Prescription Drug Preauthorization

Prescription Drug 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: 800-279-4000
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

Prescription Drugs Requiring Preauthorization

Please use our Medication Preauthorization Form for the following medications:

Alpha-1 Proteinase Inhibitors
  • Aralast-NP
  • Glassia
  • Prolastin-C
  • Zemaira
Antiarrhythmic
  • Antiarrhythmic Drug BetaPace Induction
Antihemophilic Factors
  • Antihemophilic Factor VIII
  • Antihemophilic Factor XI
  • Hyaluronan
Asthma Biologic Treatments
  • Fasenra
  • Nucala
  • Xolair
Botulinum Toxin Treatments
  • Botox
  • Dysport (preferred)
  • Myobloc
  • Xeomin
C1 Esterase Inhibitor
  • Berinert
  • Cinryze
  • Haegarda
  • Ruconest
Colony-Stimulating Factors
  • Epoetin (Epogen/Procrit)
Enzyme Replacement Therapy
  • Adagen
  • Aldurazyme
  • Brineura
  • Cerezyme
  • Elaprase
  • Elelyso
  • Fabrazyme
  • Kanuma
  • Lumizyme
  • Mepsevii
  • Naglazyme
  • Revcovi
  • Vimizim
  • Vpriv
Immune Globulins
  • Bivigam
  • Carimune NF
  • Cinqair
  • Cuvitru
  • Flebogamma
  • GamaSTAN
  • Gammagard
  • Gammaplex
  • Gamunex
  • Hizentra (SC only)
  • HyQvia (SC only)
  • Octagam
  • Privigen
  • Xembify – effective 1/1/2020
  • Zinplava – effective 1/1/2020
Inflammatory Biologics
  • Actemra IV
  • Cimzia
  • Entyvio
  • Ilaris
  • Inflectra (not covered)
  • Ixifi
  • Orencia IV
  • Remicade (no GF after 7/1/2019)
  • Renflexis
  • Simponi Aria
  • Soliris
  • Stelara IV
  • Ultomiris
  • Ustekinumab
Interferons/Biologic Response Modifier
  • Interferon and Peginterferon for Hepatitis B
Iron Product
  • Feraheme
  • Injectafer
Kallikrein Inhibitor
  • Kalbitor
  • Takhzyro - effective 1/1/2020
Multiple Sclerosis
  • Lemtrada
  • Ocrevus
Ophthalmic Agent
  • Lucentis
  • Macugen
Prostaglandin
  • Flolan – effective 1/1/2020
  • Remodulin
  • Veletri
siRNA Agent
  • Onpattro – effective 1/1/2020
  • Patisiran
Others
  • Aripiprazole (Others) antipsychotic
  • Beuprenorphine Implant
  • Crysvita
  • Eylea
  • Flolan
  • HP Acthar
  • Makena (hydroxyprogesterone)
  • Nplate
  • Paricalcitol
  • Parsabiv - effective1/1/2020
  • Prolia
  • Rituxan(non-oncology)
  • Signifor LAR
  • Somatuline Depot
  • Supprelin LA
  • Synagis
  • Trogarzo - effective 1/1/2020
  • Xgeva
  • Xiaflex

Additional Prescription Drug Policies


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