01.03 |
Formulary
|
 |
Tofacitinib (Xeljanz®) |
06.05.02 |
Formulary
|
 |
Tolvaptan Jinarc® |
08.01.05 |
Formulary
|
 |
Trametinib Mekinist® |
08.01.05 |
Formulary
|
 |
Trastuzumab Herceptin® |
08.01.05 |
Formulary
|
 |
Trastuzumab emtansine Kadcyla® |
20 |
Non Formulary
|
 |
Treprostinil |
08.01.05 |
Formulary
|
 |
Trifluridine and Tipiracil Lonsurf ® |
01.05.03 |
Formulary
|
 |
Ustekinumab Stelera ® |
10.01.03 |
Formulary
|
 |
Ustekinumab |
13.05.03 |
Formulary
|
 |
Ustekinumab |
05.03.02.02 |
Formulary
|
 |
Valganciclovir Valcyte® |
01.05.03 |
Formulary
|
 |
Vedolizumab |
08.01.05 |
Formulary
|
 |
Vemurafenib Zelboraf® |
08.01.05 |
Formulary
|
 |
Vemurafenib (Zelboraf® ) |
08.01.05 |
Formulary
|
 |
Venetoclax Venclyxto ® |
11.08.02 |
Formulary
|
 |
Verteporfin Visudyne® |
05.02 |
Formulary
|
 |
Voriconazole Vfend® |
08.01.05 |
Restricted Use
|
 |
Vosaroxin Qinprezo |
05.03.01 |
Formulary
|
 |
Zidovudine Retrovir® |