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Updates to the Medi-Cal List of Contract Drugs

September 12, 2019

Effective for dates of service on or after October 1, 2019, for sofosbuvir/velpatasvir, the Code I restrictions will be updated as follows:

Requires a Treatment Authorization Request (TAR). Restricted to use in the treatment of chronic Hepatitis C Virus (HCV) infection in adults (≥18 years of age). Also restricted to 1) a maximum quantity of 28 tablets per dispensing; and 2) duration of therapy lasting up to 12 weeks from the dispensing date of the first prescription.

Additionally, the NDC labeler code restriction will be replaced with labeler code 72626 (Asegua Therapeutics LLC).

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