January 2022
Updated Quarterly
Specialty Pharmacy Drug List
Providing one of the broadest offerings of specialty pharmaceuticals in
the industry
The Specialty Pharmacy Drug List is a guide of medications available and distributed through CVS Specialty®. Our goal is to help
make your life better. With more than 40 years of experience, CVS Specialty provides quality care and service. Our network of
pharmacies includes certifications and accreditations from the Joint Commission, Utilization Review Accreditation Commission
(URAC), the National Association of Boards of Pharmacy (NABP) and the Accreditation Commission for Health Care (ACHC). These
nationally recognized symbols reflect an organization’s commitment to meet highest standards of quality, compliance and safety.
This list is updated quarterly. Below brand-name products are in CAPS, and generic products are shown in lowercase italics.
Prospective Patients: Ready to get started? Enroll to get your medications from CVS Specialty.
Health Care Providers: Visit the CVS Specialty website to download enrollment forms or call 1-800-237-2767 (TTY: 711).
ACROMEGALY
BYNFEZIA PEN
octreotide acetate
(SANDOSTATIN)
SANDOSTATIN LAR
SOMATULINE DEPOT
SOMAVERT
ALPHA-1 ANTITRYPSIN
DEFICIENCY
ARALAST NP
GLASSIA
ZEMAIRA
AMYLOIDOSIS
VYNDAMAX
VYNDAQEL
ANEMIA
ARANESP
EPOGEN
PROCRIT
REBLOZYL
RETACRIT
ASTHMA
CINQAIR
DUPIXENT
FASENRA
NUCALA
XOLAIR
ATOPIC DERMATITIS
DUPIXENT
BONE DISORDERS - OTHER
VOXZOGO
CARDIAC DISORDERS
ARCALYST
GOUT
KRYSTEXXA
COAGULATION
DISORDERS
CEPROTIN
GROWTH HORMONE &
RELATED DISORDERS
EGRIFTA
EGRIFTA SV
GENOTROPIN
HUMATROPE
INCRELEX
NORDITROPIN
NUTROPIN AQ
OMNITROPE
SAIZEN
SEROSTIM
SKYTROFA
ZOMACTON
ZORBTIVE
CRYOPYRIN-ASSOCIATED
PERIODIC SYNDROMES
ARCALYST
ILARIS
CYSTIC FIBROSIS
BRONCHITOL
CAYSTON
KITABIS PAK
PULMOZYME
TOBI PODHALER
tobramycin (BETHKIS)
tobramycin nebulizer (TOBI)
ELECTROLYTE DISORDERS
tolvaptan (SAMSCA)
ENDOCRINE DISORDERS OTHER
CORTROPHIN
ENZYME DEFICIENCY
DISORDERS – OTHER
nitisinone
GASTROINTESTINAL
DISORDERS - OTHER
GATTEX
OCALIVA
SOLESTA
HEMATOPOIETICS
MOZOBIL
HEMOPHILIA,
VON WILLEBRAND
DISEASE & RELATED
BLEEDING DISORDERS
ADVATE
ADYNOVATE
AFSTYLA
ALPHANATE
ALPHANINE SD
ALPROLIX
BENEFIX
COAGADEX
CORIFACT
ELOCTATE
ESPEROCT
FEIBA
FIBRYGA
HEMLIBRA
HEMOFIL M
HUMATE-P
IDELVION
IXINITY
JIVI
KOATE
KOATE-DVI
KOGENATE FS
KOVALTRY
MONONINE
NOVOEIGHT
NOVOSEVEN RT
NUWIQ
OBIZUR
PROFILNINE
PROFILNINE SD
REBINYN
RECOMBINATE
RIASTAP
RIXUBIS
SEVENFACT
STIMATE
TRETTEN
VONVENDI
WILATE
XYNTHA
HEPATITIS C
EPCLUSA
HARVONI
LEDIPASVIR-SOFOSBUVIR
MAVYRET
PEGASYS
PEGINTRON
Specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, may change from time to time. In
addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of their appearance on this document. Call CVS Specialty
at 1-800-237-2767 (TTY: 711) for specific medications available through CVS Specialty. Listing is subject to change. This document contains references to brandname prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445;
e-Prescribe: CVS Specialty Pharmacy.
©2021 CVS Specialty. All rights reserved. 75-CTC14953A January 2022 v12152021 Specialty Pharmacy Drug List
Page 1 of 4
January 2022
Updated Quarterly
ribavirin caps
ribavirin tabs
SOFOSBUVIR-VELPATASVIR
SOVALDI
VIEKIRA PAK
VOSEVI
ZEPATIER
HEREDITARY
ANGIOEDEMA
BERINERT
CINRYZE
HAEGARDA
icatibant acetate (FIRAZYR)
KALBITOR
RUCONEST
TAKHZYRO
HORMONAL THERAPIES
AVEED
ELIGARD
FENSOLVI
FIRMAGON
leuprolide acetate (LUPRON)
LUPRON DEPOT
NATPARA
SUPPRELIN LA
TRELSTAR
ZOLADEX
IMMUNE DEFICIENCIES &
RELATED DISORDERS
ASCENIV
BIVIGAM
CUTAQUIG
CUVITRU
CYTOGAM
FLEBOGAMMA DIF
GAMASTAN
GAMASTAN S/D
GAMMAGARD LIQUID
GAMMAGARD S/D
GAMMAKED
GAMMAPLEX
GAMUNEX C
HEPAGAM B
HIZENTRA
HYPERHEP B S/D
HYPERRHO S/D
HYQVIA
MICRHOGAM
NABI-HB
OCTAGAM
PANZYGA
PRIVIGEN
RHOGAM
RHOPHYLAC
VARIZIG
WINRHO SDF
XEMBIFY
INFECTIOUS DISEASE –
OTHER
ACTIMMUNE
ALFERON N
INFERTILITY
CETROTIDE
CHORIONIC GONADOTROPIN
FOLLISTIM AQ
GANIRELIX ACETATE
GONAL-F
MENOPUR
NOVAREL
OVIDREL
PREGNYL
INFLAMMATORY
BOWEL DISEASE
AVSOLA
CIMZIA
ENTYVIO
HUMIRA
INFLECTRA
INFLIXIMAB
REMICADE
RENFLEXIS
SIMPONI ARIA
STELARA IV
TYSABRI
XELJANZ
ZEPOSIA
IRON OVERLOAD
deferasirox (EXJADE,
JADENU)
deferiprone
deferoxamine (DESFERAL)
LYSOSOMAL STORAGE
DISORDERS
ALDURAZYME
CERDELGA
CEREZYME
CYSTAGON
ELAPRASE
ELELYSO
FABRAZYME
KANUMA
LUMIZYME
miglustat
NAGLAZYME
NEXVIAZYME
VIMIZIM
VPRIV
MENTAL HEALTH
CONDITIONS
ZULRESSO
MOVEMENT DISORDERS
APOKYN
AUSTEDO
droxidopa (NORTHERA)
DUOPA
INGREZZA
KYNMOBI
NUPLAZID
RADICAVA
SOLIRIS
tetrabenazine (XENAZINE)
MULTIPLE SCLEROSIS
AUBAGIO
AVONEX
BAFIERTAM
BETASERON
CORTROPHIN
dalfampridine ER (AMPYRA)
dimethyl fumarate
(TECFIDERA)
EXTAVIA
GILENYA
glatiramer acetate
(COPAXONE, glatopa)
KESIMPTA
LEMTRADA
MAVENCLAD
MAYZENT
mitoxantrone hcl
OCREVUS
PLEGRIDY
PONVORY
REBIF
TYSABRI
VUMERITY
ZEPOSIA
NEUROLOGICAL DISORDERS
ADUHELM
NEUROMUSCULAR
VYVGART
NEUTROPENIA
FULPHILA
GRANIX
LEUKINE
NEULASTA
NEUPOGEN
NIVESTYM
NYVEPRIA
UDENYCA
ZARXIO
ZIEXTENZO
OCULAR DISORDERS
BEOVU
EYLEA
ILUVIEN
LUCENTIS
MACUGEN
OZURDEX
RETISERT
SUSVIMO
TEPEZZA
VISUDYNE
ONCOLOGY – INJECTABLE
ABRAXANE
ADCETRIS
ARZERRA
ASPARLAS
AVASTIN
azacitidine (VIDAZA)
BAVENCIO
BELEODAQ
BELRAPZO
BENDAMUSTINE
HYDROCHLORIDE
BENDEKA
BESPONSA
BLINCYTO
BORTEZOMIB
CYRAMZA
DARZALEX
DARZALEX FASPRO
decitabine (DACOGEN)
EMPLICITI
ENHERTU
ERBITUX
ERWINAZE
EVOMELA
FOLOTYN
GAZYVA
HALAVEN
HERCEPTIN
HERCEPTIN HYLECTA
HERZUMA
IMFINZI
INTRON A
ISTODAX
IXEMPRA
JEMPERLI
JEVTANA
Specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, may change from time to time. In
addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of their appearance on this document. Call CVS Specialty
at 1-800-237-2767 (TTY: 711) for specific medications available through CVS Specialty. Listing is subject to change. This document contains references to brandname prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445;
e-Prescribe: CVS Specialty Pharmacy.
©2021 CVS Specialty. All rights reserved. 75-CTC14953A January 2022 v12152021 Specialty Pharmacy Drug List
Page 2 of 4
January 2022
Updated Quarterly
KADCYLA
KANJINTI
KEYTRUDA
KHAPZORY
KYPROLIS
levoleucovorin calcium
LUMOXITI
MARGENZA
mitoxantrone hcl
MVASI
MYLOTARG
OGIVRI
ONCASPAR
ONTRUZANT
OPDIVO
PADCEV
PERJETA
PHESGO
POLIVY
PORTRAZZA
POTELIGEO
PROLEUKIN
RIABNI
RITUXAN
RITUXAN HYCELA
ROMIDEPSIN
RUXIENCE
RYBREVANT
SARCLISA
SYLVANT
SYNRIBO
TECENTRIQ
TEMODAR
temsirolimus (TORISEL)
TEPADINA
THYROGEN
TIVDAK
TRAZIMERA
TREANDA
TRUXIMA
valrubicin (VALSTAR)
VECTIBIX
VELCADE
VYXEOS
XGEVA
YERVOY
YONDELIS
ZALTRAP
ZEPZELCA
ZIRABEV
zoledronic acid
ONCOLOGY –
ORAL/TOPICAL
abiraterone acetate (ZYTIGA)
ALECENSA
bexarotene (TARGRETIN)
BOSULIF
BRAFTOVI
CABOMETYX
capecitabine (XELODA)
COMETRIQ
COTELLIC
DAURISMO
ERIVEDGE
ERLEADA
erlotinib hydrochloride
everolimus (AFINITOR)
FARYDAK
GAVRETO
HYCAMTIN
IBRANCE
IDHIFA
imatinib mesylate (GLEEVEC)
INLYTA
INQOVI
INREBIC
IRESSA
JAKAFI
KISQALI
KISQALI FEMARA
lapatinib ditosylate (TYKERB)
LENVIMA
LONSURF
LORBRENA
LUMAKRAS
LYNPARZA
MEKINIST
MEKTOVI
NERLYNX
NEXAVAR
NINLARO
NUBEQA
ODOMZO
ONUREG
PIQRAY
POMALYST
PURIXAN
RETEVMO
REVLIMID
ROZLYTREK
RUBRACA
RYDAPT
SCEMBLIX
SPRYCEL
STIVARGA
sunitinib malate (SUTENT)
TABRECTA
TAFINLAR
TAGRISSO
TALZENNA
TASIGNA
temozolomide (TEMODAR)
THALOMID
VERZENIO
VITRAKVI
VIZIMPRO
VOTRIENT
XALKORI
XTANDI
YONSA
ZEJULA
ZELBORAF
ZOLINZA
ZYDELIG
ZYKADIA
OSTEOPOROSIS
EVENITY
FORTEO
PROLIA
TERIPARATIDE
TYMLOS
zoledronic acid (RECLAST)
PAROXYSMAL
NOCTURNAL
HEMOGLOBINURIA
SOLIRIS
ULTOMIRIS
PHENYLKETONURIA
PALYNZIQ
sapropterin dihydrochloride
(KUVAN)
PRE-TERM BIRTH
hydroxyprogesterone capro
(MAKENA)
PSORIASIS
AVSOLA
CIMZIA
COSENTYX
ENBREL
HUMIRA
ILUMYA
INFLECTRA
INFLIXIMAB
OTEZLA
OTREXUP
RASUVO
REMICADE
RENFLEXIS
SILIQ
SKYRIZI
STELARA
TALTZ
TREMFYA
XELJANZ
PULMONARY ARTERIAL
HYPERTENSION
ADEMPAS
ambrisentan (LETAIRIS)
bosentan (TRACLEER)
epoprostenol sodium
(FLOLAN, VELETRI)
OPSUMIT
ORENITRAM
sildenafil citrate (REVATIO)
tadalafil (ADCIRCA, alyq)
treprostinil sodium
(REMODULIN)
TYVASO
UPTRAVI
VENTAVIS
PULMONARY DISORDERS –
OTHER
ESBRIET
OFEV
RARE DISORDERS – OTHER
CRYSVITA
DOJOLVI
ENSPRYNG
UPLIZNA
RENAL DISEASE
cinacalcet hydrochloride
(SENSIPAR)
PARSABIV
tiopronin
RESPIRATORY SYNCYTIAL
VIRUS
SYNAGIS
RHEUMATOID ARTHRITIS
ACTEMRA
AVSOLA
CIMZIA
ENBREL
HUMIRA
INFLECTRA
INFLIXIMAB
KEZVARA
OLUMIANT
ORENCIA
OTREXUP
RASUVO
REMICADE
RENFLEXIS
RIABNI
RINVOQ
RITUXAN
Specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, may change from time to time. In
addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of their appearance on this document. Call CVS Specialty
at 1-800-237-2767 (TTY: 711) for specific medications available through CVS Specialty. Listing is subject to change. This document contains references to brandname prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445;
e-Prescribe: CVS Specialty Pharmacy.
©2021 CVS Specialty. All rights reserved. 75-CTC14953A January 2022 v12152021 Specialty Pharmacy Drug List
Page 3 of 4
January 2022
Updated Quarterly
RUXIENCE
SIMPONI
SIMPONI ARIA
XELJANZ
SEIZURE DISORDERS
ACTHAR
EPIDIOLEX
vigabatrin pwd (SABRIL PWD)
vigabatrin tabs (SABRIL TABS)
SICKLE CELL DISEASE
ADAKVEO
OXBRYTA
SLEEP DISORDERS
WAKIX
SYSTEMIC LUPUS
ERYTHEMATOSUS
BENLYSTA
MARGENZA
THROMBOCYTOPENIA
DOPTELET
MULPLETA
NPLATE
PROMACTA
UREA CYCLE DISORDERS
RAVICTI
sodium phenylbutyrate
(BUPHENYL)
WILSON’S DISEASE
penicillamine (CUPRIMINE,
DEPEN TITRA)
trientine (CLOVIQUE,
SYPRINE)
Specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, may change from time to time. In
addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of their appearance on this document. Call CVS Specialty
at 1-800-237-2767 (TTY: 711) for specific medications available through CVS Specialty. Listing is subject to change. This document contains references to brandname prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445;
e-Prescribe: CVS Specialty Pharmacy.
©2021 CVS Specialty. All rights reserved. 75-CTC14953A January 2022 v12152021 Specialty Pharmacy Drug List
Page 4 of 4