Monday , December 11 2017
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Letter from the Editor, #767

I was working in the pharmacy and my technician attempted to process a prescription for a 71 y/o patient for glyburide 5 mg. The claim kept rejecting as "drug not covered, prior authorization requested." This made no sense to her or the intern as it is a cheap generic medication. When I saw the rejection, I was impressed that WellCare had put a hard stop on the use of glyburide in a patient over 70 years old. As a project I had the intern call the processor and when he got off the phone he verified that glyburide was not indicated in patients over 70 because of hypoglycemic risk. A simple call to the prescriber and the medication was changed to glimepiride. Going along with reasons certain populations might want to avoid this drug, there is a study from the BMJ that discusses why glyburide may not be a viable choice for gestational diabetes mellitus as well.

Our fitness guru, Dr. Sheri Colberg, shares a very good paper with us that helps identify the best times to exercise based on type and duration to prevent hypoglycemia or hyperglycemia and maximize effect.

The new drug combination Glyxambi (empagliflozin/linagliptin) was approved by the FDA this past week and I spent all day trying to get BI and Lilly to give me pricing information. If they price it as a sum of the two medications, that would put it at around $700 a month but if the price is equal to only one of the ingredients then they will have a hit on their hands.

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Dave Joffe, Editor-in-chief