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Effective DatePolicy NameReviewed Date
1/1/2022 Samsca® (tolvaptan)
2/18/2026
1/1/2025 Sancuso® (granisetron) transdermal patch
6/17/2026
1/1/2024 Sandostatin® S.C., Sandostatin LAR® Depot (octreotide acetate for injection)
2/18/2026
1/1/2025 Santyl (collagenase)
6/17/2026
11/1/2025 Saphnelo™ (anifrolumab-fnia)
5/20/2026
11/1/2025 Saphnelo™ (anifrolumab-fnia)
5/20/2026
5/27/2026 Saphnelo™ (anifrolumab-fnia)
5/20/2026
12/15/2021 Saphnelo™ (anifrolumab-fnia)
5/20/2026
1/1/2025 Saphris® (asenapine)
4/15/2026
12/1/2025 Sarclisa (isatuximab-irfc)
5/20/2026
12/1/2025 Sarclisa (isatuximab-irfc)
5/20/2026
12/1/2025 Sarclisa (isatuximab-irfc)
5/20/2026
1/1/2026 Savaysa® (edoxaban)
4/15/2026
1/1/2025 Savella® (milnacipran)
12/10/2025
12/15/2021 Scemblix® (asciminib)
4/15/2026
6/17/2020 Scenesse® (afamelanotide)
11/19/2025
1/1/2025 Secuado® (asenapine) Transdermal System
4/15/2026
1/1/2025 Seglentis® (celecoxib-tramadol)
3/18/2026
9/24/2025 Sephience™ (sepiapterin)
9/17/2025
1/1/2026 Seroquel XR® (quetiapine fumarate) extended release tablets
3/18/2026
1/1/2020 Serostim® (somatropin)
1/21/2026
1/1/2026 SGLT2 Inhibitors
5/20/2026
2/20/2019 Short Acting Beta Agonists
5/20/2026
3/21/2013 Signifor® (pasireotide)
2/18/2026
1/1/2024 Signifor® LAR (pasireotide)
2/18/2026
11/1/2025 Signifor® LAR (pasireotide)
2/18/2026
1/1/2026 Siklos (hydroxyurea) tablet
6/18/2025
1/1/2026 Siklos (hydroxyurea) tablet
3/18/2026
1/1/2026 Siliq (brodalumab) injection
5/20/2026
1/1/2026 Simponi (golimumab)
7/15/2026
1/1/2019 Simponi ARIA (golimumab)
7/15/2026
3/21/2018 Sinuva® (mometasone furoate) sinus implant
6/17/2026
12/1/2025 Sinuva® (mometasone furoate) sinus implant
6/17/2026
12/1/2025 Sinuva® (mometasone furoate) sinus implant
6/17/2026
5/2/2013 Sirturo® (bedaquiline)
9/17/2025
6/28/2023 Skyclarys™ (omaveloxolone)
3/18/2026
1/1/2022 Skyrizi® (risankizumab-rzaa)
7/15/2026
7/7/2019 Smart Maintenance Dose
9/17/2025
4/20/2022 Soaanz® (torsemide)
1/21/2026
1/28/2026 Sofdra (sofpironium)
1/21/2026
1/24/2024 Sohonos® (palovarotene)
11/19/2025
1/1/2025 Soliris® (eculizumab) and biosimilars
5/20/2026
8/1/2026 Soliris® (eculizumab) and biosimilars
5/20/2026
2/21/2018 Solosec® (secnidazole)
4/15/2026
1/1/2026 Somavert® (pegvisomant)
4/15/2026
1/1/2026 Sotyktu (deucravacitinib)
5/20/2026
1/1/2026 Sovaldi® (sofosbuvir)
6/17/2026
7/24/2024 Spevigo (spesolimab-sbzo) subcutaneous syringe
2/18/2026
11/23/2022 Spevigo® (spesolimab-sbzo) intravenous solution
2/18/2026
1/1/2024 Spinraza® (nusinersen)
1/21/2026
3/1/2026 Spinraza® (nusinersen)
1/21/2026
1/1/2020 Spritam® (levetiracetam)
10/15/2025
1/1/2026 Sprix (ketorolac tromethamine) nasal spray
4/15/2026
1/1/2022 Statin Products
11/19/2025
1/1/2026 Stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor)
4/15/2026
1/1/2026 Stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor)
4/15/2026
1/1/2026 Stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor)
4/15/2026
7/1/2026 Stem cell mobilizing agents (Mozobil, Aphexda, Plerixafor)
4/15/2026
1/1/2026 Stivarga (regorafenib)
3/18/2026
1/1/2025 Strensiq® (asfotase alfa)
3/18/2026
1/1/2026 Sublingual Allergen Extract
5/20/2026
1/1/2025 Sucraid® (sacrosidase)
5/20/2026
1/1/2025 Sunosi® (solriamfetol)
4/15/2026
7/23/2025 Sustol® granisetron
6/17/2026
1/1/2024 Susvimo® (ranibizumab)
3/18/2026
1/1/2025 Susvimo® (ranibizumab)
3/18/2026
8/1/2025 Susvimo® (ranibizumab)
3/18/2026
11/1/2025 Susvimo® (ranibizumab)
3/18/2026
1/1/2026 Sutent (sunitinib)
7/15/2026
5/24/2023 Syfovre® (pegcetacoplan) intravitreal solution
12/10/2025
2/1/2026 Syfovre® (pegcetacoplan) intravitreal solution
12/10/2025
2/1/2026 Syfovre® (pegcetacoplan) intravitreal solution
12/10/2025
6/12/2014 Sylvant® (siltuximab)
11/19/2025
1/1/2026 Sylvant® (siltuximab)
11/19/2025
1/1/2026 Sylvant® (siltuximab)
11/19/2025
1/1/2026 Sylvant® (siltuximab)
11/19/2025
1/1/2025 Sympazan® (clobazam oral film)
5/20/2026
1/1/2024 Symproic® (naldemedine)
1/21/2026
1/1/2022 Synagis® (palivizumab)
2/18/2026
7/1/2024 Synagis® (palivizumab)
2/18/2026
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