Upcoming changes to L&I's Outpatient Drug Formulary

Washington State Department of Labor & Industries sent this bulletin at 03/01/2022 11:51 AM PST

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washington state department of labor and industries - claims and insurance

Self-Insurance

Upcoming changes to L&I's Outpatient Drug Formulary

The Washington State Department of Labor & Industries announces changes to our Outpatient Drug Formulary effective April 1, 2022. The changes are available for review in our online Outpatient Drug Formulary PDF.
Summary of changes

Added new drug classes:

Drug class code

Drug class description

Drugs in class

Q2X

Ophthalmic VEGF-A and Angiopoietin-2 (Ang-2) Inhibitors, Bispecific Antibody Type

faricimab (Vabysmo)

V17

Antineoplastic - Immunotherapy, T-cell Engager

tebentafusp (Kimmtrak)

V4F

Thymic Stromal Lymphopoietin (TSLP) Inhibitors

tezepelumab (Tezspire)

V4G

Interleukin-13 (IL-13) Inhibitors, Monoclonal Antibody

tralokinumab (Adbry)

W0M

Antiviral - Main Protease (Mpro) Inhibitor

nirmatrelvir/ritonavir (Paxlovid)

Z12

Natriuretic Peptides

vosoritide (Voxzogo)

Z29

Neonatal Fc Receptor (FcRn) Inhibitors

efgartigimod alfa-fcab (Vyvgart)