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Farxiga

Drug - Farxiga™ (dapaglifozin) [E.R.Squibb & Sons, L.L.C.]

June 2014

Therapeutic area - Antihyperglycemics

Approval criteria

  • Patient has a diagnosis of Type 2 diabetes AND
  • Patient has tried metformin (alone or in combination) or has a contraindication to metformin AND
  • Patient has tried a sulfonylurea (alone or in combination) or has a contraindication to sulfonylureas AND
  • Patient has patient has tried a preferred DPP4 inhibitor or has a contraindication to DPP4 inhibitors AND
  • Patient has tried a GLP-1 agonist or has a contraindication to GLP-1 agonists AND
  • Patient has tried and failed Invokana

Quantity limit

34 tablets per 34-day supply

Background information

Farxiga™ (dapagliflozin) is indicated as an adjunct to diet and exercise to improve glycemic control in patients with Type 2 diabetes.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411

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