Pharmacy Clinical Guidelines
The following criteria have changes going into effect on November 2, 2026:
The following criteria have changes going into effect on January 4, 2027:
- Avastin and Bevacizumab Biosimilars
- Beovu (brolucizumab-dbll)
- Bylvay (odevixibat)
- Cinqair (reslizumab)
- Elfabrio (pegunigalsidase alfa-iwxj)
- Emrelis (telisotuzumab vedotin-tllv)
- Entyvio (vedolizumab)
- Exdensur (depemokimab-ulaa)
- Eylea-Eylea HD and Biosimilars
- Fabrazyme (agalsidase beta)
- Fasenra (benralizumab)
- Galafold (migalastat)
- Gattex (teduglutide)
- Gomekli (mirdametinib)
- Iqirvo (elafibranor)
- Isturisa (osilodrostat)
- Kanuma -(sebelipase alfa)
- leuprolide acetate (Eligard-Vabrinty)
- (Camcevi) leuprolide mesylate
- Livdelzi (seladelpar)
- Livmarli (maralixibat)
- Lucentis and Ranibizumab Biosimilars
- Lumakras (sotorasib)
- Lumizyme (alglucosidase alfa)
- Lupron Depot (leuprolide acetate for depot suspension) Prostate Cancer
- Lupron Depot Endometriosis-Fibroid (leuprolide acetate for depot suspension)
- Myalept (metreleptin)
- Nexviazyme (avalglucosidase alfa-ngpt)
- Northera (droxidopa)
- Nucala (mepolizumab)
- Ocaliva (obeticholic acid)
- Ojemda (tovorafenib)
- Opdivo (nivolumab)
- Retevmo (selpercatinib)
- Romvimza (vimseltinib)
- Signifor (pasireotide)
- Susvimo (ranibizumab)
- Tasigna-Danziten (nilotinib)
- Trelstar (triptorelin pamoate)
- Vabysmo (faricimab-svoa)
- Xolair (omalizumab)
- Yervoy (ipilimumab)
- Zoladex (goserelin acetate)
The following criteria have changes going into effect on February 1, 2027:
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Pharmacy Clinical Guidelines
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Exceptions
Select the starting letter of the medication or condition to find the desired form.
View Oscar's Custom Exceptions Criteria for Autoimmune Conditions