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Important SNAP Updates: See what’s changing and where to get support. Learn more
Important SNAP Updates: See what’s changing and where to get support. Learn more

Rybelsus Transition to Ozempic Tablets: Provider Update and GLP-1 Prior Authorization Criteria

Date: 06/10/26

Novo Nordisk has informed the Department of Healthcare and Family Services (HFS) that it will discontinue all strengths of Rybelsus tablets, requiring patients to be transitioned to Ozempic tablets. Beginning in May 2026, shipments of Rybelsus tablets to wholesalers will cease, with existing inventory expected to become limited starting in July 2026. The manufacturer-recommended conversion guidance can be found in the HFS provider notice issued May 21, 2026.

Meridian and YouthCare members will not be automatically converted from Rybelsus to Ozempic tablets. A new prescription and prior authorization (PA) request will be required for any transition.

For patients with type 2 diabetes with or without high cardiovascular risk, Rybelsus is currently preferred with PA on the Meridian Preferred Drug List (PDL). Ozempic tablets will now be preferred with PA for the same indication.

Please see the excerpt below of updated GLP-1 receptor agonist PA criteria, including Ozempic tablets:

  1. Type 2 Diabetes Mellitus (must meet all):
    1. If the request is for Ozempic tablets, Trulicity or Victoza;
      1. Diagnosis of Type 2 Diabetes mellitus only- all other indications should be denied;
      2. Weight loss/obesity: NOTE: Weight loss is a benefit exclusion and is not a covered benefit;
    2. HbA1c ≥ 7% in the past 3 months
    3. Age is one of the following (1 or 2):
      1. Bydureon BCise, Mounjaro, Trulicity, Victoza: ≥ 10 years;
      2. All other GLP-1 receptor agonists: ≥ 18 years;
    4. Member meets the following (1 or 2):
      1. If request is for Ozempic injection and member has established cardiovascular disease (e.g., ASCVD) or multiple cardiovascular risk factors (see Appendix D): Failure of ≥ 3 consecutive months of Ozempic tablets, Trulicity and Victoza or their generic equivalents, if available (as evidenced by pharmacy claims history), unless clinically significant adverse effects are experienced or contraindicated;
      2. If request is for a non-preferred GLP-1 receptor agonist for Type 2 Diabetes, failure of ≥ 3 consecutive months of 2 preferred GLP-1 receptor agonists (Ozempic tablets, Trulicity, Victoza or their generic equivalents, if available) as evidenced by pharmacy claims history, unless clinically significant adverse effects are experienced or all are contraindicated.