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
Asthma Biologic Treatments
  • Xolair
  • Nucala
  • Fasenra
Botulinum Toxin Treatments
  • Dysport (preferred)
  • Botox
  • Myobloc
  • Xeomin
Colony-Stimulating Factors
  • Epoetin (Epogen/Procrit)
Enzyme Replacement Therapy
  • Aldurazyme
  • Brineura
  • Cerezyme
  • Elaprase
  • Elelyso
  • Fabrazyme
  • Kanuma
  • Lumizyme
  • Mepsevii
  • Naglazyme
  • Revcovi
  • Vimizim
Immune Globulins
  • Bivigam
  • Carimune NF
Inflammatory Biologics
  • Entyvio
  • Ilaris
  • Inflectra (not covered)
  • Remicade (no GF after 7/1/2019)
  • Renflexis
  • Soliris
  • Simponi Aria
  • Actemra IV
  • Orencia IV
  • Stelara IV
Interferons/Biologic Response Modifier
  • Interferon and Peginterferon for Hepatitis B
Multiple Sclerosis
  • Lemtrada
  • Ocrevus
Others
  • Crysvita
  • HP Acthar
  • Makena (hydroxyprogesterone)
  • Nplate
  • Prolia
  • Rituxan (non-oncology)
  • Signifor LAR
  • Somatuline Depot
  • Synagis
  • Xiaflex

Additional Prescription Drug Policies


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