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 XL glipizide ER $12 $5 Micronase, Diabeta glyburide $5 Metaglip Glucovance glipizide/metfor min glyburide/metf ormin $22 $5 $15 $5 TZD/Combinations Actos pioglitazone $10 $5 must fail Duetact pioglitazone/ glimepiride $122 $5 ACTOplus met pioglitazone/m etformin $55 $5 must fail
DIABETES (2 of 5) DPP-4 Inhibitors/Combinations Januvia sitagliptin $469 $25 $25 Tradjenta linagliptin $338 $25 $25 Kombiglyze XR saxagliptin/metf ormin ER $394 $50 GLP-1 Mimetic Byetta exenatide $474 (3ml) $50 Bydureon Bydureon BCise Onglyza saxagliptin $316 $50 Nesina alogliptin $172 $5 $5-$10 Kazano alogliptin/metfo $172 $5 $5-$10 rmin Janumet sitagliptin/metfo $435 $25 $25 rmin Janumet XR sitagliptin/metfo $435 $25 $25 rmin ER exenatide ER $514 (8ml) $50 $25 Victoza liraglutide $440 6ml $25 $25 Trulicity dulaglutide 99 $25 $25 Ozempic Semaglutide $773 Preferred $25 $25 ** : Trulicity, Victoza, Ozempic - trial of 30 days Januvia, Janumet, Janumet XR trial of, sulfonylurea, or insulin sensitizer. * ***: all GLP-1 memetic drugs need a, even Bydureon and Victoza which are the drugs. Non- drugs may require explaining why Bydureon and Victoza are a good choice. ***United Health : Nesina, Kazano, Trulicity, Tanzeum, --trial of Metformin 1500mg qd for 90 days
SGLT2 Inhibitors/Combinations DIABETES (3 of 5) Invokana canagliflozin $453 $25 Invokamet canagliflozin/met formin $453 $25 Invokamet XR canagliflozin/met formin $453 $25 Jardiance empagliflozin $415 $25 Synjardy empagliflozin/me tformin $415 $25 Synjardy XR empagliflozin/me tformin $415 $25 Farxiga dapagliflozin $457 $25 Xigduo XR dapagliflozin/met formin ER $457 $25 Steglatro ertugliflozin $287 $50 Segluromet ertugliflozin/metf ormin $274 $50 : - Jardiance - Only FDA approval use that is consistent with ADA or AACE guidelines for T2DM and A1C monitoring within the past 3 months. : Invokana, Invokamet, Invokamet XR - must try, sulfonylurea, or insulin sensitizer : Steglatro, Segluromet - must try, er, or Riomet wtihn past 100 days United Health : Steglatro, Segluromet --90 day trial of 1500mg/day
Insulin (Rapid-Acting) DIABETES (4 of 5) $210 10ml, Apidra glulisine $430 15ml $196 10 ml, Humalog lispro $423 15ml Pen, Vial Admelog lispro $485 vial, Novolog aspart Insulin (Short-Acting) $197 10ml, $375 15ml vial, vial, vial, vial, vial, vial - ( - ) Humulin R insulin $89 vial OTC vial only vial, vial, vial Novolin R insulin $28 Walmart OTC vial $15 vial Insulin (Intermediate-Acting) Humulin N NPH $309 15ml OTC vial, Novolin N NPH $29 Walmart OTC vial, $15 vial Insulin (Long-Acting) Lantus glargine $240 10ml, $371 15ml vial, vial, Vial, Pen vial, vial, vial, Pen, Vial vial, vial Basaglar glargine $248 Pen $5 Toujeo glargine $308 bayer Levemir detemir $189 10ml Insulin (Ultra Long-Acting) $25 Tresiba degludec??? $5
Insulin (Pre-Mixed) DIABETES (5 of 5) Humalog Mix 50/50 lispro mix $131 10ml, $841 15ml $5 vial, vial, vial Humalog Mix 75/25 Humulin 70/30 lispro mix NPH/reg mix $158 10ml, $423 15ml $90 10ml, $385 15ml Novolin 70/30 NPH/reg mix $25 Walmart OTC vial Novolog 70/30 aspart mix $240 10ml, $375 15 ml $5 OTC vial, $5 vial, $5 vial, vial, vial, vial, vial, vial vial, vial vial, vial Glucometers United Healthcare Accu-Chek Aviva Plus, Accu-Chek Compact Plus free meter* Accu-check compact plus foote Bayer Breeze 2/ Bayer Contour free meter* Freestyle Lite/ Freestyle Freedom Lite free meter* Freestyle, Freestyle Lite Freestyle Freedom Lite (kit & strips) foote Onetouch (Ultra2, Ultramini, or Verio) free meter* may One Touch Verio Sure, Fast Take, Verio, Ultra 2 strips/day Ultra 2, (no insulin) 6 Ultra Mini, strips/day Verio (insulin) - glucometer. Website and customer service both say accu-chek (AvivaPlus, Compact, Nano 100 stp/30d) and freestyle (Lite, Freedom Lite), but pharmacists tell us onetouch glucometer/lancets (verio, ultra2, ultramini) although says. *** : Accu-Chek or One Touch glucometers- call 1-800-588-4456.