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Updates to the Medi-Cal List of Contract Drugs

August 1, 2019

Effective for dates of service on or after April 1, 2019, VITRAKVI (larotrectinib) capsules and oral solution are reimbursable, subject to the following Code I restrictions: restricted to use in the treatment of cancer only. Also restricted to NDC labeler code 71777 (Loxo Oncology, Inc.) only.

Effective for dates of service on or after August 1, 2019, SAPHRIS (asenapine) 2.5 mg sublingual tablets are reimbursable, subject to the following Code I restrictions. Restricted to:

  1. The use of antipsychotics for Medi-Cal beneficiaries less than 18 years of age requires an approved Treatment Authorization Request (TAR);

  2. The use of antipsychotics for Medi-Cal beneficiaries residing in nursing facilities is restricted to FDA-approved indications; and

  3. Restricted to labeler code 00456 (Forest Laboratories, Inc.).

Updated provider manual sections will be released in a future Medi-Cal Update.