California’s Division of Workers’ Compensation (DWC) ordered an update to the state’s drug formulary, effective May 15.
The update adds 20 drugs to the formulary and removes 12, bringing the total listed drugs from 275 to 283 drugs. The update also includes one change in exemption status, changes to “special fill” rules, and changes to application recommendations for several drugs.
The drug formulary took effect on January 1 of this year. Per State Assembly Bill 1124, before dispensing or prescribing a drug, providers must check the formulary list to determine if the drug requires prior authorization.
Cost containment, as well as concerns regarding opioid abuse, sparked the push to more tightly regulate pharmaceuticals.
The MTUS formulary lists drugs in alphabetical order and designates each either:
The formulary list notes exceptions to “non-exempt” status, referred to as “special fill.” When a drug is assigned a “special fill” exception, a provider may dispense or prescribe the drug without prior authorization, as long as the following conditions are true:
The formulary also offers American College of Occupational and Environmental Medicine (ACOEM) recommendations for each drug regarding the use of the drug for various body parts and conditions.
The May 15th update to the formulary is the first update since the introduction of the formulary. A DWC Newsline announced the update which adopts two addendums to the formulary: one highlighting the changes with strikethroughs and red font, the other a clean final version of the list, effective May 15.
Per the update order, the table below lists:
MTUS Formulary Changes Effective 5/15/18 |
Drug |
Drugs Added |
Alcaftadine (exempt) Azelastine Ophth (exempt) Azithromycin Ophth (exempt) Bepotastine Ophth (exempt) Besifloxacin Ophth (exempt) Cromolyn Sodium (exempt) Desloratadine (exempt) Emedastine Ophth (exempt) Epinastine HCL (exempt) Flurbiprofen Sodium (exempt) Irrigating Eyewash (exempt) Ketotifen Fumarate (exempt) Lidocaine HCl Ophth (exempt) Lodoxamide Ophth (exempt) Loratadine (exempt) Natamycin Ophth (exempt) Nedocromil (exempt) Olopatadine HCL (exempt) Prednisolone Sodium Ophth (non-exempt) Tranexamic Acid (exempt) |
Drugs Deleted |
Bacitracin Ophthalmic Bacitracin-Polymyxin B Ophthalmic Balanced Salt Solution Gentamicin-Prednisolone Ace Ophthalmic Neomycin/Bacitracin/Polymyxin B Ophthalmic Neomycin/Polymyxin B/Gramicidin Ophthalmic Nepafenac Ophthalmic Suspension Polymyxin B-Trimethoprim Rimexolone Ophthalmic Sodium Sulfacetamide Sulfacetamide Sodium/Prednisolone Tobramycin/Dexamethasone |
Exemption Status Changes |
Cyclopentolate HCL (non-exempt) |
Special Fill Changes |
Betamethasone (4 days) Dexamethasone Sodium Phosphate Ophthalmic (4 days) Fluorometholone (4 days) Loteprednol Etabonate Ophthalmic (4 days) |
ACOEM Guidelines Changes |
Acetaminophen Celecoxib Choline Magnesium Trisalicylate Chondroitin Sulfate Ciprofloxacin HCL Ophthalmic Clindamycin HCL Cyclopentolate HCL Diclofenac Potassium Diclofenac Sodium/Misoprostol Diflunisal Doxycycline Etodolac Fenoprofen Calcium Fluorometholone Flurbiprofen Gatifloxacin Homatropine HBr Ophthalmic Ibuprofen Imipramine HCL Indomethacin Ketoprofen Levofloxacin Ophthalmic Solution Loteprednol Etabonate Ophthalmic Meclofenamate Sodium Mefenamic Acid Meloxicam Moxifloxacin HCL Ophthalmic Nabumetone Ofloxacin Ophthalmic Solution Oxaprozin Prednisolone Acetate Salsalate Sulindac Tobramycin Ophthalmic Tolmetin Sodium Tropicamide Ophthalmic |
If poring over 22 pages of 8-point font to check the status of a given drug isn’t your idea of efficiency, DaisyBill offers an alternative to the DWC drug formulary PDF.
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3. Enter a search term, such as the name of a drug, class, or condition.
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