Lumicera Specialty Drug List

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The Lumicera Specialty Drug list is a guide to medications distributed through Lumicera Specialty Pharmacy. Our mission is to provide exceptional service and comprehensive care so that our members can live happier, better lives. In fact, our dedication has earned us a 99% patient satisfaction rate. We support our prescribers and members with pre-screening therapy, ongoing support and education, clinical monitoring and refill reminders.

Condition Brand Name Generic Name

Allergy/Asthma, Dermatology, Actemra® tocilizumab Gastroenterology, Rheumatology, Avsola® infliximab - axxq

Benlysta® belimumab

Cimzia® certolizumab

Cosentyx® secukinumab

Dupixent® dupilumab

Enbrel® etanercept

Entyvio® vedolizumab

Fasenra®* benralizumab

Humira® adalimumab

Ilumya® tildrakizumab-asmn

Inflectra® infliximab-dyyb

Kevzara® sarilumab

Nucala® mepolizumab

Olumiant® baricitinib

Orencia® abatacept

Otezla® apremilast

Otrexup® methotrexate

Rasuvo® methotrexate

Remicade® infliximab

Renflexis® infliximab-abda

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Allergy/Asthma, Dermatology, Rinvoq® upadacitinib Gastroenterology, Rheumatology, Siliq® brodalumab

Simponi/Simponi Aria® golimumab

Skyrizi® risankizumab

Soriatane® acitretin

Stelara® ustekinumab

Talt z ® ixekizumab

Tremfya® guselkumab

Xeljanz/Xeljanz XR® tofacitinib

Xolair® omalizumab

Condition Brand Name Generic Name

Cystic Fibrosis Cayston® aztreonam

Pulmozyme® dornase alfa

Tobi/Tobi Podhaler® tobramycin

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Growth Hormone Genotropin® somatropin

Humatrope® somatropin

Norditropin® somatropin

Nutropin AQ NuSpin® somatropin

Omnitrope® somatropin

Saizen® somatropin

Zomacton® somatropin

Zorbtive® somatropin

Condition Brand Name Generic Name

Hepatitis C Epclusa® velpatasvir/sofosbuvir

Harvoni® ledipasvir/sofosbuvir

Mavyret® glecaprevir/pibrentasvir

Rebetol® ribavirin

dasabuvir/ombitasvir/ Viekira Pak® paritaprevir/ritonavir

Sofosbuvir/velpatasvir, Vosevi® voxilaprevir

Zepatier® elbasvir/grazoprevir

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Hematology/Oncology Aranesp®** darbapoetin alfa Supplemental Rx Arimidex®** anastrozole

Aromasin®** Exemestane

Epogen®** epoetin alfa

Exjade® deferasirox

Femara® letrozole

Fulphila® pegfilgrastim-jmdb

Granix® tbo-filgrastim

Hydrea®** hydroxyurea

Jadenu® deferasirox

Mesnex® mesna

Mozobil® plerixafor

Neulasta® pegfilgrastim

Neupogen® filgrastim

Nivestym® filgrastim-aafi

Nolvadex®** tamoxifen

Nplate® romiplostim

Procrit®** epoetin alfa

Promacta® eltrombopag olamine

Retacrit® epoetin alfa-epbx

Sandostatin/LAR® octreotide

Udenyca® pegfilgrastim-cbqv

Xgeva® denosumab

Zarxio® filgrastim-sndz

Ziextenzo® pegfilgrastim-bmez

Zirabvex® bevacizumab-bvzr

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Multiple Sclerosis Aubagio® teriflunomide

Avonex® interferon B-1a

Betaseron® interferon B-1b

Copaxone® glatiramer acetate

Ampyra® dalfampridine

Extavia® interferon B-1b

Gilenya® fingolimod

Glatopa® glatiramer acetate

Kesimpta® ofatumumab

Mayzent® siponimod

Plegridy® peginterferon B-1a

Rebif® iInterferon B-1a

Tecfidera® dimethyl fumarate

Vumerity® diroximel fumarate

Zeposia® ozanimod

Condition Brand Name Generic Name

Oncology/Hematology Afinitor® Everolimus

Alecensa®* alectinib

Alunbrig®* brigatinib

Ayvakit®* avapritinib

Balversa® erdafitinib

Bosulif®* bosutinib

Braftovi®* encorafenib

Brukinsa®* zanubrutinib

Cabometyx®* cabozantinib

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Oncology/Hematology Calquence®* acalabrutinib

Copiktra®* duvelisib

Cotellic®* cobimetinib

Cytoxan® cyclophosphamide

Daurismo®* glasdegib

Doptelet®* avatrombopag

Eligard® leuprolide

Erivedge®* vismodegib

Erleada*® apalutamide

Fulphila® pegfilgrastim-jmdb

Giotrif®* afatinib

Gleevec® imatinib

Gleostine® lomustine

Herzuma® trastuzumab-pkrb

Hycamtin® topotecan

Ibrance®* palbociclib

Imbruvica®* ibrutinib

Inlyta®* axitinib

Inqovi®* decitabine/cedazuridine

Inrebic® fedratinib

Iressa®* gefitinib

Jakafi®* ruxolitinib

Kanjinti® trastuzumab-anns

Kisqali® ribociclib

Koselugo®* selumetinib

Lenvima®* lenvatinib

Leukeran® Chlorambucil

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Oncology/Hematology Lonsurf®* trifluridine/tipiracil

Lorbrena®* lorlatinib

Lupron® leuprolide acetate

Lynparza®* olaparib

Mekinist® trametinib

Mozobil® plerixafor

Mvasi® bevacizumab-awwb

Nerlynx®* neratinib

Neulasta® Pegfilgrastim

Nexavar®* sorafenib

Nilandron® nilutamide

Ninlaro®* ixazomib

Nplate® romiplostim

Nubeqa®* darolutamide

Odomzo® sonidegib

Ogivri® trastuzumab-dkst

Ontruzant® trastuzumab-dttb

Onureg® azacitadine

Pegasys® Peginterferon A-2a

PEGIntron Redipen® Peginterferon A-2b

Piqray® alpelisib

Promacta® eltrombopag Olamine

Retevmo®* selpercatinib

Rozlytrek®* entrectinib

Rubraca®* rucaparib

Rydapt® midostaurin

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Oncology/Hematology Somatuline Depot® lanreotide

Sprycel® dasatinib

Stivarga®* regorafenib

Sutent®* sunitinib

Tabrecta® capmatinib

Tafinlar® Dabrafenib

Tagrisso®* osimertinib

Talzenna®* talazoparib

Tarceva® erlotinib

Targretin® Bexarotene

Targretin Gel® Bexarotene

Tasigna® nilotinib

Tazverik®* tazemetostat

Temodar® Temozolomide

Thyrogen® thyrotropin Alfa

Tibsovo®* ivosidenib

Trazimera® trastuzumab-qyyp

Truxima® rituximab-abbs

Tukysa®* tucatinib

Tykerb® Lapatinib

Venclexta®* venetoclax

Vepesid® etoposide

Verzenio®* abemaciclib

Vesanoid® tretinoin (oral)

Vitrakvi®* larotrectinib

Votrient® Pazopanib

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Oncology/Hematology Xalkori®* crizotinib

Xeloda® Capecitabine

Xgeva® Denosumab

Xospata®* gilteritinib

Xtandi®* enzalutamide

Yonsa® abiraterone

Zejula®* niraparib

Zelboraf®* vemurafenib

Zirabvex® bevacizumab-bvzr

Zolinza® vorinostat

Zometa® zoledronic Acid

Zydelig®* idelalisib

Zykadia® ceritinib

Zytiga®* abiraterone acetate

Condition Brand Name Generic Name

Osteoporosis Evenity® romosozumab

Forteo® teriparatide

Prolia® denosumab

Reclast® zoledronic Acid

Tymlos® abaloparatide

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Other Abilify Maintena® aripiprazole

Adcirca® tadalafil

Letairis® ambrisentan

Aristada® aripiprazole lauroxil

Austedo® deutetrabenazine

Beovu® brodlucizumab-dbll

Botox® onabotulinumtoxin A

Cuprimine® penicillamine

Depen® penicillamine

Dibenzyline® phenoxybenzamine

Durolane® hyaluronic acid

Dysport® abobotulinmutoxin A

Endari® glutamine

Enspryng®* satralizumab

Epidiolex® cannabidiol

Esbriet® pirfenidone

Euflexxa® hyaluronate sodium

Firazyr® icatibant acetate

Gel-One® hyaluronate sodium

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply

Other GelSyn-3® hyaluronate sodium

GenVisc 850® hyaluronate sodium

Hemlibra® emicizumab

Hyalgan® hyaluronate sodium

Hymovis® hyaluronan

Ingrezza®* valbenazine

Invega Sustenna® paliperidone palmitate

Krystexxa®* pegloticase

Leukine® sargramostim

leuprolide acetate and Lupaneta® norethindrone acetate

Makena® hydroxyprogesterone caproate

Monovisc® hyaluronic acid

Orthovisc® hyaluronic acid

Relistor® methylnaltrexone bromide

Supartz FX® hyaluronic acid

Synagis® palivizumab

Synvisc/Synvisc One® hylan polymers A and B

Syprine® trientine hydrochloride

Visco-3® hyaluronic acid

Vivitrol® naltrexone

Vyndaqel®* tafamidis meglumine

Xenazine® tetrabenazine

Zortress® everolimus

*Health Sytem Own Use **Support medications only dispensed with other specialty medications Access Limitations May Apply