Zituvio — CareFirst (Caremark)
Type 2 diabetes mellitus (adjunct to diet and exercise to improve glycemic control)
Preferred products
- metformin
Initial criteria
- Diagnosis of type 2 diabetes mellitus
- Patient has NOT been receiving a stable maintenance dose of the requested drug for at least 3 months
- AND ONE of the following:
- Patient has experienced an inadequate treatment response, intolerance, or has a contraindication to metformin
- OR patient requires combination therapy AND has an A1C of 7.5 percent or greater
Reauthorization criteria
- Diagnosis of type 2 diabetes mellitus
- Patient has been receiving a stable maintenance dose of the requested drug for at least 3 months
- AND patient has demonstrated a reduction in A1C since starting this therapy
Approval duration
36 months