UnitedHealthcare
Bydureon (exenatide microspheres)
Hormones : Drugs for Diabetes
  • Prior Authorization: Diabetes Type 2: GLP1 + Combo:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

  • Diabetes Type 2: GLP1 + Combo:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)
    Supporting Documentation Requirements: Medication History

  • Step Therapy: Diabetes Type 2: GLP1 + Combo:
    ST Single Generic

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