PRIOR AUTHORIZATION BYPASS Tanzeum (albiglutide) Bypass the Prior Authorization by Modifying the following Prescription Forms to the Patient's Needs
|
|
- Scarlett Harrington
- 5 years ago
- Views:
Transcription
1 Please ote: Medical ecessity Prior Authorization may be overrided for both formulary coverage and benefit design restrictions. They are issued at the full discretion of the benefit manager. PRIOR AUTHORIZATIO BPASS Tanzeum (albiglutide) Bypass the Prior Authorization by Modifying the following Prescription Forms to the Patient's eeds Drug ame Refer for Diabetes/ Insulin Protocol COMPLETE PRIOR AUTHORIZATIO FORMS: as directed by physician Dx: DIABETES ICD 10: E 11.9 SAMPLE
2 Prescriber Information Last ame: DEA/PI: Specialty: Phone Fax Member Information Last ame: Member ID umber DOB: Medication Information: Drug ame and Strength: Diagnosis: Quantity and Dosing: Duration: When advised below, please include all requested fax documentation (lab results, etc.) when submitting this Prior Authorization fax form; not submitting requested documentation could delay the clinical review process. Tanzeum Prior Authorization Form ou must answer ALL of the following questions 1. Has the patient had a trial and failure or intolerance to Victoza, Byetta, or Bydureon? Please submit documentation 2. Does the patient have a diagnosis of type 2 diabetes? 3. Is the patient 18 years of age or older? 4. Does the patient have gastroparesis? 5. Has the patient been on this therapy previously? 6. Is the patient s HbA1c greater than 6.9%? HbA1c must be taken within the past 6 months and documentation is required 7. Was the patient s HbA1c greater than 6.9% prior to starting therapy? Documentation is required 8. Has the patient had a trial and an inadequate response or intolerance to a sulfonylurea? 9. Does the patient have a contraindication to therapy with a sulfonylurea (i.e., debilitated state, past history of falls, high risk for falls, hepatic insufficiency)? 10. Is the patient currently taking and will he/she continue to take a sulfonylurea? If no, please provide rationale for discontinuing therapy: 11. Has the patient had a trial and an inadequate response or intolerance to metformin? Page 1 of 3
3 12. Does the patient have a contraindication to therapy with metformin (i.e., renal insufficiency, hepatic insufficiency)? 13. Is the patient currently taking and will he/she continue to take metformin while on Tanzeum therapy? If no, please provide rationale for discontinuing therapy: 14. Is the patient currently taking any of the following medications? (Please Circle) Precose (acarbose) Byetta, Bydureon (exenatide) Symlin (pramlintide) esina (alogliptin) Jentadueto (linagliptin / metformin) Kombiglyze XR (saxagliptin / metformin) Farxiga (dapagliflozin) Kazano (alogliptin / metformin) Invokamet (canagliflozin / metformin) Trulicity (dulaglutide) Glyset (miglitol) Tradjenta (linagliptin) Xigduo XR (dapagliflozin-metformin) Januvia (sitagliptin) Onglyza (saxagliptin) Oseni (alogliptin / pioglitazone) Victoza (liraglutide) Invokana (canagliflozin) Jardiance (empagliflozin) Janumet/Janumet XR (sitagliptin / metformin) 15. If the patient is taking any of the following medications, will concomitant therapy with those agents be discontinued? Precose (acarbose) Byetta, Bydureon (exenatide) Symlin (pramlintide) esina (alogliptin) Jentadueto (linagliptin / metformin) Kombiglyze XR (saxagliptin / metformin) Farxiga (dapagliflozin) Kazano (alogliptin / metformin) Invokamet (canagliflozin / metformin) Trulicity (dulaglutide) Glyset (miglitol) Tradjenta (linagliptin) Xigduo XR (dapagliflozin-metformin) Januvia (sitagliptin) Onglyza (saxagliptin) Oseni (alogliptin / pioglitazone) Victoza (liraglutide) Invokana (canagliflozin) Jardiance (empagliflozin) Janumet/Janumet XR (sitagliptin / metformin) Please note, not all drugs/diagnoses are covered on all plans. Page 2 of 3
4 Comments: Information given on this form is accurate as of this date. Prior Authorization forms are located on the Cover Page. Print a new form for each request as forms are updated periodically. Prescriber or Authorized Signature Date Authorized Medical Staff ame/title Attention Healthcare Provider: If you would like to discuss this request with a medical professional, please contact the Prior Authorization Department whose numbers appear on the Cover Page. I understand that USDoctor's use or disclosure of individually identifiable health information, whether furnished by me or obtained by another source such as medical providers, shall be in accordance with federal privacy regulations under HIPAA (Health Insurance Portability and Accountability Act of 1996). Page 3 of 3
5 Contact Information: Telephone: (855) Fax: (248) Please ote: Medical ecessity Prior Authorization may be utilized to override both formulary coverage and benefit design restrictions. They are issued at the full discretion of the benefit manager. PRIOR AUTHORIZATIO FORM: COVER PAGE Plan Member ID Drug ame Quantity Directions Diagnosis MEMBER IFORMATIO DRUG IFORMATIO Last ame Date of Birth ICD-10 Duration of Therapy PLEASE LIST ALTERATIVE THERAPIES THAT HAVE BEE ATTEMPTED AD A OTHER PERTIET IFORMATIO RELATED TO DRUG AD/OR DISEASE STATE. IF OT PRESET, WITHI ORMAL LIMITS WILL BE USED FOR THE REVIEW. Medication/Failure Reason: IgE: ESR: CRP: # Joints: %BSA: Height: Weight: BMI: HA1C: Hemoglobin: Hematocrit: T-Score: Dialysis: Long Term Care Facility: Self Injecting: Stimulation test: / Growth velocity: #Chemotherapy cycles/month: Mini-Mental Status Test: Baseline Free testosterone/total testosterone: / HCV RA viral load: Viral Genotype: ALT: PHSICIA IFORMATIO Physician Signature Date Physician ame PI # Phone umber Action eeded Only mark Urgent when standard review time would seriously harm the member s life or health or ability to regain maximum function Fax umber Pharmacy Fax Urgent For Review The information contained in this facsimile message, including the attachments, may be privileged, may constitute inside information and is intended only for use of the addressee. If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited and may be unlawful. If you have received this communication in error, please immediately notify me by replying to this message and destroy the original message.
PRIOR AUTHORIZATION BYPASS Bydureon (long acting exenatide)
Please ote: Medical ecessity Prior Authorization may be overrided for both formulary coverage and benefit design restrictions. They are issued at the full discretion of the benefit manager. PRIOR AUTHORIZATIO
More informationSAMPLE IgE: ESR: CRP: # Joints: %BSA: Height: Weight: BMI:
Please Note: Medical Necessity Prior Authorization may be overrided for both formulary coverage and benefit design restrictions. They are issued at the full discretion of the benefit manager. PRIOR AUTHORIZATION
More informationDrug Class Review Newer Diabetes Medications and Combinations
Drug Class Review Newer Diabetes Medications and Combinations Final Update 2 Report July 2016 The purpose reports is to make available information regarding the comparative clinical effectiveness and harms
More informationDeaths Hospitalizations Company. Takeda Pharmaceuticals. Takeda Pharmaceuticals. Takeda Pharmaceuticals. Janssen Pharmaceuticals
Takeaways: Diabetes Drug Investigation From: BSardi@aol.com Sent: Mon, Dec 22, 2014 at 10:51 am To: Cc: gemcap2@reagan.com martie.whittekin@verizon.net, katjames008@gmail.com clip_image002.jpg (64.5 KB)
More information6/1/2018. Lou Haenel, IV, DO, FACE, FACOI Endocrinology Roper St Francis Charleston, SC THE OMINOUS OCTET: HOW PATHOPHYSIOLOGY AND THERAPY MERGE
Lou Haenel, IV, DO, FACE, FACOI Endocrinology Roper St Francis Charleston, SC THE OMINOUS OCTET: HOW PATHOPHYSIOLOGY AND THERAPY MERGE 1 2 3 Sulfonylureas Glipizide Glyburide Glimeperide 4 Metformin Gold
More informationObjectives. How Medicine Works to Control Blood Sugar Levels. What Happens When We Eat? What is diabetes? High Blood Glucose (Hyperglycemia)
How Medicine Works to Control Blood Sugar Levels Stacie Petersen, RN, CDE Objectives Define Diabetes List how medications work (ominous octet) Identify side effects of medications for diabetes What is
More informationDiabetes Update Bryan Heart Conference September 5, 2015 Shannon Wakeley, MD. Disclosures. Objectives 9/1/2015
Diabetes Update Bryan Heart Conference September 5, 2015 Shannon Wakeley, MD Disclosures I speak on behalf of the following companies: Astra Zeneca, Boehringer Ingelheim, Johnson & Johnson, Sanofi and
More informationCollaborative Practice Agreement
Collaborative Practice Agreement [community pharmacy name] [address] [phone number] [physician practice] [address] [phone number] Effective: [date] Expiration: [date] 1 Table of Contents 1.0 Introduction...4
More informationDIABETES (1 of 5) Generic. Generic $0 $5 $5-10 $0 $0 $0. Generic $0 $5 $5-10. Generic. Generic $0 $5 $5-10 $0 $0 $0. Generic $0 $5 $5-10 $0 $0 $0
Metformin DIABETES (1 of 5) Glucophage Glucophage XR ER $7 (500mg) $7 (500mg) $5 $5 500mg, 750mg only 500mg, 750mg only Sulfonylurea/Combinations Amaryl Glucotrol glimepiride glipizide $5 $5 Glucotrol
More informationDate of Review: September 2016 Date of Last Review: September 2015
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationDiabetes Medication Updates Erica Bukovich, PharmD, BC-ADM, CDE September 20, 2018
Diabetes Medication Updates Erica Bukovich, PharmD, BC-ADM, CDE September 20, 2018 Learning Objectives Identify medication classes available for treatment of individuals with diabetes. Demonstrate understanding
More informationNon-Insulin Diabetes Medications Summary
Non-Insulin Diabetes Medications Summary Medications marked with an asterisk (*) can cause hypoglycemia INSULIN SECRETAGOGUES Sulfonylureas* GLYBURIDE* (Diabeta) (Micronase) production. Side effects: Potential
More informationType 2 Diabetes: Where Do We Start with Treatment? DIABETES EDUCATION. Diabetes Mellitus: Complications and Co-Morbid Conditions
Diabetes Mellitus: Complications and Co-Morbid Conditions ADA Guidelines for Glycemic Control: 2016 Retinopathy Between 2005-2008, 28.5% of patients with diabetes 40 years and older diagnosed with diabetic
More informationFARXIGA (dapagliflozin) Jardiance (empagliflozin) tablets. Synjardy (empagliflozin and metformin hydrochloride) tablets. GLUCOPHAGE* (metformin)
Type 2 Medications Drug Class How It Works Brand and Generic Names Manufacturers Usual Starting Dose The kidneys filter sugar and either absorb it back into your body for energy or remove it through your
More informationDipeptidyl-Peptidase 4 (DPP-4) Inhibitors Drug Class Prior Authorization Protocol
Dipeptidyl-Peptidase 4 (DPP-4) Inhibitors Drug Class Prior Authorization Protocol Line of Business: Medicaid P&T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed
More informationSTEP THERAPY CRITERIA
CATEGORY DRUG CLASS BRAND NAME (generic) STEP THERAPY CRITERIA AMYLIN ANALOG: SYMLIN/SYMLINPEN (pramlintide acetate) ANTIDIABETIC AGENTS GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST (GLP-1): ADLYXIN (lixisenatide)
More informationThe Death of Sulfonylureas? A Review of New Diabetes Medications
The Death of Sulfonylureas? A Review of New Diabetes Medications Kelly Hoenig, Pharm.D., BCPS Cedar Rapids Family Medicine Residency 2/4/17 Objectives Review GLP-1 Agonists, DPP-IV Inhibitors and SGLT-2
More informationJonathan Stoehr, MD PhD Endocrinology, Diabetes, Metabolism and Nutrition Virginia Mason Medical Center Seattle, WA 2012 Virginia Mason Medical
Jonathan Stoehr, MD PhD Endocrinology, Diabetes, Metabolism and Nutrition Virginia Mason Medical Center Seattle, WA There is no conflict of interest that could be perceived as prejudicing the impartiality
More informationGLYXAMBI (empagliflozin-linagliptin) oral tablet
GLYXAMBI (empagliflozin-linagliptin) oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This
More informationManagement of Type 2 Diabetes Mellitus. Heather Corn, MD, MS Endocrinology, Diabetes, and Metabolism
Management of Type 2 Diabetes Mellitus Heather Corn, MD, MS Endocrinology, Diabetes, and Metabolism Disclosures Working for Intermountain Healthcare Some of the views represented are the opinion of ABIM-certified
More informationPhysician Drug Reference Chart for Diabetes Antidiabetic Medications
Drug Class Compound Brand Name Mechanism of Action Advantages Disadvantages Alpha-glucosidase inhibitors Medium Cost by Bayer Healthcare, Pfizer, Takeda Research Acarbose Miglitol Voglibose Precose Glyset
More informationSGLT2 Inhibitors
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: SGLT2 Inhibitors Page: 1 of 7 Last Review Date: June 22, 2018 SGLT2 Inhibitors Description Invokana
More informationTABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations
177 TABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations Formulary Coverage Indication for use with: INSULIN THERAPY NS NB NL PE ADULTS PEDIATRICS PREGNANCY BOLUS
More information4/9/2018 HOW TO REGULATE DIABETES MEDICATIONS. By Sarah Froemsdorf MSN, RNC, CDE, FNP DISCLOSURES NONE. Diagnosis
HOW TO REGULATE DIABETES MEDICATIONS By Sarah Froemsdorf MSN, RNC, CDE, FNP DISCLOSURES NONE Diagnosis 1 NORMAL BODY The normal pancreas releases one unit of insulin every hour all day. The normal pancreas
More informationRPCC Pharmacy Forum. The Type 2 Diabetes Issue. Type 2 Diabetes: The Basics
Nov/Dec 2015 Issue 11 RPCC Pharmacy Forum Special Interest Articles: Diabetes Medication Chart Insulin Chart Afreeza Did you know? Exanatide, marketed as Byetta, is the synthetic form of exendin-4, which
More information1/15/2018. Disclosures. Current Diabetes Medications. Objectives NON-INSULIN AGENTS. Diabetes Med Classes. Mealtime
Disclosures Current Diabetes Medications None Claire Baker, M.D. Diabetes & Endocrine Associates January 24, 2018 Objectives Identify categories of diabetes medications Understand the pharmacology of diabetes
More informationUpdate on Therapies for Type 2 Diabetes: Angela D. Mazza, DO July 31, 2015
Update on Therapies for Type 2 Diabetes: 2015 Angela D. Mazza, DO July 31, 2015 Objectives To present the newer available therapies for the management of T2D To discuss the advantages and disadvantages
More informationWhat s New in Diabetes Treatment. Disclosures
What s New in Diabetes Treatment Shiri Levy M.D. Henry Ford Hospital Senior Staff Physician Service Chief, West Bloomfield Hospital Endocrinology, Metabolism, Bone and Mineral Disorders Disclosures None
More informationTABLE 1A: Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations
177 TABLE 1A: Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations TABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations Formulary
More informationDisclosures. Objectives. Bryan Cardiology Conference DM2 & Cardiovascular Outcome Trials 8/28/2017
Bryan Cardiology Conference DM2 & Cardiovascular Outcome Trials Shannon Wakeley MD Complete Endocrinology 9/2/2017 Disclosures Speakers Bureau: Astra Zeneca, Sanofi, Abbvie, Boehringer-Ingelheim, Medtronic,
More informationSGLT2 Inhibitors
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.30.19 Subject: SGLT2 Inhibitors Page: 1 of 6 Last Review Date: September 15, 2016 SGLT2 Inhibitors Description
More informationPharmacology Updates. Quang T Nguyen, FACP, FACE, FTOS 11/18/17
Pharmacology Updates Quang T Nguyen, FACP, FACE, FTOS 11/18/17 14 Classes of Drugs Available for the Treatment of Type 2 DM in the USA ### Class A1c Reduction Hypoglycemia Weight Change Dosing (times/day)
More informationDiabetes Mellitus II CPG
1 Diabetes Mellitus II CPG Candidates for Screening Integrated Complex Care Patients: Check Yearly Prediabetes: Check Yearly No Diabetes Mellitus (DM) Risk Factors: Check at Age 45, Repeat Every 3 Years
More informationUnderstanding Your Diabetes: A Basic Guide
Understanding Your Diabetes: A Basic Guide Table of Contents First Steps to Managing Your Diabetes at Home When Your Blood Sugar is Too High (Hyperglycemia) Blood Sugar Targets and Blood Sugar Log How
More informationWhat s New in Diabetes Medications. Jena Torpin, PharmD
What s New in Diabetes Medications Jena Torpin, PharmD 1 Objectives Discuss new medications in the management of diabetes Understand the mechanism of the medications discussed Understand the side effects
More informationSGLT2 Inhibitors
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.07.19 Subject: SGLT2 Inhibitors Page: 1 of 5 Last Review Date: December 3, 2015 SGLT2 Inhibitors Description
More informationPharmacologic Agents for Treatment of Type 2 Diabetes
Pharmacologic Agents for Treatment of Type 2 Diabetes SCAN Drugs Medication Biguanides 1 1 er uncoated tabs 500 mg & 750 mg Sulfonylureas 1 1 500 850 mg QD - TID 500 2000 mg glimepiride 1 1 1 8 mg glipizide
More informationTable 1. Antihyperglycemic agents for use in type 2 diabetes
Table 1. Antihyperglycemic agents for use in type 2 diabetes DRUG IN ALPHA-GLUCOSIDASE INHIBITOR: inhibits pancreatic alpha-amyle and intestinal alpha-glucoside Acarbose (Glucobay) 0.6% Negligible Not
More informationGlucagon-like peptide-1 (GLP-1) Agonists Drug Class Prior Authorization Protocol
Glucagon-like peptide-1 (GLP-1) Agonists Drug Class Prior Authorization Protocol Line of Business: Medicaid P&T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed
More informationDiabetes Treatment Guidelines
Diabetes Treatment Guidelines For more comprehensive information about current approaches to the diagnosis and treatment of diabetes, visit the American Diabetes Association Standards of Medical Care 2018
More informationTYP 2 DIABETES. Marc Donath
TYP 2 DIABETES Marc Donath Treatment of Typ 2 Diabetes GLP-1 Anti-IL-1β Insulin sulfonylureas Metformin UCP-1 IL-1β Sport SGLT2i Bariatric surgery Cardiomyocytes Control Glucose Dyntar et al. Diabetes
More informationDiabetes Medications: Oral Anti-Hyperglycemic Medications
Diabetes Medications: Oral Anti-Hyperglycemic Medications Medication Types 1. Biguanides 2. Sulfonylureas 3. Thiazolidinediones (TZDs) 4. Alpha-Glucosidase Inhibitors 5. D-Phenylalanine Meglitinides 6.
More informationVery Practical Tips for Managing Type 2 Diabetes
Very Practical Tips for Managing Type 2 Diabetes Jean-François Yale, MD, FRCPC McGill University Health Centre, Montreal, Canada Jean-francois.yale@mcgill.ca www.dryale.ca OBJECTIVES DISCLOSURES The participant
More informationOral Medication for the Management of Diabetes Mechanism of. Duration of Daily Dosing Action
Glyburide (Micronase, Diabeta, Glynase) Glipizide (Glucotrol) Glipizide XL (Glucotrol XL) Glimepiride (Amaryl) Prandin (Repaglinide) Starlix (Nateglinide) 1.25, 2.5, 5mg tabs, Dosing: 2.5-20 mg 12- (Glynase:
More informationClinical Pharmacotherapeutic Applications of the American Diabetes Association Standards of Care 2018
Clinical Pharmacotherapeutic Applications of the American Diabetes Association Standards of Care 2018 RACHEL NAIDA, PHARMD, CDE CLINICAL ASSOCIATE PROFESSOR UNIVERSITY OF NEW ENGLAND COLLEGE OF PHARMACY
More informationDiabetes 2016: Strategies for achieving optimal diabetes control
PHASE Safety Net Community Benefit Diabetes 2016: Strategies for achieving optimal diabetes control Presented by: Lisa Gilliam, MD, PhD Clinical Leader Diabetes Program Kaiser Permanente Northern California
More informationSide Effects of: GLP-1 agonists DPP-4 inhibitors SGLT-2 inhibitors. Bryce Fukunaga PharmD April 25, 2018
Side Effects of: GLP-1 agonists DPP-4 inhibitors SGLT-2 inhibitors Bryce Fukunaga PharmD April 25, 2018 Objectives For each drug class: Identify the overall place in therapy Explain the mechanism of action
More informationImages have been removed from the PowerPoint slides in this handout due to copyright restrictions. Insulins. Rapid Short Intermediate Long Mix
Diabetes Medications Diabetes Medications Type 1 Insulin is needed Type 2 Oral Diabetes Medications Or Oral Diabetes Medications plus Insulin Or Insulin Alone Diabetes Medications Secretagogues Glipizide
More informationOral and Injectable Non-insulin Antihyperglycemic Agents
Appendix 5: Diabetes Education and Medical Management in Adults with Diabetes Oral and Injectable Non-insulin s This directive will be implemented by RPhs, RNs or RDs who have been deemed authorized implementers.
More informationUnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2018 P 3086-5 Program Step Therapy Diabetes Medications - SGLT2 Inhibitors Medication Farxiga (dapagliflozin)*, Glyxambi (empagliflozin/linagliptan),
More informationMultiple Small Feedings of the Mind: Diabetes. Sonja K Fredrickson, MD, BC-ADM March 7, 2014
Multiple Small Feedings of the Mind: Diabetes Sonja K Fredrickson, MD, BC-ADM March 7, 2014 Question 1: Setting A1c Goals Describe the evidence based approach to determining the target HgbA1c in different
More informationUpdate Diabetes Therapie. Marc Y Donath
Update Diabetes Therapie Marc Y Donath Recent CV outcome studies in Diabetes N Engl J Med. 2015 373:2117-28 (Empa-Reg outcome study) N Engl J Med. 2016 June 13 (LEADER trial) N Engl J Med. 2017 June 12
More informationDiabetes Update 2018: Challenging Transitions. Patricia A. Daly, MD, FACP, FACE Medical Director for Diabetes Valley Health System
Diabetes Update 2018: Challenging Transitions Patricia A. Daly, MD, FACP, FACE Medical Director for Diabetes Valley Health System 1 Patricia A. Daly, MD, FACP, FACE Medical Director for Diabetes Valley
More informationHow can we improve outcomes in Type 2 diabetes?
How can we improve outcomes in Type 2 diabetes? Earlier diagnosis Better patient education Stress central role of lifestyle management Identify and treat all risk factors Use rational pharmacological therapy
More informationDIABETES. overview of pharmacologic agents used in the management of. Overview 4/3/2014 OBJECTIVES. Injectable Agents
overview of pharmacologic agents used in the management of DIABETES Kyle Roberts, Pharm.D. PGY-1 Pharmacy Resident Saint Alphonsus RMC 1. List the different classes of diabetes medications, including the
More informationAdvanced Practice Education Associates. Endocrine
Advanced Practice Education Associates Endocrine Overview Diabetes Thyroid Disease 162 Copyright 2016 Advanced Practice Education Associates DIABETES MELLITUS What is the BMI cut point for screening adults
More informationFirst Name. Specialty: Fax. First Name DOB: Duration:
Prescriber Information Last ame: First ame DEA/PI: Specialty: Phone - - Fax - - Member Information Last ame: First ame Member ID umber DOB: - - Medication Information: Drug ame and Strength: Diagnosis:
More informationNewer Therapies for Type 2 Diabetes
Newer Therapies for Type 2 Diabetes Sandra Indacochea Sobel, MD Clinical Assistant Professor of Medicine Clinical Chief of Endocrinology, UPMC Mercy Division of Endocrinology, Diabetes, and Metabolism
More informationHalting the Rise, Newest Non- Insulin Options for Lowering A1c
Halting the Rise, Newest Non- Insulin Options for Lowering A1c Alecia Rottinghaus, PharmD PGY-1 Pharmacy Resident Iowa City Veterans Affairs Health Care System January 29 th, 2019 Disclosures Alecia Rottinghaus
More informationHalting the Rise, Newest Non- Insulin Options for Lowering A1c
Halting the Rise, Newest Non- Insulin Options for Lowering A1c Alecia Rottinghaus, PharmD PGY-1 Pharmacy Resident Iowa City Veterans Affairs Health Care System January 29 th, 2019 Disclosures Alecia Rottinghaus
More informationGlycemic Management of Type 2 Diabetes. Gail Nunlee-Bland, M.D. Professor Medicine & Pediatrics Director, Diabetes Treatment Center Howard University
Glycemic Management of Type 2 Diabetes Gail Nunlee-Bland, M.D. Professor Medicine & Pediatrics Director, Diabetes Treatment Center Howard University 1 None Disclosures Learning Objectives Understand the
More information3. Does the patient meet ALL of the following requirements? Y N
Pharmacy Prior Authorization AETA BETTER HEALTH FLORIDA Procrit - Retacrit (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign
More informationFirst Name. Specialty: Fax. First Name DOB: Duration:
Prescriber Information Last ame: First ame DEA/PI: Specialty: Phone - - Fax - - Member Information Last ame: First ame Member ID umber DOB: - - Medication Information: Drug ame and Strength: Diagnosis:
More informationWhat the Pill Looks Like. How it Works. Slows carbohydrate absorption. Reduces amount of sugar made by the liver. Increases release of insulin
Diabetes s Oral s - Pills These are some of the pills that are currently available in Canada to treat diabetes. Each medication has benefits and side effects you should be aware of. Your diabetes team
More informationDiabetes management in liver and kidney disease
Diabetes management in liver and kidney disease Epidemiology 1 Clinical case A 59 year old man with alcoholic cirrhosis; portal hypertension; mild encephalopathy Fasting plasma glucose - 103, March 2016;
More informationCurrent and future market dynamics overview
OVERVIEW Catalyst Summary EXECUTIVE SUMMARY Strategic scoping and focus Datamonitor key findings Related reports MARKET DEFINITION Published diabetes reports Market definition for antidiabetic drugs Forecast
More informationSGLT2 Inhibitors
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: SGLT2 Inhibitors Page: 1 of 7 Last Review Date: November 30, 2018 SGLT2 Inhibitors Description
More informationDiabetes Update 2018: Challenging Transitions. Patricia A. Daly, MD, FACP, FACE Medical Director for Diabetes Valley Health System
Diabetes Update 2018: Challenging Transitions Patricia A. Daly, MD, FACP, FACE Medical Director for Diabetes Valley Health System 1 Patricia A. Daly, MD, FACP, FACE Medical Director for Diabetes Valley
More informationClinical Cases in Diabetes Management. Joseph Cook D.O.
Clinical Cases in Diabetes Management Joseph Cook D.O. Objectives State the prevalence of Diabetes Mellitus in Ohio State the percentage of diabetic patients in the U.S. treated by Primary Care Physicians
More informationGlucagon-Like Peptide (GLP-1) Receptor Agonists Clinical Edit Criteria
Glucagon-Like Peptide (GLP-1) Receptor Agonists Clinical Edit Criteria Drug/Drug Class: Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Superior HealthPlan follows the guidance of the Texas Vendor Drug
More informationFeidhmeannacht na Seirbhíse Sláinte
Feidhmeannacht na Seirbhíse Sláinte Health Service Executive Feidhmeannacht na Seirbhíse Sláinte Seirbhís Aisíocaíochta Cúraim Phríomhúil Bealach amach 5 an M50 An Bóthar Thuaidh Fionnghlas Baile Átha
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Reference Number: HIM.PA.53 Effective Date: 03.01.18 Last Review Date: 02.18 Line of Business: Health Insurance Marketplace See Important
More informationSodium-Glucose Co-Transporter 2 (SGLT-2) Inhibitors Drug Class Prior Authorization Protocol
Sodium-Glucose Co-Transporter 2 (SGLT-2) Inhibitors Drug Class Prior Authorization Protocol Line of Business: Medicaid P&T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has
More information3. Cardiovascular Disease?
Swiss recommendations 2016 Swiss Society of Endocrinology and Diabetology 1. Deficiency? Basal Premixed- Basal + GLP-1 RA (Xultophy ) or Basal Bolus 2. egfr < 30 ml/min? 3. Cardiovascular Disease? 4. Heart
More informationObjectives. Recognize all available medical treatment options for diabetes. Individualize treatment and glycemic target based on patient factors
No disclosure Objectives Recognize all available medical treatment options for diabetes Individualize treatment and glycemic target based on patient factors Should be able to switch to more affordable
More information2. Does the member have a diagnosis of central precocious puberty? Y N
Pharmacy Prior Authorization AETA BETTER HEALTH PESLVAIA & AETA BETTER HEALTH KIDS Leuprolide (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
More informationThis program applies to Commercial, GenPlus and Health Insurance Marketplace formularies.
OBJECTIVE The intent of the GLP-1 (glucagon-like peptide-1) Agonists [Adlyxin (lixisenatide), Byetta (exenatide), Bydureon (exenatide extended-release), Tanzeum (albiglutide), Trulicity (dulaglutide),
More informationWelcome to the PHASE Learning Community! October 31, 2018
Welcome to the PHASE Learning Community! October 31, 2018 Webinar Housekeeping 1. Dial in for audio: 303-248-0285, Access Code: 5617817 2. Lines are muted. You can chat in questions or unmute your line
More informationImproving Patient Outcomes with Individualized Therapy in the Management of Type 2 Diabetes
Improving Patient Outcomes with Individualized Therapy in the Management of Type 2 Diabetes Timothy S. Reid, M.D. Mercy Diabetes Center Janesville, WI Duality Statement Dr. Reid is a Speaker and Consultant
More informationRequest for Special Authorization Enbrel
Certain prescription drugs call for a more detailed assessment to help ensure that they represent reasonable treatment. Special Authorization requires that you request approval from Great-West Life for
More informationDM Fundamentals Class 4 Meds for Type 2
DM Fundamentals Class 4 Meds for Type 2 Beverly Thomassian, RN, MPH, BC ADM, CDE President, Diabetes Education Services Copyright 1999 2015, Diabetes Education Services, All Rights Reserved. Diabetes Meds
More informationFormulary Medical Necessity Program
BENEFIT APPLICATION Formulary Medical Necessity Program DRUG POLICY Benefit determinations are based on the applicable contract language in effect at the time the services were rendered. Exclusions, limitations
More informationNavigating the New Options for the Management of Type 2 Diabetes
Navigating the New Options for the Management of Type 2 Diabetes Clinical Associate Professor Mark Kennedy Department of General Practice, University of Melbourne Chair, Primary Care Diabetes Society of
More informationPharmacy Prior Authorization
Pharmacy Prior Authorization MERC CARE (MEDICAID) Promacta (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and date. Fax
More information2. Is this request for a preferred medication? Y N
Pharmacy Prior Authorization AETA BETTER HEALTH EW JERSE (MEDICAID) Opioids Long-Acting and Short-Acting (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
More information2/9/2016. The Evolving Armamentarium for Type 2 Diabetes: Incorporating New Classes in the Treatment of Our Patients. Objectives: Pharmacists
WAYNE STATE UNIVERSITY COLLEGE OF PHARMACY & HEALTH SCIENCES FEBRUARY 28, 2016 The Evolving Armamentarium for Type 2 Diabetes: Clinical Assistant Professor, Department of Pharmacy Practice Ambulatory Care
More information3. Has the patient had a sustained improvement in Pain or Function (e.g. PEG scale with a 30 percent response from baseline)?
Pharmacy Prior Authorization AETA BETTER HEALTH KETUCK Opioids Long-Acting and Short-Acting (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
More informationWhat s New in Type 2 Diabetes? 2018 Diabetes Updates
What s New in Type 2 Diabetes? 2018 Diabetes Updates Gretchen Ray, PharmD, PhC, BCACP, CDE Associate Professor, UNM College of Pharmacy January 28, 2018 gray@salud.unm.edu OBJECTIVES Describe the most
More informationClinical Policy: Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists
Clinical Policy: Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Reference Number: LA.PST.14 Effective Date: 03.18 Last Review Date: 3.18 Line of Business: Medicaid Revision Log 1Revision Log 1Revision
More informationDept of Diabetes Main Desk
Dept of Diabetes Main Desk 01202 448060 Glucose management in Type 2 Diabetes in Adults The natural history of type 2 diabetes is for HbA1c to deteriorate with time. A stepwise approach to treatment is
More informationORAL AND INJECTABLE (NON-INSULIN) PHARMACOLOGICAL AGENTS FOR TYPE 2 DIABETES
ORAL AND INJECTABLE (NON-INSULIN) PHARMACOLOGICAL AGENTS FOR TYPE 2 DIABETES Joseph L. Evans, Ph.D., President, P & N Development Ventures, Saint Louis, MO USA Email: jevansphd@earthlink.net Börk Balkan,
More informationPharmacy Prior Authorization
Pharmacy Prior Authorization AETA BETTER HEALTH PESLVAIA & AETA BETTER HEALTH KIDS Promacta (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
More informationClinical Policy: Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Reference Number: HIM.PA.53 Effective Date: Last Review Date: 02.
Clinical Policy: Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Reference Number: HIM.PA.53 Effective Date: 03.01.18 Last Review Date: 02.19 Line of Business: HIM Revision Log See Important Reminder
More information2/17/2016. Objectives. Define. Hey Sugar! DMII Management in Hospice Care
Hey Sugar! DMII Management in Hospice Care Michelle Huber, R.Ph., PharmD.,CGP Objectives Review treatment for hyperglycemia discussing how these medications work, hypoglycemia risk, special considerations.
More informationCardiovascular Impact of Medications for Treating Type 2 Diabetes
Friday CME Breakfast Lecture Cardiovascular Impact of Medications for Treating Type 2 Diabetes Thomas Blevins, MD Endocrinologist, Private Practice Texas Diabetes and Endocrinology Austin, Texas Educational
More information2. Does the patient have a diagnosis of chronic idiopathic thrombocytopenic purpura (ITP)?
Pharmacy Prior Authorization MERC CARE (MEDICAID) Promacta (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and date. Fax
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Policy: Sodium-Glucose Co-Transpter 2 (SGLT2) Inhibits Reference Number: TCHP.PHAR.182 Effective Date: 07.01.18 Last Review Date: 04.13.18 Line of Business: Oregon Health Plan Revision Log See Imptant
More informationNew Therapies for Diabetes
Type 2 diabetes is increasingly prevalent New Therapies for Diabetes Lynn Mack, M.D. Associate Professor Diabetes, Endocrinology, & Metabolism The Nebraska Medical Center lmack@unmc.edu No Conflicts of
More informationDM Fundamentals Class 4 Meds for Type 2
DM Fundamentals Class 4 Meds for Type 2 Beverly Thomassian, RN, MPH, BC ADM, CDE President, Diabetes Education Services Copyright 1999 2015, Diabetes Education Services, All Rights Reserved. Diabetes Meds
More informationManaging Complex Diabetes Cases: Medication Update. Celia Levesque MSN, RN, CNS-BC, CDE, BC-ADM
Managing Complex Diabetes Cases: Medication Update Celia Levesque MSN, RN, CNS-BC, CDE, BC-ADM clevesqu@mdanderson.org Objectives Describe how each diabetes medication class is used to treat diabetes Differentiate
More information