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Dear Provider,
Effective for claims with dates of service on and after December 1, 2015, Washington Apple Health (Medicaid) administered by the Health Care Authority (agency) will make the following changes to the Washington Preferred Drug List (WPDL).
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Drug Class
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Drug Name
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Preferred Status
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Multiple Sclerosis
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Glatopa®
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Preferred
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mitoxantrone
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Non-preferred
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Rebif®
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Non-preferred
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Rebif Titration Pack®
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Non-preferred
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Rebif Rebidose®
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Non-preferred
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Rebif Rebidose Titration Pack®
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Non-preferred
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Tecfidera®
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Preferred
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Tecfidera Starter Pack®
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Preferred
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Tysabri®
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Non-preferred
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Drug Class
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Drug Name
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Change
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Targeted Immune Modulators (TIMs)
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Xeljanz®
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Now subject to DAW-1 override
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For more details, see the agency’s Washington Preferred Drug List (WPDL).
Thank you.
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