Diabetes - Ozempic Drug Quantity Management Policy - Per Days
Defines per-days drug quantity limits for Ozempic (semaglutide SC injection) for Cigna-administered health benefit plans and describes the program's intent and applicability.
No material clinical or coverage changes in this revision.
Coverage Criteria
Quantity-based coverage
Covered when ALL of the following dispensing limits are met
Per-days dispensing limits
Retail (per 28 days) maximums - any one of the following applies
- 1.5 mL retail limit: Retail maximum quantity per 28 days = 1.5 mL (1 pen) for the 2 mg/1.5 mL pen (discontinued).
- 3 mL retail limits: Retail maximum quantity per 28 days = 3 mL (1 pen) for the 2 mg/3 mL, 4 mg/3 mL, and 8 mg/3 mL pens; and 3 mL (2 pens) where applicable for discontinued packings described in the policy.
Home delivery (per 84 days) maximums - any one of the following applies
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