WHA

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Guideline Drug Name
Healthcare Reform Copay Waiver Review - Contraceptives Contraceptives, Health Care Reform Exceptions, Healthcare, Healthcare Reform Exceptions
Hemangeol (propranolol hydrochloride oral solution) Hemangeol (propranolol hydrochloride oral solution)
Hemophilia B Gene Therapies - PA, NF Beqvez (fidanacogene elaparvovec-dzkt), Hemgenix (etranacogene dezaparvovec-drlb)
Hereditary Angioedema Agents (HAE) Quantity Limit Override Berinert (C1 esterase inhibitor [Human]), Ekterly (sebetralstat), Firazyr (icatibant), Kalbitor (ecallantide), Ruconest (C1 esterase inhibitor [Recombinant]), Sajazir (icatibant)
Hereditary Angioedema Agents - PA, NF Andembry (garadacimab-gxii), Berinert (C1 esterase inhibitor [Human]), Cinryze (C1 esterase inhibitor [Human]), Dawnzera (donidalorsen), Ekterly (sebetralstat), Firazyr (icatibant), Haegarda (C1 esterase inhibitor [Human]), Kalbitor (ecallantide), Orladeyo (berotralstat), Ruconest (C1 esterase inhibitor [Recombinant]), Sajazir (icatibant), Takhzyro (lanadelumab-flyo)
Hernexeos (zongertinib) Hernexeos (zongertinib)
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
High-Cost Brand with Generics Program
Horizant (gabapentin enacarbil) Horizant (gabapentin enacarbil)
Human Chorionic Gonadotropin (hCG) Novarel (chorionic gonadotropin), Pregnyl (chorionic gonadotropin), Ovidrel (chorionic gonadotropin) PreFilled Syringe
Hyaluronic Acid Derivatives - PA, NF Durolane/Euflexxa/Hyalgan/Sodium Hyaluronate/Supartz FX/Gelsyn-3/Genvisc 850/Triluron/TriVisc/Visco-3 (sodium hyaluronate), Gel-One (cross-linked hyaluronate), Monovisc/Orthovisc/Hymovis (hyaluronan), Synvisc/Synvisc-One (hylan), Synojoynt
Hyftor (sirolimus) topical gel Hyftor (sirolimus) topical gel
Ibrance (palbociclib) Ibrance (palbociclib)
IBS - Diarrhea Lotronex (alosetron hydrochloride), Viberzi (eluxadoline)
Ibsrela (tenapanor) - PA, NF Ibsrela (tenapanor)
Ibtrozi (taletrectinib) Ibtrozi (taletrectinib)
Iclusig (ponatinib) Iclusig (ponatinib)
Idhifa (enasidenib) Idhifa (enasidenib)