1000 E. University Ave.
Laramie, WY 82070
Preferred Drug List (PDL)
The Wyoming Medicaid Preferred Drug List (PDL) including step utilization for anti-depressant medications and prior authorization information is available at the Wyoming EqualityCare Pharmacy Provider website. To view the current PDL, please visit www.wymedicaid.org.
Public Comment at Meetings
A new policy for public comment at meetings is effective December 1, 2012.
PhRMA Guidelines and PhRMA Comment Request Form (updated December 3, 2012)
Public Guidelines and Public Comment Request Form (updated December 3, 2012)
The following prior authorization criteria were approved at the August 13, 2015 P & T Committee meeting.
Vyvanse will be allowed for patients aged 18 years and older with a diagnosis of binge eating disorder. Approvals will be given in 12 week increments.
Xenazine will be limited to the indication of chorea associated with Huntington’s Disease. All other uses will require prior authorization.
Immunomodulators will be limited to 120% of labeled maximum dosages.
Corlanor will be approved for patients with congestive heart failure.
There is no evidence of improved efficacy or safety of Stiolto versus existing combination drugs for COPD. The Department of Health will conduct a cost analysis and determine PDL placement.
Entresto will be allowed for those with congestive heart failure. Due to the ARB component, duplicate therapy with ACE inhibitors or ARBs will not be allowed.
Orkambi will be approved for patients 12 years and older with cystic fibrosis as a result of homozygous F508 del genetic mutation.
Comments may be sent by email to firstname.lastname@example.org or by mail to: Wyoming Drug Utilization Review Board, Dept. 3375, 1000 E. University Avenue, Laramie, WY 82071. Comments should be received prior to October 31, 2015.
Agenda August 13, 2015
Minutes August 13, 2015
Wednesday, February 18; Thursday, May 14; Thursday, August 13; Thursday, November 12
All meetings are at 10 am at Laramie County Community College. Please see agenda for room location.