| Medical Mutual | Givlaari ® (givosiran) | 2026-01-15 |
| Medical Mutual | Prior approval is required for some or all procedure codes listed in this Corporate Drug Policy. | 2026-01-15 |
| Medical Mutual | Imcivree (setmelanotide) | 2026-01-15 |
| Medical Mutual | Kineret (anakinra) subcutaneous injection | 2026-01-15 |
| Medical Mutual | Luxturna ® (Voretigene Neparvovec-rzyl) | 2026-01-15 |
| Medical Mutual | Omvoh ® (mirikizumab-mrkz injection for | 2026-01-15 |
| Medical Mutual | Omvoh ® (mirikizumab-mrkz injection for | 2026-01-15 |
| Medical Mutual | Onapgo™ (apomorphine subcutaneous injection – Supernus) | 2026-01-15 |
| Medical Mutual | Trogarzo ® (ibalizumab-uiyk) | 2026-01-15 |
| Medical Mutual | Zolgensma (onasemnogene abeparvovec-xioi) | 2026-01-15 |