POS edit to prevent therapeutic duplication of GLP-1 medications

Effective Nov. 1, 2024, we’ll apply a point of sale (POS) edit on prescription fills of multiple glucagon-like peptide 1 (GLP-1) agonists or multiple strengths of the same GLP-1 agonist. This applies to UnitedHealthcare Individual Exchange plans* and will be part of our Concurrent Drug Utilization Review (cDUR) program. It will help minimize the duplication of therapeutic medications for our members.

This applies to the following GLP-1 agonists: Bydureon®, Byetta®, Mounjaro®, Ozempic®, Saxenda®, Trulicity®, Victoza®, Wegovy® and Zepbound®.

What this means

We won’t approve your patient’s claim if we identify GLP-1 agonist therapeutic duplication. POS messaging alerts the dispensing pharmacy of the duplication and directs the pharmacy to contact the prescriber.

What you need to do

If there is a clinical reason your patient needs more than one GLP-1 agonist, please request an override by contacting Optum Rx® at 800-711-4555.

How the cDUR program works

The cDUR program uses the pharmacy claims processing system to screen all prescriptions at point-of-service. It screens for unsupported drug prescriptions and utilization, as well as potentially dangerous medical implications or drug interactions. We communicate with the dispensing pharmacy at point-of-service through claims messaging.