Diagnosis: Diabetes Mellitus Type 2.
Treatment: Jentadueto XR (extended release) 2.5/1000 tablet.
The insurer denied Jentadueto XR 2.5/1000 tablet.
The determination is overturned.

This is a patient with type 2 diabetes treated with Jardiance and Jentadueto. The patient's hemoglobin A1C was 7.8 percent (%). The patient has tried Janumet and metformin. Jentadueto extended release (XR) is under review.

This request is for Jentadueto XR for the treatment of type 2 diabetes. The formulary alternatives are Janumet and Xigduo. This patient has already tried Janumet in the past. The patient is already on Jardiance and it is not appropriate to use Xigduo and Jardiance together due to both containing sodium glucose co-transporter-2 inhibitors. In addition, Jentadueto has a dipeptidyl peptidase 4 (DPP-4) inhibitor, whereas Xigduo does not. Therefore, Janumet and Xigdu are not appropriate alternatives as they will be either not as effective as Jentadueto XR 2.5/1000 milligrams (mg) tablet or would have adverse effects.

This patient is stable on Jentadueto XR. Without Jentadueto XR, this patient will be at increased risk of hyperglycemia, which can cause neuropathy, nephropathy, and retinopathy.