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

Afstyla

Aldurazyme

Alimta

Alprolix

Aralast Np

Aranesp

Aripiprazole Lauroxil

Artesunate - 10-1-21

Belrapzo

Benralizumab

Berinert

Bevacizumab

Beuprenorphine Implant

Bivigam

Blenrep - 10-1-21

Bortezomib

Botox

Botulinum

Brineura

C1 Esterase Inhibitor

Cablivi

Carimune

Cerezyme

Cerliponase Alfa

Cinqair

Cinryze

Copanlisib

Cosela

Crysvita

Cubicin

Cuvitru

Danyelza

Darzalex

Durvalumab

Dysport

Elaprase

Elelyso

Eligard

Eloctate

Emicizumab-Kxwh

Emtansine

Enfortumab Vedotin

Enhertu - 10-1-21

Entyvio

Epoetin Alfa

Epoetin Beta

Epogen

Erbitux

Esperoct

Evenity

Evomela

Eylea

Fabrazyme

Factor Ix

Factor Viii

Fasenra

Faslodex

Firazyr

Flebogamma Dif

Flolan

Fotivda

Fulphila

Gamastan

Gammagard

Gammaked

Gammaplex

Gamunex

Glassia

Granix

Haegarda

Hemlibra

Herceptin

Herzuma

Hizentra

Hyqvia

Ilaris

Imfinzi

Inflectra

Infugem

Inotuzumab Ozogamicin

Interferon Beta-1A

Interferon Beta-1B

Interferon, Alfa-2A

Interferon, Alfa-2B

Interferon, Alfacon-1

Interferon, Alfa-N3

Interferon, Gamma 1-B

Ipilimumab

Istodax

Ixifi

Jelmyto - 10-1-21

Jemperli

Kadcyla

Kalbitor

Kanjinti

Kanuma

Keytruda

Kogenate Fs

Kovaltry

Lemtrada

Leuprolide Acetate

Lorbrena

Lucentis

Lumakras

Lumizyme

Lupron

Lutetium

Makena

Margenza

Mepsevii

Methotrexate

Micerna - 10-1-21

Monjuvi - 10-1-21

Mvasi

Myobloc

Myozyme

Naglazyme

Neupogen

Nivestym

Novoeight

Novoseven

Nplate

Nucala

Nyvepria - 10-1-21

Obizur

Ocrevus

Octagam

Ogivri

Onivyde

Onpattro

Ontruzant

Opdivo

Orencia Iv

Otrexup

Paclitaxel/Encequifar

Padcev - 10-1-21

Parsabiv

Patisiran

Pepaxto

Perjeta

Phesgo

Polivy

Privigen

Procrit

Prolastin-C

Prolia

Rebinyn

Remicade

Remodulin

Renflexis

Revcovi

Riabni

Rituxan

Ruconest

Ruxience

Rybrevant

Rylaze

Sandostatin

Sarclisa - 10-1-21

Signifor Lar

Simponi Aria

Soliris

Somatuline Depot

Stelara

Supartz

Supprelin LA

Sylvant

Synagis

Takhzyro

Tecentriq

Tepmetko

Trazimera

Triluron

Trivisc

Trodelvy - 10-1-21

Trogarzo

Truseltiq

Truxima

Udenyca

Ukoniq

Ultomiris

Ustekinumab

Vectibix

Velcade

Veletri

Vimizim

Vpriv

Xembify

Xeomin

Xgeva

Xiaflex

Xyntha

Yervoy

Yutiq

Zaraxio

Zemaira

Zepzelca - 10-1-21

Ziextenzo

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

800-279-4000

Call us Monday through Friday - 7:30 a.m. to 5:00 p.m. CST

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