metformin extended-release tablets (generic to obsolete brand Fortamet only) — Cigna
type 2 diabetes mellitus
Preferred products
- metformin extended-release tablets (generic to obsolete brand Glucophage XR only)
Initial criteria
- If the patient has tried one Step 1 extended-release product, approve a Step 2 extended-release product.
- If the patient has tried one Step 1 extended-release product AND one Step 2 extended-release product, approve a Step 3 extended-release product.
Approval duration
1 year