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Getting access to Ozempic and other semaglutides/GLP-1s

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By demonstrating their expertise, practitioners reassure patients that they are receiving the highest quality of care.

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Recommended Drug Usage:

[ ] The patient has an FDA labeled indication for the requested agent (lower blood sugar levels in type II diabetic or type II diabetic with heart disease)

[ ] Ozempic is not prescribed concurrently with another GLP-1 receptor agonist

[ ] Dose does not exceed the FDA-approved maximum recommended dose

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Patients WITH Type 2 Diabetes Mellitus submit one of the following: 

[ ] A1C greater than or equal to 6.5% within the past 30 days

[ ] Fasting plasma glucose (FPG) greater than 126 mg/dL within the past 30 days

[ ] 2-hour plasma glucose (PG) greater than 200 mg/dL during oral glucose tolerance test within the past 30 days

OR

[ ] For patients diagnosed greater than 2 years ago submit medical records (e.g. chart notes) confirming diagnosis of type 2 diabetes mellitus

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Select one of the following: 

[ ] There is evidence of a claim that the patient is currently being treated with the requested agent within the past 90 days

[ ] Prescriber states the patient is currently being treated with the requested agent within the past 90 days

[ ] Patient’s medication history includes use of metformin or agent containing metformin within the past 90 days

[ ] Patient has an intolerance or hypersensitivity to metformin or agent containing metformin

[ ] Patient had an ineffective treatment response to metformin or agent containing metformin

[ ] Patient has an FDA labeled contraindication to metformin or agent containing metformin