Drug Policies

Showing 76– 81 of 81 Results

Title	Last Updated
Tezspire™ (tezepelumab-ekko subcutaneous injection) Open a PDF	02/12/2026
Ustekinumab Drug Policy (Imuldosa [ustekinumab-srlf], Otulfi [ustekinumab-aauz], Pyzchiva [ustekinumab-ttwe], Pyzchiva [ustekinumab-ttwe][Cordavis]], (Selarsdi [ustekinumab-aekn], Stelara [ustekinumab], Steqeyma [ustekinumab-stba], ustekinumab [Janssen Biotech], ustekinumab-aekn, ustekinumab-ttwe [Quallent], Wezlana [ustekinumab-auub][Optum-Nuvalia]], Yesintek [ustekinumab-kfce]) (Self-Administered & Health Professional Administered) – Rx Benefit & Medical Benefit Open a PDF	02/23/2026
Viscosupplementation with Hyaluronic Acid (Durolane, Euflexxa, Gel-One, Gelsyn-3, Genvisc 850, Hyalgan, Hymovis, Hymovis One, Monovisc, Orthovisc, Supartz, Synojoynt, Synvisc One, Triluron, TriVisc, Visco-3) (Health Professional Administered) – Medical Benefit Open a PDF	12/17/2025
Weight Related Comorbidities for Overweight, Obesity, Noncirrhotic Metabolic Dysfunction - Associated Steatohepatitis (MASH) & Cardiovascular Disease (Contrave, Liraglutide, Orlistat, Qsymia, phentermine-topiramate ER, Saxenda, Wegovy, Xenical, & Zepbound, Zepbound Kwikpen) (Self-Administration) - Rx Benefit (New Start and Recertification) Open a PDF	02/05/2026
Xiaflex - Medical Benefit (collagenase clostridium histolyticum) Policy Open a PDF	01/15/2026
Xolair (omalizumab) Drug Policy Open a PDF	11/19/2025

Showing 76– 81 of 81 Results