Sutter Health Plus
Trulicity (dulaglutide)
Hormones : Drugs for Diabetes
  • Step Therapy: Diabetes Type 2: GLP1 + Combo:
    ST Single Generic

  • Prior Authorization: Diabetes Type 2: GLP1 + Combo:
    Documented Diagnosis: Yes

  • QL (2 per Rx);
  • Diabetes Type 2: GLP1 + Combo:
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

  • PA_APPLIES
  • ST_APPLIES