Pharmacy education: GLP-1 medications

07/01/2026

Hennepin Health has observed a significant increase in prior authorization (PA) requests for GLP-1 receptor agonists used in both obesity management and type 2 diabetes care. This integrated bulletin outlines updated requirements for weight-loss indications, criteria for diabetes-related use (including Ozempic®), and provides links to the Minnesota Department of Human Services Preferred Drug List (PDL) and prior authorization (PA) criteria.

GLP-1 medications for obesity management

Wegovy® and Saxenda® remain the State-preferred GLP-1 medications for obesity treatment. These agents must be trialed prior to submitting PA requests for non-preferred alternatives.

Initial approval criteria (6-month authorization)

Age meets FDA-labeled requirements.
Documentation of initiation or continuation of a reduced-calorie diet OR ongoing care with a registered dietitian nutritionist.
Documentation of initiation or continuation of increased physical activity unless medically contraindicated.
In-person BMI and weight documented:

Adults (≥18 yrs): BMI ≥ 30 kg/m² OR BMI ≥ 27 kg/m² with ≥1 comorbidity (HTN, T2DM, dyslipidemia).
Adolescents (12–17 yrs): BMI ≥ 30 kg/m² AND weight > 60 kg.

Baseline in-person weight must be submitted.
No contraindications unless benefits outweigh risks and this is documented.
No concurrent use of other weight-loss medications.
Step-therapy requirement: inadequate response to phentermine OR documented contraindication.
Initial approval duration: 6 months.

Renewal criteria (12-month authorization)

Adults (≥18 yrs): ≥5% weight loss from baseline (in-person weight).
Adolescents (12–17 yrs): ≥5% reduction in baseline BMI.
Continued adherence to reduced-calorie diet OR ongoing care with a registered dietitian nutritionist.
Continuation of physical activity regimen unless medically contraindicated.
No contraindications unless benefits outweigh risks.
Renewal duration: 12 months.

Subsequent renewals (beyond 18 months)

Must continue to meet all renewal criteria AND maintain weight loss achieved during initial approval.

GLP-1 medications for type 2 diabetes (Ozempic®)

For members with type 2 diabetes, Ozempic® (semaglutide) is the preferred GLP-1 medication when specific clinical criteria are met:

Documented diagnosis of type 2 diabetes.
Most recent A1C > 7%.
Member has been on metformin for three months OR has a documented contraindication.
PA submission must include recent A1C and medication history.

Reference documents and clinical resources

Providers can see the preferred drugs by the State of Minnesota and the DHS prior authorization criteria for many medications.