1. No category

SPECIALTY PHARMACY
DRUG LIST
Specialty medications are used to treat complex conditions like multiple sclerosis, hepatitis C and rheumatoid
arthritis. The following is a list of specialty medications. Those medications marked with an asterisk must be
obtained through Ascension’s in-house pharmacy or Cigna Specialty Pharmacy Services for it to be covered.
Please note, this list is subject to change.
A
Abacavir*
Abacavir-LamivudineZidov*
Actemra*
Actimmune*
Adcirca*
Adefovir Dipivoxil*
Adempas
Afinitor Disperz*
Afinitor*
Agrylin*
Amicar*
Aminocaproic Acid*
Ampyra*
Anagrelide HCl*
Anzemet
Apokyn*
Aptivus*
Arcalyst
Astagraf XL*
Atripla*
Aubagio*
Avonex*
Avonex Administration
Pack*
Avonex Pen*
Azasan*
Azathioprine*
B
Baraclude*
Betaseron*
Bicalutamide*
Bosulif*
C
Capecitabine*
Caprelsa
Casodex*
Cayston
Cellcept (oral)*
Cimzia*
Combivir*
Cometriq
Complera*
Copaxone*
Copegus*
Crixivan*
Cyclophosphamide (oral)*
Cyclosporine (oral)*
Cyclosporine Modified*
Cystadane
Cystagon
Cytoxan (oral)*
D
Didanosine*
E
Edurant*
Egrifta*
Emcyt*
Emtriva*
Enbrel*
Epivir HBV*
Epivir*
Epzicom*
Erivedge*
Exjade
Extavia*
F
Firazyr*
Flutamide*
Fuzeon*
G
Gattex
Gengraf*
Genotropin*
Gilenya*
Gilotrif
Gleevec*
H
Harvoni*
Hecoria*
Hepsera*
Hexalen*
Humatrope*
Humira*
Hycamtin*
Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company or their affiliates.
879677 b 02/15
Drug Name
I
Iclusig
Imbruvica
Imuran*
Incivek*
Increlex
Infergen*
Inlyta*
Intelence*
Invirase*
Iressa
Isentress*
J
Jakafi
Juxtapid
K
Kaletra*
Kalydeco*
Kineret*
Kynamro
L
Lamivudine*
Lamivudine-Zidovudine*
Letairis*
Leucovorin Calcium (oral)*
Lexiva*
M
Matulane
Mekinist*
Mesnex
Methotrexate (injectable)
Methotrexate (oral)*
Methotrexate Sodium
Moderiba*
Myalept
Mycophenolate*
Myfortic*
N
Neoral*
Nevirapine*
Nevirapine ER*
Nexavar*
Norditropin*
Norditropin Flexpro*
Norditropin Nordiflex*
Norvir*
Nutropin*
Nutropin AQ*
Nutropin AQ Nuspin*
Rheumatrex
Ribapak*
Ribasphere*
Ribatab*
Ribavirin*
Rilutek*
Riluzole*
O
Sabril
Saizen*
Sandimmune (oral)*
Selzentry*
Sensipar
Serostim*
Signifor
Sildenafil*
Simponi*
Simponi Aria*
Sirolimus*
Somavert
Sovaldi*
Sprycel*
Stavudine*
Stelara*
Stivarga*
Stribild*
Sucraid
Sustiva*
Sutent*
Sylatron*
S
Oforta*
Olysio*
Omnitrope*
Opsumit
Orencia*
Orenitram ER
Orfadin
Otezla*
P
Paricalcitol*
Pegasys*
Pegasys Proclick*
PegIntron*
PegIntron Redipen*
Pomalyst*
Prezista*
Procysbi DR
Prograf (oral)*
Promacta*
Pulmozyme*
Purixan
T
R
Tacrolimus*
Tafinlar*
Tarceva*
Targretin*
Tasigna*
Tecfidera*
Temodar (oral)*
Temozolomide*
Tev-Tropin*
Thalomid*
Rapamune*
Rebetol*
Rebif*
Rebif Rebidose*
Rescriptor
Retrovir (oral)*
Revatio*
Revlimid*
Reyataz*
Tivicay*
Tobi Podhaler*
Tracleer*
Trexall*
Trizivir*
Truvada*
Tykerb*
Tyzeka*
V
Vandetanib
Ventavis
Victrelis*
Videx EC*
Videx*
Viekira Pak*
Viracept*
Viramune*
Viramune XR*
Virazole*
Viread*
Votrient*
X
Xalkori*
Xeljanz*
Xeloda*
Xenazine
Xolair*
Xtandi*
Xyrem
Z
Zavesca
Zelboraf*
Zemplar (oral)*
Zerit*
Ziagen*
Zidovudine*
Zolinza
Zorbtive
Zortress*
Zykadia*
Zytiga*
“Cigna” and the “Tree of Life” logo are registered service marks and “Together, all the way.” is a service mark, “Cigna Home Delivery Pharmacy,”“Cigna Specialty Pharmacy Management,” and “Cigna
Specialty Pharmacy Services” are service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by
or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company,
Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C., and HMO or service company subsidiaries of Cigna Health Corporation. “Cigna Specialty Pharmacy Services” refers to the specialty drug division
of Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C., doing business as Cigna Home Delivery Pharmacy.
879677 b 02/15 © 2015 Cigna. Some content provided under license.
2