Pharmacy education: GLP-1 medications

• 07/01/2026

Addendum – Formulary expansion (effective 11/3/2026) 

Beginning November 3, 2026, the Hennepin Health formulary will expand to include additional GLP‑1 receptor agonists. Newly added agents include: 

• Mounjaro 
• Ozempic (tablet formulation) 
• Wegovy (tablet formulation) 
• Zepbound 

Prior authorization (PA) will be required for all newly added GLP‑1 medications. 
While final coverage criteria are still being finalized, the PA requirements will likely mirror the current criteria used for: 

• Wegovy and Saxenda for obesity management 
• Ozempic for type 2 diabetes management 

Similar to existing policy, documentation requirements will include clinical justification, baseline measurements, lifestyle interventions, and verification of criteria alignment. Updated PA criteria will be released once finalized. 

Original article (posted 7/1/2026) 

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 until Nov. 3, 2026. Criteria are as follows: 

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.

• A list of the most recent Minnesota DHS Preferred Drug Lists can be found here: Links - Preferred Drug Lists
• Minnesota DHS Prior Authorization Criteria