| Hetlioz, Hetlioz LQ (tasimelteon) - PA, NF |
Hetlioz (tasimelteon) capsule, Hetlioz LQ (tasimelteon) suspension |
| High Cost, Low Value Non-Formulary Program |
ABSORICA, ABSORICA LD, ACZONE, ADAPALENE, ANUSOL-HC, ARAZLO, ATOPADERM, AZESCO, BENSAL HP, CABTREO, CHLORZOXAZONE, COXANTO, DICLOFENAC EPOLAMINE, DORYX, DORYX MPC, DOXEPIN HYDROCHLORIDE, DUEXIS, EPICERAM, FENOPROFEN CALCIUM, FLECTOR, FLUOVIX, FLUOVIX PLUS, FOLIC-K, GENICIN VITA-S, IBUPROFEN/FAMOTIDINE, INDERAL XL, INNOPRAN XL, KAMDOY, KELARX, LICART, LIDOCAINE AND TETRACAINE CREAM, LIDOCAINE/TETRACAINE, NAPROSYN, NAPROXEN/ESOMEPRAZOLE MAGNESIUM, ORACEA, ORTHO DF, OXAPROZIN, PENNSAID, PLIAGLIS, POKONZA, PREGENNA, PRODIGEN, PROMETHAZINE HYDROCHLORIDE, PROMETHAZINE HYDROCHLORIDE PLAIN, PROMETHAZINE VC, PRUDOXIN, RAYOS, RELAFEN DS, SAJAZIR, SITAVIG, SPRIX, TOLSURA, VIMOVO, WINLEVI, XERESE, XHANCE, YOSPRALA, ZIPSOR, ZONALON, ZORVOLEX, ZTLIDO, ZYCLARA, ZYCLARA PUMP, ZYFLO |
| High Dollar/Claim Dollar |
Claim, Dollar, High |
| Human Chorionic Gonadotropin (hCG) |
Pregnyl (chorionic gonadotropin) |
| Ibrance (palbociclib) |
Ibrance (palbociclib) |
| IBS - Diarrhea |
Lotronex (alosetron hydrochloride), Viberzi (eluxadoline) |
| Iclusig (ponatinib) |
Iclusig (ponatinib) |
| Ilaris (canakinumab injection) |
Ilaris (canakinumab injection) |
| Ilumya (tildrakizumab-asmn) - PA, NF |
Ilumya (tildrakizumab-asmn) |
| Imatinib Products - PA, NF |
Gleevec (imatinib mesylate), Imkeldi |
| Imbruvica (ibrutinib) - PA, NF |
Imbruvica (ibrutinib) |
| Immune Globulins - PA, NF |
Alyglo (immune globulin intravenous, human-stwk), Asceniv (immune globulin intravenous, human - slra), Bivigam (immune globulin [Human]), Cutaquig (Immune globulin subcutaneous [Human] - hipp), Cuvitru (immune globulin [Human]), Cytogam (cytomegalovirus immune globulin [Human]), Flebogamma 5% (immune globulin [Human]), Gamastan (immune globulin [Human]), Gammagard Liquid (immune globulin [Human]), Gammagard S/D (immune globulin [Human]), Gammaked and Gamunex-C (immune globulin [Human]), Gammaplex (immune globulin [Human]), Hizentra (immune globulin [Human]) for subcutaneous administration, HyQvia (immune globulin with recombinant human hyaluronidase) for subcutaneous administration, Immune globulin products (IVIG), Octagam 10% (immune globulin [Human]), Octagam 5% (immune globulin [Human]), Panzyga (immune globulin intravenous [Human] - ifas), Privigen (immune globulin [Human]), Varizig (varicella zoster immune globulin [Human] solution), Xembify (immune globulin subcutaneous, human - klhw), Yimmugo (immune globulin intravenous, human - dira) |
| Increlex (mecasermin [rDNA origin]) |
Increlex (mecasermin [rDNA origin]) injection |
| Infliximab – PA, NF |
Remicade (infliximab), Infliximab, Avsola (infliximab-axxq), Inflectra (infliximab-dyyb), Renflexis (Infliximab-abda), Zymfentra (infliximab-dyyb) SC injection |
| Inhaled Corticosteroids - ST, NF |
Alvesco (ciclesonide) Inhalation Aerosol, ArmonAir Digihaler (fluticasone propionate) Inhalation Powder, Asmanex (mometasone furoate) Inhalation Powder, Asmanex HFA (mometasone furoate) Inhalation Aerosol, Beclomethasone dipropionate HFA, Fluticasone propionate aerosol HFA, Fluticasone propionate powder Diskus, Pulmicort (budesonide aerosol) Flexhaler |
| Inlyta (axitinib) |
Inlyta (axitinib) |
| Inqovi (decitabine and cedazuridine) - PA, NF |
Inqovi (decitabine and cedazuridine) |
| Insulin Delivery Systems |
cartridge, Delivery, doser, Insulin, pen, System |
| Insulin Pump |
Omnipod 5 G6 and Omnipod 5 DASH: |
| Interstitial Lung Disease (ILD) Agents - PA, NF |
Esbriet (pirfenidone), Jascayd (nerandomilast), Ofev (nintedanib) |
HEALTHY LIVING