Generic liraglutide recombinant subcutaneous injection — Medical Mutual
Type 2 Diabetes Mellitus
Preferred products
- Bydureon (exenatide extended-release)
- Bydureon BCise (exenatide extended-release)
- Byetta (exenatide)
- Mounjaro (tirzepatide)
- Ozempic (semaglutide inection)
- Rybelsus (semaglutide oral tablet)
- Trulicity (dulaglutide)
Initial criteria
- If the patient has tried a preferred medication, authorization for a non-preferred medication may be given
Approval duration
12 months