Listing The Most Common Drugs Requiring Preauthorization

Drugs Requiring Preauthorization

Helping keep costs down and getting the most appropriate treatment.

The WEA Trust requires preauthorization for certain prescription drugs.The sections below detail which drugs are handled by which company.

Questions About Drug Preauthorization?

WEA Trust Customer Service for Members: 800-279-4000
WEA Trust Customer Service for Providers: 800-279-4090
MedImpact: 888-807-8106

 

Q:Managed By MedImpact

For a list of the most Common Drugs Requiring Preauthorization, please reference our Preferred Drug List.

For a complete list, please reference our Complete Formulary.


Most common prescription drugs requiring preauthorization:

  • Adapalene (over age 25)
  • Androgel
  • Aripiprazole
  • Copaxone
  • Crestor
  • Dextroamphetamine-amphetamine (quantity limit)
  • Dextroamphetamine-amphetamine ER (over age 18)
  • Elidel
  • Enbrel
  • Enoxaparin Sodium
  • Fentanyl
  • Gleevac
  • Harvoni
  • Humira
  • Imiquimod
  • Jublia
  • Latuda
  • Methylphenidate ER (over age 18)
  • Modafinil
  • Neulasta
  • Nexium
  • Nuvaring
  • Nuvigil
  • Pristiq ER
  • Sovaldi
  • Subuxone
  • Tecfidera
  • Tretinoin (over age 25)
  • Vancomycin
  • Vesicare
  • Vyvanse
  • Xyrem
  • Zolpidem tartrate ER

Q:Managed By WEA Trust

Preferred Biosimilars

Click here for the preferred Biosimilars chart

Prescription Drugs Requiring Preauthorization

Please use our Medication Preauthorization Form for the following medications:


Abraxane

Actemra

Acthar Hp

Adagen

Adcetris

Adynovate

Afstyla

Aldurazyme

Alimta

Alprolix

Aralast Np

Aranesp

Aripiprazole Lauroxil

Artesunate

Ayvakit

Balversa

Beleodaq

Belrapzo

Benralizumab

Berinert

Besremi

Bevacizumab

Beuprenorphine Implant

Bivigam

Blenrep

Blincyto

Bortezomib

Botox

Botulinum

Brineura

C1 Esterase Inhibitor

Cablivi

Camptosar

Carimune

Cerezyme

Cerliponase Alfa

Cinqair

Cinryze

Coagadex

Copanlisib

Cosela

Crysvita

Cubicin

Cuvitru

Danyelza

Darzalex

Durvalumab

Dysport

Elaprase

Elelyso

Eligard

Elitek

Ellence

Eloctate

Emicizumab-Kxwh

Empliciti

Emtansine

Enfortumab Vedotin

Enhertu

Entyvio

Epoetin Alfa

Epoetin Beta

Epogen

Erbitux

Esperoct

Evenity

Evomela

Exkivity

Eylea

Fabrazyme

Factor Ix

Factor Viii

Fasenra

Faslodex

Firazyr

Flebogamma Dif

Flolan

Folotyn

Fotivda

Gamastan

Gammagard

Gammaked

Gammaplex

Gamunex

Gavreto

Glassia

Haegarda

Hemlibra

Herceptin

Herzuma

Hizentra

Humate-P

Hyqvia

Idamycin PFS

Idelvion

Ilaris

Imfinzi

Imlygic

Inflectra

Infugem

Inotuzumab Ozogamicin

Inrebic

Interferon Beta-1A

Interferon Beta-1B

Interferon, Alfa-2A

Interferon, Alfa-2B

Interferon, Alfacon-1

Interferon, Alfa-N3

Interferon, Gamma 1-B

Ipilimumab

Istodax

Ixempra Kit

Ixifi

Jelmyto

Jemperli

Jevtana

Jivi

Kadcyla

Kalbitor

Kanjinti

Kanuma

Keytruda

Khapzory

Kimmtrak

Kogenate Fs

Kovaltry

Kyprolis

Lemtrada

Leukine

Leuprolide Acetate

Lorbrena

Lucentis

Lumakras

Lumizyme

Lupron

Lutetium

Makena

Margenza

Mepsevii

Methotrexate

Mircera

Monjuvi

Mozobil

Mvasi

Mylotarg

Myobloc

Myozyme

Naglazyme

Neupogen

Nivestym

Novoeight

Novoseven

Nplate

Nucala

Nuwiq

Nyvepria

Obizur

Ocrevus

Octagam

Ogivri

Onivyde

Onpattro

Ontruzant

Opdivo

Orencia Iv

Otrexup

Ozurdex

Paclitaxel/Encequifar

Padcev

Parsabiv

Patisiran

Pemazyre

Pepaxto

Perjeta

Phesgo

Polivy

Portrazza

Prialt

Privigen

Procrit

Prolastin-C

Prolia

Qinlock

Rebinyn

Remicade

Remodulin

Renflexis

Retevmo

Retisert

Revcovi

Riabni

Rozlytrek

Ruconest

Ruxience

Rybrevant

Rylaze

Sandostatin

Sarclisa

Signifor Lar

Simponi Aria

Soliris

Somatuline Depot

Stelara

Supartz

Supprelin LA

Sylvant

Synagis

Takhzyro

Tecentriq

Tepmetko

Tivdak

Torisel

Totect

Trastuzumab-hyaluronidase

Trazimera

Tretten

Triluron

Trivisc

Trodelvy

Trogarzo

Truseltiq

Truxima

Tukysa

Turalio

Tivdak

Ukoniq

Ultomiris

Ustekinumab

Vectibix

Velcade

Veletri

Vimizim

Vpriv

Wilate

Xembify

Xeomin

Xgeva

Xiaflex

Xolair

Xpovio

Xyntha

Yervoy

Yutiq

Zaltrap

Zemaira

Zepzelca

Zevalin Y-90

Zinplava

Zirabev

Zokinvy

Zoladex

Zynlonta

 

* Please see additional prescription drug policies (below) for new drugs, oncology drugs, and opiate medications.

Additional Prescription Drug Policies


Customer Service

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