GLP1 Agonist and DPP4 Inhibitor Combination Therapy Update Details

Effective on 02/01/2025, the State of Michigan Medicaid Common Formulary Prior Authorization Criteria prohibits the use of duplicate therapy between glucagon-like peptide-1 (GLP-1) agonist agents for diabetes (such as Victoza, Trulicity, Ozempic, Mounjaro, Byetta, Rybelsus, and applicable generics) or for obesity management (such as Wegovy, Saxenda, Zepbound), in combination with Dipeptidyl peptidase-4 (DPP-4) inhibitor containing agents (Januvia, Zituvio, Tradjenta, Onglyza, Nesina, Janumet, Jentadueto, Glyxambi, Kazano, Kombiglyze, Oseni, Qtern, Steglujan, Trijardy, and applicable generics).

The State of Michigan Medicaid Program has updated their clinical prior authorization criteria which all Michigan Medicaid Managed Care Plans follow. This change reflects recommendations from current clinical practice guidelines from multiple medical professional societies including the American Diabetes Association (ADA), American Association of Clinical Endocrinologists (AACE), and the Food & Drug Administration (FDA), all of which do not recommend combining dipeptidyl peptidase 4 inhibitors (DPP-4) with glucagon-like peptide 1 receptor agonists (GLP-1). Guidelines and recommendations indicate that there is no added clinical benefit when combining the two drug classes together within the same patient.