Update to the ​Biosimilar Preferred Drug List​

Jan 02, 2024

Effective January 4, 2024, the Department will add preferred and non-preferred drugs to the Biosimilar Preferred Drug List (PDL). 

The Department will add the following preferred drugs:  

• Q5122 – Nyvepria, pegfilgrastim-apgf 

The Department will add the following non-preferred drugs:  

• Q5108 – Fulphila, pegfilgrastim-jmdb 

• Q5107 – Mvasi, bevacizumab-awwb 

The Biosimilar PDL, implemented in 2022, establishes preferred and non-preferred Physician-Administered Drugs (PADs). Preferred drugs are available without a Prior Authorization (PA).  Providers must have members try preferred drugs first.  

Non-preferred drugs require a PA and these forms are available on the Health PAS Online Portal. For the Department to consider approving a non-preferred drug, the provider must include documentation of preferred drug failure due to lack of efficacy, intolerable side effects to the preferred drug, or clinical exceptions with their PA request. Clinical exceptions include the presence of a condition that prevents usage of the preferred drug or a significant drug interaction between another drug and the preferred drug.