1000 E. University Ave.
Laramie, WY 82070
Preferred Drug List (PDL)
The 2015 PDL, which is subject to change, is available for review. If you have any comments, please submit them prior to Decmeber 15, 2014. Comments may be sent by email to email@example.com or by mail to: Wyoming Drug Utilization Review Board, Dept. 3375, 1000 E. University Avenue, Laramie, WY 82071.
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 February 18, 2015 P & T Committee meeting.
Butrans patches will be limited to a maximum 20 mcg/hour due to the potential for QTc changes at higher doses.
Esbriet, Ofev, Akynzeo and Viekira will be limited to their approved indications. In addition, the clinical criteria for the Hepatitis C class will be applied to Viekira.
Lemtrada, Belsomra, and Hysingla will be non-preferred in their respective classes.
Afrezza will require prior authorization and requests will be reviewed on a case by case basis.
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 March 31, 2015.
Agenda May 14, 2015
Minutes February 18, 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.