Lilly

Wholesale Acquisition Cost (WAC)
Information for Colorado Prescribers

Provided Pursuant to Colorado House Bill 19-1131



Marketed Prescription Drug Colorado WAC Disclosure Form
Alimta® (pemetrexed for injection) WAC Disclosure Sheet
Amyvid™ (Florbetapir F18 injection) WAC Disclosure Sheet
Baqsimi® (glucagon nasal powder) WAC Disclosure Sheet
Basaglar® (insulin glargine injection) WAC Disclosure Sheet
Cialis® (tadalafil tablets) WAC Disclosure Sheet
Cymbalta® (duloxetine delayed-release capsules)
See Prescribing Information, including Boxed Warning.
WAC Disclosure Sheet
Cyramza® (ramucirumab injection) WAC Disclosure Sheet
Effient® (prasugrel tablets)
See Prescribing Information, including Boxed Warning.
WAC Disclosure Sheet
Emgality® (galcanezumab-gnlm injection) WAC Disclosure Sheet
Erbitux® (cetuximab injection)
See Prescribing Information, including Boxed Warnings.
WAC Disclosure Sheet
Evista® (raloxifene hydrochloride tablets)
See Prescribing Information, including Boxed Warnings.
WAC Disclosure Sheet
Forteo® (teriparatide injection)
See Prescribing Information, including Boxed Warning.
WAC Disclosure Sheet
Glucagon Emergency Kit (glucagon) WAC Disclosure Sheet
Humalog® (insulin lispro injection) WAC Disclosure Sheet
Humatrope® (somatropin for injection) WAC Disclosure Sheet
Humulin® 70/30 (human insulin isophane suspension and human insulin injection) WAC Disclosure Sheet
Humulin® N (isophane insulin human suspension) WAC Disclosure Sheet
Humulin® R U-500, Humulin® R U-100 (insulin human injection) WAC Disclosure Sheet
Lyumjev™ (insulin lispro-aabc) WAC Disclosure Sheet
Olumiant® (baricitinib tablets)
See Prescribing Information, including Boxed Warnings.
WAC Disclosure Sheet
Portrazza® (necitumumab injection)
See Prescribing Information, including Boxed Warnings.
WAC Disclosure Sheet
Prozac® (fluoxetine capsules)
See Prescribing Information, including Boxed Warning.
WAC Disclosure Sheet
Retevmo™ (selpercatinib capsules) WAC Disclosure Sheet
Reyvow® (lasmiditan (C-V) tablets) WAC Disclosure Sheet
Strattera® (atomoxetine capsules)
See Prescribing Information, including Boxed Warning.
WAC Disclosure Sheet
Symbyax® (olanzapine and fluoxetine capsules)
See Prescribing Information, including Boxed Warnings.
WAC Disclosure Sheet
Taltz® (ixekizumab injection) WAC Disclosure Sheet
Trulicity® (dulaglutide injection)
See Prescribing Information, including Boxed Warning.
WAC Disclosure Sheet
Verzenio® (abemaciclib tablets) WAC Disclosure Sheet
Zyprexa® (olanzapine tablets)
Zyprexa® Zydis® (olanzapine tablets)
Zyprexa® IntraMuscular (olanzapine injection)
See Prescribing Information, including Boxed Warning.

Zyprexa® Relprevv™ (olanzapine for extended release)
See Prescribing Information, including Boxed Warnings.
WAC Disclosure Sheet