Blood Formation Modifiers

Showing all 7 results

NAME	ALSO KNOW AS	DRUG CATEGORY	FORMULARY CATEGORY	WHAT WE COVER	COST SHARE
C1 Esterase Inhibitor (Human) Kit 500 Unit (Generic)	Berinert Kit 500 Unit (Brand)	Blood Formation Modifiers	MA	Administered in Medical Office	N/A
C1 Esterase Inhibitor (Human) Solr 500 Unit (Generic)	Cinryze Solr 500 Unit (Brand)	Blood Formation Modifiers	MA	Administered in Medical Office	N/A
C1 Esterase Inhibitor (Recombinant) Solr 2100 Unit (Generic)	Ruconest Solr 2100 Unit (Brand)	Blood Formation Modifiers	MA	Administered in Medical Office	N/A
Crizanlizumab-Tmca Soln 100Mg/10Ml (Generic)	Adakveo Soln 100 Mg/10Ml (Brand)	Blood Formation Modifiers	MA	Administered in Medical Office	N/A
Firazyr Soln 30 Mg/3Ml (Brand)	Icatibant Acetate Soln 30Mg/3Ml (Generic)	Blood Formation Modifiers	3	Non-Formulary Brand	$68
Icatibant Acetate Soln 30Mg/3Ml (Generic)	Firazyr Soln 30 Mg/3Ml (Brand)	Blood Formation Modifiers	1	Generic	$14
Oxbryta Tabs 500 Mg (Brand)	Voxelotor Tabs 500Mg (Generic)	Blood Formation Modifiers	3	Non-Formulary Brand	$68