Health Net
Trulicity (dulaglutide)
Hormones : Drugs for Diabetes
  • Prior Authorization: Multiple Sclerosis (MS):
    Documented Diagnosis: Yes
    Duration: 1 year(s)

  • Gaucher Disease:
    Age Requirement: >= 18
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: Unspecified

  • Quantity Limit: 2 devices per prescription