Special Authority: Third-Line Anti-Diabetic Medications eFORM

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  • Create Date May 22, 2024
  • Last Updated May 26, 2024

Special Authority: Third-Line Anti-Diabetic Medications eFORM

How to Import an e-Form

Use download button below, then import eform into your EMR by following these instructions

This from was introduced in 2022 to provide access to DPP4 inhibitors (Linagliptin, Saxagliptin), and TZD (Pioglitazone).  Approvals for SGLT2 and GLP1 drugs are found in separate eFORMS.

Attached Files and Latest Versions

FileAction
SA_3rd_Line_DM_Meds_V1_Jan8_2023.zipDownload