Pharmacy Clinical Guidelines
- Aucatzyl (obecabtagene autoleucel)
- Augtyro (repotrectinib)
- Brukinsa (zanubrutinib)
- cabazitaxel-Jevtana
- Calquence (acalabrutinib)
- Caprelsa (vandetanib)
- Copiktra (duvelisib)
- Danyelza (naxitamab-gqgk)
- Erbitux (cetuximab)
- Eylea-Eylea HD and Biosimilars
- GamaSTAN (immune globulin) (human)
- Gavreto (pralsetinib)
- Inlexzo (gemcitabine intravesical system)
- IVIG
- Jascayd (nerandomiliast)
- Jaypirca (pirtobrutinib)
- Joenja (leniolisib)
- Kevzara (sarilumab)
- Krazati (adagrasib)
- levoleucovorin-Khapzory
- Monjuvi (tafasitamab-cxix)
- Orencia (abatacept)
- Palsonify (paltusotine)
- Prolia and Biosimilars (denosumab)
- Rozlytrek (entrectinib)
- Rubraca (rucaparib)
- Rybrevant (amivantamab-vmjw)
- SCIG
- Simponi (golimumab for subcutaneous injection)
- Simponi Aria (golimumab)
- States Global Step Therapy Nebraska Mandate
- Tavalisse (fostamatinib disodium hexahydrate)
- Tivdak (tisotumab vedotin-tftv)
- Tretinoins (Topical)
- Vitrakvi (larotrectinib)
- Vyloy (zolbetuximab-clzb)
- Xeljanz-Xeljanz XR (tofacitinib)
- Xgeva and Biosimilars (denosumab)
- Xolremdi (mavorixafor)
The following criteria have changes going into effect on March 2, 2026:
The following criteria have changes going into effect on May 1, 2026:
- Akeega (niraparid and abiraterone acetate)
- Arzerra (ofatumumab)
- Besponsa (inotuzumab ozogamicin)
- Blincyto (blinatumomab)
- Cometriq (cabozantinib)
- Elrexfio (elranatamab-bcmm)
- Firdapse (mifampridine)
- Gazyva (obinutuzumab)
- Imbruvica (ibrutinib)
- Imfinzi (durvalumab)
- Imjudo (tremelimumab-actl)
- Lenvima (lenvatinib)
- Leukine (sargramostim)
- Lorbrena (lorlatinib)
- Lunsumio (mosunetuzumab-axgb)
- Lynparza (olaparib)
- Neulasta and Pegfilgrastim Biosimilars
- Neupogen and Filgrastim Biosimilars
- Nplate (romiplostim)
- Promacta - Alvaiz (eltrombobag olamin/choline)
- Pyrukynd (mitapivat)
- Reblozyl (luspatercept-ammt)
- Revuforj (revumenib)
- Rolvedon (eflapegrastim-xnst)
- Ryzneuta (efbemalenograstim alfa-vuxw)
- Stivarga (regorafenib)
- Strontium Chloride Sr-89 (Metastron)
- Talvey (talquetamab-tgvs)
- Talzenna (talazoparib)
- Tecvayli (teclistamab-cqyv)
- Voranigo (vorasidenib)
- Xeloda (capecitabine)
- Zytiga (abiraterone)
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Pharmacy Clinical Guidelines
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Exceptions
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