CVS Specialty® Pharmacy Distribution Drug List

April 2024

Updated Quarterly

CVS Specialty? Pharmacy Distribution Drug List

Providing one of the broadest offerings of specialty pharmaceuticals in the industry

The CVS Specialty Pharmacy Distribution 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).

Therapy Class

Acromegaly

Alcohol/Opioid Dependency

Allergen Immunotherapy

Alopecia Areata

Alpha-1 Antitrypsin Deficiency

Amyloidosis

Anemia

Asthma

Brand Name

LANREOTIDE

SANDOSTATIN

SANDOSTATIN LAR

SOMATULINE DEPOT

SOMAVERT

BRIXADI

SUBLOCADE

VIVITROL

ORALAIR

XOLAIR

LITFULO

OLUMIANT

ARALAST NP

GLASSIA

ZEMAIRA

AMVUTTRA

ONPATTRO

VYNDAMAX

VYNDAQEL

ARANESP

ENJAYMO

EPOGEN

PROCRIT

REBLOZYL

RETACRIT

ZYNTEGLO

CINQAIR

DUPIXENT

FASENRA

NUCALA

TEZSPIRE

XOLAIR

Generic Name

octreotide acetate (SANDOSTATIN)

*Indicates Limited Distribution drug distributed only by Coram? CVS Specialty Infusion Services.

?Drug Not Stocked

Specialty and non-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 brand-name 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.

?2024 CVS Specialty. All rights reserved. 75-CTC14953E April 2024 v05012024 CVS Specialty Pharmacy Distribution Drug List

Page 1 of 19

April 2024

Updated Quarterly

Therapy Class

Atopic Dermatitis

Bone Disorders ¨C Other

Botulinum Toxins

Cardiac Disorders

Coagulation Disorders

Contraceptives

Cryopyrin-Associated Periodic

Syndromes

Cushing¡¯s

Cystic Fibrosis

Dermatological Disorders ¨C Other

Dupuytren¡¯s Contracture

Electrolyte Disorders

Endocrine Disorders ¨C Other

Brand Name

ADBRY

CIBINQO

DUPIXENT

RINVOQ

SOHONOS

VOXZOGO

DYSPORT

MYOBLOC

XEOMIN

ARCALYST

CAMZYOS

TIKOSYN

CEPROTIN

KYLEENA

LILETTA

MIRENA

NEXPLANON

SKYLA

ARCALYST

ILARIS

BETHKIS

BRONCHITOL

CAYSTON

KITABIS PAK

PULMOZYME

TOBI

TOBI PODHALER

VYJUVEK

XIAFLEX

SAMSCA

Gout

Growth Hormone & Related Disorders

(Continued on next page)

dofetilide (TIKOSYN)

mifepristone

tobramycin (BETHKIS)

tobramycin nebulizer (TOBI)

dichlorphenamide

tolvaptan (SAMSCA)

ACTHAR

CORTROPHIN

Enzyme Deficiency Disorders ¨C Other

Gastrointestinal Disorders ¨C Other

Generic Name

betaine anhydrous

nitisinone

DUPIXENT

GATTEX

MYTESI

OCALIVA

REZDIFFRA

SOLESTA

ILARIS

KRYSTEXXA

EGRIFTA SV

GENOTROPIN

HUMATROPE

INCRELEX

NGENLA

*Indicates Limited Distribution drug distributed only by Coram? CVS Specialty Infusion Services.

?Drug Not Stocked

Specialty and non-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 brand-name 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.

?2024 CVS Specialty. All rights reserved. 75-CTC14953E April 2024 v05012024 CVS Specialty Pharmacy Distribution Drug List

Page 2 of 19

April 2024

Updated Quarterly

Therapy Class

Growth Hormone & Related Disorders

(continued)

Hematopoietics

Hemophilia, Von Willebrand Disease

& Related Bleeding Disorders

(Continued on next page)

Brand Name

NORDITROPIN

NUTROPIN AQ

OMNITROPE

SAIZEN

SEROSTIM

SKYTROFA

SOGROYA

ZOMACTON

MOZOBIL

ADVATE

ADYNOVATE

AFSTYLA

ALPHANATE

ALPHANINE SD

ALPROLIX

ALTUVIIIO

BENEFIX

COAGADEX

CORIFACT

ELOCTATE

ESPEROCT

FEIBA

FIBRYGA

HEMGENIX

HEMLIBRA

HEMOFIL M

HUMATE-P

IDELVION

IXINITY

JIVI

KOATE

KOATE-DVI

KOGENATE FS

KOVALTRY

NOVOEIGHT

NOVOSEVEN RT

NUWIQ

OBIZUR

PROFILNINE

PROFILNINE SD

REBINYN

RECOMBINATE

RIASTAP

RIXUBIS

ROCTAVIAN

SEVENFACT

TRETTEN

VONVENDI

WILATE

Generic Name

plerixafor (MOZOBIL)

*Indicates Limited Distribution drug distributed only by Coram? CVS Specialty Infusion Services.

?Drug Not Stocked

Specialty and non-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 brand-name 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.

?2024 CVS Specialty. All rights reserved. 75-CTC14953E April 2024 v05012024 CVS Specialty Pharmacy Distribution Drug List

Page 3 of 19

April 2024

Updated Quarterly

Therapy Class

Hemophilia, Von Willebrand Disease

& Related Bleeding Disorders

(continued)

Hepatitis

Hereditary Angioedema

Hormonal Therapies

Human Immunodeficiency Virus

(Continued on next page)

Brand Name

Generic Name

XYNTHA

BARACLUDE

EPCLUSA

EPIVIR HBV

HARVONI

LEDIPASVIR-SOFOSBUVIR

MAVYRET

PEGASYS

PEGINTRON

SOFOSBUVIR/VELPATASVIR

SOVALDI

VEMLIDY

VIEKIRA PAK

VIREAD

VOSEVI

ZEPATIER

BERINERT

CINRYZE

FIRAZYR

HAEGARDA

KALBITOR

RUCONEST

TAKHZYRO

AVEED

ELIGARD

FENSOLVI

FIRMAGON

LUPRON

LUPRON DEPOT

SUPPRELIN LA

TRELSTAR

ZOLADEX

APRETUDE

APTIVUS

BIKTARVY

CABENUVA

CIMDUO

COMPLERA

DELSTRIGO

DESCOVY

DOVATO

EDURANT

EMTRIVA

EPIVIR

EVOTAZ

FUZEON

GENVOYA

adefovir dipivoxil

entecavir (BARACLUDE)

lamivudine hbv (EPIVIR HBV)

ribavirin caps

ribavirin tabs

tenofovir disoproxil fumarate (VIREAD)

icatibant acetate (FIRAZYR)

leuprolide acetate (LUPRON)

abacavir tab (ZIAGEN)

abacavir-lamivudine

atazanavir sulfate (REYATAZ)

darunavir (PREZISTA)

efavirenz (SUSTIVA)

efavirenz-emtricitabine-tenofovir df

efavirenz-lamivudine-tenofovir df

(SYMFI, SYMFI LO)

emtricitabine (EMTRIVA)

emtricitabine-tenofovir df

(TRUVADA)

etravirine (INTELENCE)

fosamprenavir

lamivudine (EPIVIR)

lamivudine-zidovudine

*Indicates Limited Distribution drug distributed only by Coram? CVS Specialty Infusion Services.

?Drug Not Stocked

Specialty and non-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 brand-name 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.

?2024 CVS Specialty. All rights reserved. 75-CTC14953E April 2024 v05012024 CVS Specialty Pharmacy Distribution Drug List

Page 4 of 19

April 2024

Updated Quarterly

Therapy Class

Human Immunodeficiency Virus

(continued)

Immune Deficiencies & Related

Disorders

(Continued on next page)

Brand Name

INTELENCE

ISENTRESS

JULUCA

KALETRA

NORVIR

ODEFSEY

PIFELTRO

PREZCOBIX

PREZISTA

RETROVIR

RETROVIR IV

REYATAZ

RUKOBIA

SELZENTRY

STRIBILD

SUNLENCA

SUSTIVA

SYMFI

SYMFI LO

SYMTUZA

TIVICAY

TRIUMEQ

TROGARZO

TRUVADA

TYBOST

VIRACEPT

VIREAD

ZIAGEN

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

Generic Name

lopinavir-ritonavir (KALETRA)

maraviroc (SELZENTRY)

nevirapine

ritonavir (NORVIR)

stavudine

tenofovir disoproxil fumarate (VIREAD)

zidovudine (RETROVIR)

*Indicates Limited Distribution drug distributed only by Coram? CVS Specialty Infusion Services.

?Drug Not Stocked

Specialty and non-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 brand-name 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.

?2024 CVS Specialty. All rights reserved. 75-CTC14953E April 2024 v05012024 CVS Specialty Pharmacy Distribution Drug List

Page 5 of 19

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