September 5, 2019
Starting November 1, 2019 Victoza will be non-preferred medication and will require prior authorization for all members. Victoza is a GLP-1 agonist used in the treatment of type II diabetes.
Premera offers multiple drugs in the GLP-1 agonist class available at preferred cost share such as Trulicity, Ozempic, and Exenatide/Bydureon. These options offer the advantage of once weekly dosing, whereas Victoza requires daily injections.
The prior authorization review will look for diagnosis of Type II diabetes, trial and failure of metformin, and trial and failure of two preferred GLP-1 agonists: Ozempic, Trulicity, and/or Exenatide/Bydureon. If covered, members may have a higher cost share depending on their benefit structure.
If there’s a medical reason for your patient to remain on Victoza, you can submit documentation showing the patient tried and failed the preferred options in the medical policy or document. You have 3 options for submitting the information:
- Submit prior authorization requests electronically via CoverMyMeds, EMR (if provider system allows it), or ExpressPass.
- Fax prior authorization request to our Pharmacy Services team at 888-260-9836.
- Call our pharmacy services team at 888-261-1756 for a prior authorization review. Our pharmacy services team is available Monday through Friday during business hours.
We know paying for high-cost medications is a concern for our customers. We regularly review the cost of prescription medications to determine if there are similar, but less expensive, medications on the market. This policy change is an effort to help our customers find and use affordable alternatives to high-cost medications.