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Apple Health Preferred Drug List (PDL) Updates

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Apple Health Preferred Drug List (PDL) Updates Apple Health Preferred Drug List (PDL) Updates The Health Care Authority (HCA) implemented the Apple Health Preferred Drug List (PDL) on January 1, 2018. All managed care plans and the fee-for-service program serving Apple Health clients use this PDL. The PDL now includes over-the-counter medications, vitamins, and many other outpatient drugs. There are now 441 therapeutic drug classes included in the PDL. Updates are ongoing. See which drugs are preferred and whether they require a PA: https://www.hca.wa.gov/billers-providers-partners/programs-and-services/apple-health-preferred- drug-list-pdl. HCA has created policies that document the coverage criteria for drug classes or individual drugs. To view the policies visit: https://www.hca.wa.gov/billers-providers-partners/programs-and- services/apple-health-medicaid-drug-coverage-criteria The drugs within a chosen therapeutic class are evaluated by the HCA Pharmacy and Therapeutic (P&T) Committee/Drug Utilization Review (DUR) Board. The HCA P&T Committee / DUR Board meet at least quarterly. All meetings are open to the public. You can read more about the meetings here: https://www.hca.wa.gov/about-hca/prescription-drug-program/meetings-and-materials Upcoming meeting dates are below: April 21, 2021 June 16, 2021 August 18, 2021 October 20, 2021 December 15, 2021 Current drug classes are listed below: ADHD / ANTI-NARCOLEPSY : DOPAMINE AND NOREPINEPHRINE REUPTAKE INHIBITORS (DNRIS) ADHD / ANTI-NARCOLEPSY : HISTAMINE H3-RECEPTOR ANTAGONIST / INVERSE AGONIST ADHD / ANTI-NARCOLEPSY : NON-STIMULANTS ADHD / ANTI-NARCOLEPSY : STIMULANTS - LONG ACTING ADHD / ANTI-NARCOLEPSY : STIMULANTS - MISC ADHD / ANTI-NARCOLEPSY : STIMULANTS - SHORT ACTING ALLERGY : ALLERGENIC EXTRACTS / BIOLOGICALS - ORAL ALLERGY : ANAPHYLAXIS - VASOPRESSOR SELF-INJECTABLES ALLERGY : ANTIHISTAMINE - DECONGESTANTS COMBINATIONS ALLERGY : ANTIHISTAMINES ALLERGY : MISC ALLERGY : NASAL ANTICHOLINERGICS ALLERGY : NASAL ANTIHISTAMINES ALLERGY : NASAL STEROIDS ANALGESICS - ANTIINFLAMMATORY : ANTIRHEUMATIC AGENTS ANALGESICS : MISC - TOPICAL ANALGESICS : NON-NARCOTIC ANALGESICS : NON-STEROIDAL ANTIINFLAMMATORY ANALGESICS : OPIOID AGONISTS - LONG ACTING ANALGESICS : OPIOID AGONISTS - SHORT ACTING ANALGESICS : OPIOID PARTIAL AGONISTS ANORECTAL AGENTS : RECTAL ANESTHETIC / STEROID COMBINATIONS ANORECTAL AGENTS : RECTAL ANESTHETICS ANORECTAL AGENTS : RECTAL STEROIDS ANORECTAL AGENTS : VASODILATING AGENTS ANTIANXIETY AGENTS : BENZODIAZEPINES ANTIANXIETY AGENTS : MISC ANTIBIOTICS : AMINOGLYCOSIDES - INHALED ANTIBIOTICS : AMINOGLYCOSIDES - ORAL ANTIBIOTICS : AMINOPENICILLINS - INJECTABLE ANTIBIOTICS : AMINOPENICILLINS - ORAL ANTIBIOTICS : ANTI-INFECTIVE AGENTS - MISC - INHALED ANTIBIOTICS : ANTI-INFECTIVE AGENTS - MISC - ORAL ANTIBIOTICS : ANTIMYCOBACTERIAL AGENTS - ORAL ANTIBIOTICS : CEPHALOSPORINS - 1ST GENERATION - INJECTABLE ANTIBIOTICS : CEPHALOSPORINS - 1ST GENERATION - ORAL ANTIBIOTICS : CEPHALOSPORINS - 2ND GENERATION - INJECTABLE ANTIBIOTICS : CEPHALOSPORINS - 2ND GENERATION - ORAL ANTIBIOTICS : CEPHALOSPORINS - 3RD GENERATION - INJECTABLE ANTIBIOTICS : CEPHALOSPORINS - 3RD GENERATION - ORAL ANTIBIOTICS : CEPHALOSPORINS - 4TH GENERATION - INJECTABLE ANTIBIOTICS : CEPHALOSPORINS - OTHER - INJECTABLE ANTIBIOTICS : FLUOROQUINOLONES - ORAL ANTIBIOTICS : GLYCOPEPTIDES - ORAL ANTIBIOTICS : LEPROSTATICS - ORAL ANTIBIOTICS : LINCOSAMIDES - ORAL ANTIBIOTICS : MACROLIDES - ORAL ANTIBIOTICS : MONOBACTAMS - INHALED ANTIBIOTICS : NATURAL PENICILLINS - INJECTABLE ANTIBIOTICS : NATURAL PENICILLINS - ORAL ANTIBIOTICS : OXAZOLIDINONES - ORAL ANTIBIOTICS : PENICILLIN COMBINATIONS - INJECTABLE ANTIBIOTICS : PENICILLIN COMBINATIONS - ORAL ANTIBIOTICS : PENICILLINASE-RESISTANT PENICILLINS - ORAL ANTIBIOTICS : SULFONAMIDES - INJECTABLE ANTIBIOTICS : SULFONAMIDES - ORAL ANTIBIOTICS : TETRACYCLINES - INJECTABLE ANTIBIOTICS : TETRACYCLINES - ORAL ANTIBIOTICS : TOPICAL ANTIBIOTICS : VAGINAL ANTICOAGULANTS : COUMARIN ANTICOAGULANTS ANTICOAGULANTS : FACTOR XA AND THROMBIN INHIBITORS - ORAL ANTICOAGULANTS : HEPARINS AND HEPARINOID-LIKE AGENTS ANTICONVULSANTS : AMPA GLUTAMATE RECEPTOR ANTAGONISTS ANTICONVULSANTS : BENZODIAZEPINES - ORAL ANTICONVULSANTS : BENZODIAZEPINES - RESCUE AGENTS ANTICONVULSANTS : CARBAMATES ANTICONVULSANTS : GABA MODULATORS ANTICONVULSANTS : HYDANTOINS ANTICONVULSANTS : MISC ANTICONVULSANTS : SUCCINIMIDES ANTICONVULSANTS : VALPROIC ACID ANTIDEMENTIA AGENTS : ANTIDEPRESSANTS : ALPHA-2 RECEPTOR ANTAGONISTS (TETRACYCLICS) ANTIDEPRESSANTS : GABA RECEPTOR MODULATOR - NEUROACTIVE STEROID ANTIDEPRESSANTS : MONOAMINE OXIDASE INHIBITORS (MAOI) ANTIDEPRESSANTS : NOREPINEPHRINE-DOPAMINE REUPTAKE INHIBITORS ANTIDEPRESSANTS : SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI) ANTIDEPRESSANTS : SELECTIVE SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITOR (SNRI) ANTIDEPRESSANTS : SEROTONIN MODULATORS ANTIDEPRESSANTS : TRICYCLIC AGENTS ANTIDIABETICS : ALPHA-GLUCOSIDASE INHIBITORS ANTIDIABETICS : ALPHA-GLUCOSIDASE INHIBITORS ANTIDIABETICS : AMYLIN ANALOGS ANTIDIABETICS : BIGUANIDES ANTIDIABETICS : DIABETIC OTHER ANTIDIABETICS : DOPAMINE RECEPTOR AGONISTS ANTIDIABETICS : DPP4 INHIBITOR / SGLT2 INHIBITOR COMBINATIONS ANTIDIABETICS : DPP4 INHIBITOR / TZD COMBINATIONS ANTIDIABETICS : DPP4 INHIBITORS ANTIDIABETICS : GLP1 AGONIST / INSULIN COMBINATIONS ANTIDIABETICS : GLP1 AGONISTS ANTIDIABETICS : INSULIN - INTERMEDIATE ACTING ANTIDIABETICS : INSULIN - LONG ACTING ANTIDIABETICS : INSULIN - PRE-MIXED ANTIDIABETICS : INSULIN - RAPID ACTING ANTIDIABETICS : INSULIN - SHORT ACTING ANTIDIABETICS : MEGLITINIDE ANALOGUES ANTIDIABETICS : SGLT2 INHIBITORS ANTIDIABETICS : SULFONYLUREAS ANTIDIABETICS : THIAZOLIDINEDIONES ANTIDOTES AND SPECIFIC ANTAGONISTS : CHELATING AGENTS ANTIEMETICS / ANTIVERTIGO AGENTS : 5-HT3 RECEPTOR ANTAGONISTS ANTIEMETICS / ANTIVERTIGO AGENTS : OTHER ANTIEMETICS / ANTIVERTIGO AGENTS : SUBSTANCE P/NEUROKININ 1 (NK1) RECEPTOR ANTAGONISTS ANTIEMETICS / ANTIVERTIGO AGENTS : SUBSTANCE P/NEUROKININ 1 RECEPTOR ANTAGONIST COMBINATIONS ANTIFUNGALS : INJECTABLE ANTIFUNGALS : ORAL ANTIFUNGALS : TOPICAL ANTIFUNGALS : VAGINAL ANTIHYPERLIPIDEMICS : ADENOSINE TRIPHOSPHATE-CITRATE LYASE INHIBITORS ANTIHYPERLIPIDEMICS : ANTIHYPERLIPIDEMICS MISC ANTIHYPERLIPIDEMICS : BILE ACID SEQUESTRANTS ANTIHYPERLIPIDEMICS : FIBRIC ACID DERIVATIVES ANTIHYPERLIPIDEMICS : HMG COA REDUCTASE INHIBITORS (STATINS) AND COMBINATIONS ANTIHYPERLIPIDEMICS : MICROSOMAL TRIGLYCERIDE TRANSFER PROTEIN (MTP) INHIBITOR ANTIHYPERLIPIDEMICS : PCSK-9 INHIBITORS ANTIHYPERTENSIVES : ACE INHIBITOR COMBINATIONS ANTIHYPERTENSIVES : ACE INHIBITORS ANTIHYPERTENSIVES : ANGIOTENSIN II RECEPTOR BLOCKER COMBINATIONS ANTIHYPERTENSIVES : ANGIOTENSIN II RECEPTOR BLOCKERS ANTIHYPERTENSIVES : ANTIADRENERGIC COMBINATIONS ANTIHYPERTENSIVES : ANTIADRENERGICS ANTIHYPERTENSIVES : BETA-BLOCKER COMBINATIONS ANTIHYPERTENSIVES : BETA-BLOCKERS ANTIHYPERTENSIVES : CALCIUM CHANNEL BLOCKER COMBINATIONS ANTIHYPERTENSIVES : CALCIUM CHANNEL BLOCKERS ANTIHYPERTENSIVES : DIRECT RENIN INHIBITOR COMBINATIONS ANTIHYPERTENSIVES : DIRECT RENIN INHIBITORS ANTIHYPERTENSIVES : NEPRILYSIN INHIB (ARNI)-ANGIOTENSIN II RECEPT ANTAG COMBINATIONS ANTIHYPERTENSIVES : OTHER ANTIHYPERTENSIVES : VASODILATORS ANTIPARASITICS : AMEBICIDES ANTIPARASITICS : ANTHELMINTICS ANTIPARASITICS : ANTIMALARIALS ANTIPARASITICS : ANTIPROTOZOAL AGENTS ANTIPARASITICS : SCABICIDES AND PEDICULICIDES ANTIPARKINSON AGENTS : ADENOSINE RECEPTOR ANTAGONISTS ANTIPARKINSON AGENTS : ANTICHOLINERGICS ANTIPARKINSON AGENTS : COMT INHIBITORS ANTIPARKINSON AGENTS : DOPAMINERGICS ANTIPARKINSON AGENTS : MONOAMINE OXIDASE INHIBITORS (MAOI) ANTIPSYCHOTICS / ANTIMANIC AGENTS : ANTIMANIC AGENTS ANTIPSYCHOTICS / ANTIMANIC AGENTS : ANTIPSYCHOTICS - 1ST GENERATION ANTIPSYCHOTICS / ANTIMANIC AGENTS : ANTIPSYCHOTICS - 2ND GENERATION ANTIPSYCHOTICS / ANTIMANIC AGENTS : ANTIPSYCHOTICS - COMBINATIONS ANTIPSYCHOTICS / ANTIMANIC AGENTS : PARKINSONS PSYCHOTIC DISORDER ANTIVIRALS : CMV AGENTS ANTIVIRALS : HEPATITIS B AGENTS ANTIVIRALS : HEPATITIS C AGENTS ANTIVIRALS : HERPES AGENTS ANTIVIRALS : HIV ANTIVIRALS : HIV COMBINATIONS ANTIVIRALS : INFLUENZA AGENTS ANTIVIRALS : RESPIRATORY SYNCYTIAL VIRUS (RSV) AGENTS ANTIVIRALS: HIV – INJECTABLES ASTHMA AND COPD AGENTS : ANTICHOLINERGICS ASTHMA AND COPD AGENTS : BETA AGONISTS - LONG ACTING ASTHMA AND COPD AGENTS : BETA AGONISTS - ORAL ASTHMA AND COPD AGENTS : BETA AGONISTS - SHORT ACTING ASTHMA AND COPD AGENTS : INHALED CORTICOSTEROID COMBINATIONS ASTHMA AND COPD AGENTS : INHALED CORTICOSTEROIDS ASTHMA AND COPD AGENTS : LEUKOTRIENE MODIFIERS ASTHMA AND COPD AGENTS : LONG ACTING MUSCARINIC AGENT / LONG ACTING BETA AGONIST COMBINATIONS ASTHMA AND COPD AGENTS : LONG ACTING MUSCARINIC AGENTS ASTHMA AND COPD AGENTS : MONOCLONAL ANTIBODIES ASTHMA AND COPD AGENTS : PHOSPHODIESTERASE 4 INHIBITORS ASTHMA AND COPD AGENTS : XANTHINES ATOPIC DERMATITIS AGENTS : IMMUNOSUPPRESSIVE AGENTS - TOPICAL ATOPIC DERMATITIS AGENTS : IMMUNOSUPPRESSIVE AGENTS - TOPICAL COMBINATIONS ATOPIC DERMATITIS AGENTS : MONOCLONAL ANTIBODIES ATOPIC DERMATITIS AGENTS : PHOSPHODIESTERASE 4 INHIBITORS - TOPICAL BONE DENSITY REGULATORS - CALCITONINS BONE DENSITY REGULATORS - PARATHYROID HORMONE DERIVATIVES BONE DENSITY REGULATORS : BISPHOSPHONATES BONE DENSITY REGULATORS : RANK LIGAND INHIBITORS CARDIOVASCULAR AGENTS : ANTIANGINAL AGENTS - NITRATES CARDIOVASCULAR AGENTS : ANTIANGINAL AGENTS - OTHER CARDIOVASCULAR AGENTS : ANTIARRHYTHMICS CARDIOVASCULAR AGENTS : CARDIAC GLYCOSIDES CARDIOVASCULAR AGENTS : PERIPHERAL VASODILATORS - ORAL CARDIOVASCULAR AGENTS : PHOSPHODIESTERASE INHIBITORS CARDIOVASCULAR
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