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19-707 To Help You End Opioid Abuse: Preferred Drug List Changes Focus on Opioid Pain Medications

Date: 09/11/19

Broad changes to the Preferred Drug List (PDL) are effective October 15, 2019

California Health & Wellness Plan (CHWP) is making significant changes to the Preferred Drug List (PDL).

These changes are in response to input from providers, regulatory changes, nationally recognized standard of care or treatment guideline changes, as well as the Pharmacy and Therapeutics (P&T) Committee. The P&T Committee reviews the PDL quarterly, at a minimum, to determine placement of medications on the drug list and any limitations to coverage. The P&T Committee consists of practicing physicians, pharmacists and other health care professionals.

These changes are considered more restrictive than prior PDL changes. Changes may include differences to the quantity limits (QL), age limits (AL), step therapy (ST), prior authorization (PA) status, formulary (F), and non-formulary (NF) status.

Note changes for opioids to prevent misuse

Note significant changes to the quantity limits and prior authorization requirements for opioid pain medications. These changes follow current treatment guidelines and standards of care for the utilization and prescribing of these medications. The goal is to improve safety and prevent abuse, overdose and diversion in response to the increased awareness of the opioid epidemic.

These medications will be updated with quantity limits and dosing that corresponds in most cases to less than or equal to 90 morphine milligram equivalents (MME) daily. In addition, opioid treatment-naïve patients may be limited to a seven-day supply on the first fill of preferred opioid pain medications. Requests for greater than seven days for opioid-naïve patients and requests for dosages that exceed 90 MME daily may require prior authorization. These new changes and quantity limits will be used in collaboration with the previously approved and implemented Opioid Utilization Management Program.

For the most current information and details about specific limits and restrictions, visit the CHWP website at www.CAHealthWellness.com. Go to For ProvidersPharmacy > Preferred Drug List (PDL).

Additional information

Providers are encouraged to access CHWP’s provider portal online at www.CAHealthWellness.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact CHWP at 1-877-658-0305. For prior authorization, fax 1-877-259-6961.

Changes to the PDL, effective October 15, 2019

The table below lists medications and their status on the PDL.

Changes to the PDL, effective October 15, 2019

Medication

Status

Comments

Acetaminophen with codeine tab 300-15 mg, 300-30 mg, 300-60 mg

F

QL updated

Acetaminophen with codeine solution (soln) 120-12 mg/5 ml

F

QL updated

Butalbital-acetaminophen-caffeine with codeine cap 50-300-40-30 mg,               50-325-40-30 mg

F

QL updated

Butalbital-aspirin-caffeine with codeine capsule (cap) 50-325-40-30 mg

F

QL updated

Codeine sulfate tab 15 mg, 30 mg, 60 mg

F

QL updated

Fentanyl transdermal (TD) patch 72-hour (hr), 12.5 mcg/hr, 25 mcg/hr,          50 mcg/hr, 75 mcg/hr, 100 mcg/hr

F

QL updated

Hydrocodone-acetaminophen tab 5-325 mg, 7.5-325 mg, 10-325 mg

F

QL updated

Hydrocodone-acetaminophen tab 5-300 mg, 7.5-300 mg, 10-300 mg

F

QL updated

Hydrocodone-acetaminophen soln 7.5-325 mg/15 ml

F

QL updated

Hydromorphone HCl liquid 1 mg/ml

F

QL updated

Hydromorphone HCl suppository 3 mg

F

QL updated

Hydromorphone HCl tab 2 mg, 4 mg, 8 mg

F

QL updated

Hydromorphone HCl tab extended-release (ER) 24-hr deterrent 8 mg, 12 mg,      16 mg

F

QL updated

Meperidine HCl oral soln 50 mg/5 ml

F

QL updated

Meperidine HCl tab 50 mg, 100 mg

F

QL updated

Methadone soln 5 mg/5 ml

F, PA

PA, QL updated

Methadone tab 10 mg

F, PA

PA, QL updated

Methadone tab 5 mg

F, PA

PA, QL updated

Morphine sulfate (concentrate) oral soln 20 mg/ml

F

QL updated

 

Changes to the PDL effective October 15, 2019, continued

Medication

Status

Comments

Morphine sulfate beads cap ER 24-hr 30 mg, 45 mg, 60 mg, 75 mg, 90 mg,       120 mg

F

QL updated

Morphine sulfate injection (inj) 0.5 mg/ml, 1 mg/ml, 2 mg/ml, 4 mg/ml, 5 mg/ml,      8 mg/ml, 10 mg/ml, 15 mg/ml

F

QL updated

Morphine sulfate IV soln 5 mg/ml, 25 mg/ml, 50 mg/ml

F

QL updated

Morphine sulfate oral soln 10 mg/5 ml, 20 mg/5 ml

F

QL updated

Morphine sulfate suppository 5 mg, 10 mg, 20 mg, 30 mg

F

QL updated

Morphine sulfate tab 15 mg, 30 mg

F

QL updated

Morphine sulfate tab controlled-release (CR) 15 mg, 30 mg, 60 mg, 100 mg,      200 mg

F

QL updated

Oxycodone-aspirin tab 4.88-325 mg

F

QL updated

Oxycodone HCl cap 5 mg

F

QL updated

Oxycodone HCl concentrate 100 mg/5 ml (20 mg/ml)

F

QL updated

Oxycodone HCl soln 5 mg/5 ml

F

QL updated

Oxycodone HCl tab 5 mg, 10 mg, 20 mg, 30 mg

F

QL updated

Oxycodone HCl tab ER 12-hr deterrent 10 mg, 20 mg, 30 mg, 40 mg, 60 mg,      80 mg

F, PA

QL updated

Oxycodone with acetaminophen tab 5-325 mg, 7.5-325 mg, 10-325 mg

F

QL updated

Oxycodone with acetaminophen soln 5-325 mg/5 ml

F

QL updated

Tapentadol HCl tab sustained-release (SR) 12-hr 50 mg, 100 mg, 150 mg,  200 mg, 250 mg

F, PA

QL updated

Tramadol HCl tab 50 mg

F

QL updated

Tramadol-acetaminophen tab 37.5-325 mg

F

QL updated

  • F indicates formulary
  • PA indicates prior authorization is required to verify member eligibility and that the member satisfies clinical protocols to ensure appropriate use of the medication.
  • NF indicates nonformulary
  • QL indicates quantity limit.