Information Regarding 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 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

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