Western Health Advantage
Adlyxin (lixisenatide)
Hormones : Drugs for Diabetes
  • Diabetes Type 2: GLP1 + Combo:
    Age Requirement: >= 18
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 year(s)

  • Prior Authorization: Diabetes Type 2: GLP1 + Combo:
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 1 year(s)
    Reauthorization Required: Yes

  • Quantity Limit: 30 day supply per 1 fill(s).
  • Step Therapy: Diabetes Type 2: GLP1 + Combo:
    ST Multiple Brands

  • PA Required
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