Washington Covered Treatments


Anti-HIV Drugs

[Rescriptor] [Sustiva] [Sustiva and Truvada] [Viramune]
Non-nucleosides (Non-Nukes or NNRTIs)


[Reyataz] [Prezista] [Lexiva] [Crixivan] [Kaletra] [Viracept 625] [Norvir] [Invirase] [Aptivus]
Protease Inhibitors
There are many categories of drugs related to treating AIDS, HIV or Hepatitis. You might also consider experimental drugs. Sometimes, a state will have a separate Hepatitis vaccination or screening program that offers treatments as well. Other times, the best way to find out about Hepatitis treatments is to contact an agency or organization that deals mostly with AIDS, or the HIV/STD section of your state's Department of Health.

[Ziagen] [Epzicom] [Trizivir][Videx EC][Emtriva][Truvada][Epivir][Combivir][Zerit][Viread][Retrovir]
Nucleoside/tides (NRTIs or nukes)


Entry Inhibitors

Integrase Inhibitors

Few states have AIDS Drug Assistance Programs (ADAP) that cover all the treatment types listed here, but you should always have your doctor or health care provider ask. Arrangements can sometimes be made on a case by case basis. One of the first things that an ADAP will ask is if you have already applied for Medicaid, which almost always covers more things than any ADAP. An ADAP might help pay your insurance premiums or assist with co-pays. Your Medicare Part D plan may also cover more than a state ADAP, but you should always check what any Medicare Part D plan covers. Some states will help you with premiums for insurance or even co-pays with Medicare Part D.

Washington Resources


HIV-related Treatments

All drugs are to be dispensed with a maximum 30 - day supply. Exceptions will require a prior authorization. Washington State has a wide range of covered medications (12/04/07), including treatments for chronic hepatitis B and C and related treatments. For very specific guidelines on the use of these drugs please go to download complete list. Some of the listings and requirements and restrictions below may have been updated since the last posting.
Drug Dispensing and Requirements

The following drugs are not covered - Document PA requirements as indicated for each drug on the PA form.

  • almotriptan malate (Axert), famciclovir (Famvir), frovatriptan succinate (Frova), naratriptan hydrochloride (Amerge), rizatriptan benzoate (Maxalt), sumatriptan succinate (Imitrex), testosterone (Androgel), zolmitriptan (Zomig).

The following drugs require prior authorization - Document PA requirements as indicated for each drug on the PA form.

  • Dronabinol (Marinol) - 10 lb wt loss must be documented on PA form for use
  • Olanzapine (Zyprexa) - Cov'd after failed trial of formulary meds (Depakote or Lithium)
  • Ondansetron (Zofran) - Cov'd after failed trial of Reglan, & either Compazine or Phenergan
  • PPI's including: esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) - Cov'd for tx of GERD, erosive esophagitis, or H. pylori PUD. Restricted to use after trial of H2-blockers in tx of ulcer or gastritis
  • Valacyclovir (Valtrex) - Restricted to tx of herpes zoster (shingles)

The Following drugs are code 1 - restricted to use in a specific diagnosis.

  • Azithromycin (Zithromax) - 250mg tablet only, restricted to tx of Chlamydia w/ code 1 override. For other indications use of code 1 override allowed if unable to reach prescriber. Z-pak units removed from formulary
  • Fluconazole (Diflucan) - Not cov'd for onychomycosis. Use code 1 override for all other indications
  • Itraconazole (Sporonox) - Not cov'd for onychomycosis. Use code 1 override for all other indications.

Prior authorization is required for DEA class II and III drugs when quantity exceeds 100

The following drugs are included in the pill splitting program

  • Atorvastatin (Lipitor), Citalopram (Celexa), Paroxetine (Paxil), Sertraline (Zoloft), Nefazodone (Serzone), valacyclovir (Valtrex)

Fills/refills may be obtained after 80% of the previous dispensed days-supply has been used.

Dispense generic when available; DAW overrides will require prior authorization OTC meds on the formulary are available by prescription only.


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Last modified: 12/26/2007
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