Washington Preferred Drug List (WPDL)


 

Dear Provider,

Effective for claims with dates of service on and after June 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

Antiplatelets

aspirin-dipyridamole ER

Non-Preferred

Aspirin and Extended Release Dipyridamole®

Removed

Attention Deficit/ Hyperactivity Disorder

Metadate ER™

Removed – see methylphenidate ER

Calcium Channel Blockers

Adalat®

Removed

Cartia XT®

Removed – see diltiazem ER

Taztia XT®

Removed – see diltiazem ER

Estrogens

Cenestin®

Removed

Estrasorb®

Removed

Femtrace®

Removed

Estrogen-Progestin Combinations

jinteli

Removed – see norethindrone acetate -ethinyl estradiol

mimvey

Removed -- see estradiol-norethindrone

Inhaled Corticosteroids – Long-Acting Beta-Agonist Combinations

(No changes to preferred drug status.   Separating asthma/COPD subclasses for clarity of Therapeutic Interchange.)

Advair Diskus® /HFA®

Preferred

Breo Ellipta®

Preferred

Dulera®

Non-Preferred, EA required

Symbicort®

Non-Preferred

Long-Acting Beta-Agonist – Long Acting Muscarinic Agent Combinations

(LABA – LAMA)

(No changes to preferred drug status.   Separating asthma/COPD subclasses for clarity of Therapeutic Interchange.)

Anoro Ellipta®

Preferred, EA required

Stioloto®

Non-Preferred, Not subject to TIP or DAW-1, and EA required

Utibron Neohaler®

Non-Preferred, Not subject to TIP or DAW-1, and EA required

Long-Acting Muscarinic Agents (LAMA)

(No changes to preferred drugs. Renaming drug class)

Incruse Ellipta®

Non-Preferred, Not subject to TIP or DAW-1, and EA required

Seebri Neohaler®

Non-Preferred, Not subject to TIP or DAW-1, and EA required

Spiriva Handihaler®

Preferred, EA required

Spiriva Respimat®

Preferred, EA required

Tudorza Pressair®

Non-Preferred, EA required

Nasal Corticosteroids

mometasone furoate

Non-Preferred

PCSK-9 Inhibitors

(Proprotein Convertase Subtilisin Kexin Type 9)

(new drug class)

Praluent®

Non-Preferred, PA required

Repatha®

Preferred, PA required

Repatha Sureclick®

Preferred, PA required

Statin-type Cholesterol Lowering Agents

(No changes to preferred drug status.   Separating asthma/COPD subclasses for clarityof Therapeutic Interchange.)

atorvastatin

High Potency, Preferred

Crestor®

High Potency, Non-preferred, Not subject to DAW-1 override

Lipitor®

High Potency, Non-preferred

Targeted Immune Modulaters

Taltz®

Non-preferred, not subject to DAW-1 override

Triptans

Onzetra®

Non-Preferred, not subject to TIP/DAW-1 override

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