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Prescribing the lowest cost diabetes medication
March 8, 2019

This article is for endocrinologists, primary care providers, nurse practitioners, and physician assistants. Please also share with case managers, certified diabetes educators, and pharmacists associated with your practice.

Which members use the Blue Cross standard formulary?
  • Commercial medical plan members with our pharmacy benefits
  • Medex®´ members who have a three-tier pharmacy benefit

When you prescribe the diabetes medications listed below, please consider the lower cost (lower tier) option, if clinically appropriate. There are equally effective options available on our standard formulary (list of covered medications) that don’t require a formulary exception.

Our members can also save money when they use the Express Scripts PharmacySM (mail order) for a 90-day supply of their medication.

Preferred formulation on our covered list of medications

Please consider prescribing this tier 1* medication Instead of these higher-cost medications that require formulary exception
  • Metformin XR (500, 750 mg) (generic Glucophage XR)
  • Glumetza brand
  • Metformin ER MOD (Glumetza generic)
  • Fortamet
  • Metformin ER OSM (Fortamet generic)
  • Glucophage XR brand

*This medication is covered at tier 1 for members with a three-tier pharmacy benefit.

Costs and coverage
To learn more about lower-cost options and our Metformin step therapy criteria, read our Metformin Extended Release Fact Sheet.

Call Angela Burnham, PharmD, Pharmacy Provider Partnership Manager, at 1-617-246-2448.


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