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The Policy VaultThe Policy Vault

Step 2 Products — Cigna

Type 2 diabetes mellitus

Preferred products

  • Step 1 Products
  • metformin-containing products including: Glumetza ER, Riomet, metformin oral solution, metformin extended-release (generics to Fortamet ER and Glumetza ER), glyburide/metformin, glipizide/metformin, Actoplus Met, pioglitazone/metformin, Kazano, alogliptin/metformin, Jentadueto, Jentadueto XR, Kombiglyze XR, saxagliptin/metformin extended-release, Janumet, Janumet XR, sitagliptin/metformin (authorized generic to Zituvimet), Zituvimet, Zituvimet XR

Initial criteria

  • If the patient has tried one Step 1 Product, approve a Step 2 Product.
  • If the patient has tried one Step 2 Product, approve the requested Step 2 Product.
  • If the patient has tried one Step 3 Product, approve the requested Step 2 Product.
  • If the patient will be initiating dual therapy with metformin AND Farxiga or Jardiance, approve Farxiga or Jardiance.
  • If the patient has a contraindication to metformin, according to the prescriber, approve Farxiga or Jardiance.
  • If the patient has heart failure, approve Farxiga or Jardiance.
  • If the patient has chronic kidney disease, approve Farxiga or Jardiance.
  • If the patient has atherosclerotic cardiovascular disease or, according to the prescriber, the patient has at least two risk factors for cardiovascular disease, approve Farxiga or Jardiance.
  • If the patient has type 2 diabetes AND peripheral arterial disease, approve Farxiga or Jardiance.