CommercialPrior AuthMedium impact
DPP-4 Inhibitors and Combinations
Blue Cross & Blue Shield of Mississippi·MS · Endocrinology, Family Medicine, Internal Medicine·Medical Policy
Effective date
May 1, 2025
We identified it
Jun 20, 2026
Summary
BCBSMS updated their DPP-4 inhibitor policy effective May 1, 2025, adding Jentadueto XR to the list of diabetes medications requiring prior authorization and step therapy. The policy continues to require patients try metformin, sulfonylureas, or insulin before approving DPP-4 inhibitors, and maintains that several medications (Oseni, Qtern, Steglujan, Zituvimet products) are not covered.
Action Required
By May 1, 2025: Billing team must update prior authorization requirements for DPP-4 inhibitor medications, specifically adding Jentadueto XR to the list requiring prior auth. Verify patient formulary coverage before prescribing and ensure documentation shows previous trial of metformin, sulfonylureas, or insulin. Update encounter forms to remind providers that Oseni, Qtern, Steglujan, and Zituvimet products are not covered by BCBSMS.