Washington Preferred Drug List (WPDL) Updates

 HCA Apple Health Medicaid

 

Provider Alert

Effective for claims with dates of service on and after May 1, 2016, Washington Apple Health (Medicaid) administered by the Health Care Authority (agency) will make the following changes to the Washington Preferred Drug List (WPDL).

Drug Class

Drug Name

Preferred Status

Attention Deficit/

Hyperactivity Disorder

 

Adzenys XR®

Non-preferred, not subject to DAW-1

dextroamphetamine solution

Non-preferred

Dyanavel XR®

Non-preferred, not subject to DAW-1

methylphenidate chewable

Non-preferred

Quillichew ER®

Non-preferred, not subject to DAW-1

Atypical Antipsychotic

Vraylar®

Non-preferred, not subject to DAW-1

 

Beta Blockers

Inderal XL®

Non-preferred, not subject to DAW-1

Direct-Acting Antiviral Agents for Hepatitis C

 

Zepatier®

Non-preferred, not subject to DAW-1

Estrogen-Progestin Combinations

 

norethindrone acetate – ethinyl estradiol

Preferred

Histamine-2 Receptor Antagonist (H2RA)

Pepcid Complete®

Non-preferred

 

Inhaled Beta-Agonists

Arcapta™ Neohaler™

Added EA requirement

Brovana®

Added EA requirement

Foradil® Aerolizer®

Added EA requirement

Perforomist®

Added EA requirement

Serevent® Diskus®

Added EA requirement

 

Striverdi ®

Added EA requirement

Long-Acting Anticholinergics

Incruse Ellipta®

Added EA requirement

Seebri Neohaler®

Added EA requirement

Long-Acting Beta-Agonist Combinations

Advair Diskus® / HFA®

Removed PA requirement

Breo Ellipta®

Removed PA requirement

Dulera®

Added EA requirement

Stioloto®

Added EA requirement

Symbicort®

Removed PA requirement

Utibron Neohaler®

Added EA requirement

 

For more details, see the agency’s Washington Preferred Drug List (WPDL).

Thank you.