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Apple Health Preferred Drug List (PDL)

The Health Care Authority (HCA) implemented the Apple Health Preferred Drug List (PDL) on January 1, 2018. All managed care plans and the fee-for-service program serving Apple Health clients will use this PDL.

HCA will add more drug classes to the Apple Health PDL beginning July 1, 2018. Additional drug classes that have been reviewed by the DUR Board will be added at this time and will continue to be added until all drug classes have been added to the Apple Health PDL.

Are you a pharmacist or prescriber? See what drugs are preferred and whether they need a prior authorization (PA).

View the Apple Health PDL

How to use the Apple Health PDL

The Apple Health PDL has products listed in groups by drug class. Unless otherwise indicated, the authorization criteria is that the client must have tried and failed, or is intolerant to, at least two or more preferred drugs within the drug class unless contraindicated, not clinically appropriate or only one drug is preferred.  

In addition to approval criteria for nonpreferred products, there are some products or drug classes which require additional clinical criteria to be met. These are indicated in the prior authorization (PA) status column.

Note: For continuity of care, all plans will use the same PA criteria, step therapy edits, and quantity limits developed by HCA.

Managed care and fee-for-service (FFS) plans

If you can't find the drug you are looking for on the Apple Health PDL, contact the managed care plan. For the FFS plan, see the FFS plan only coverage lists below.

Fee-for-service plan only

Preferred drug lists (PDL)

For previous versions, email us applehealthpharmacypolicy@hca.wa.gov.

The therapeutic interchange program (TIP) will apply to the 30 drug classes included in both the Washington PDL and the Apple Health PDL. Therapeutic interchange is a service for Endorsing Practitioners of the Washington PDL.

Other drug coverage lists

Note: For information on billing and rates, the Apple Health PDL, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates webpage.