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What payers require for Mounjaro prior authorization For Mounjaro (diabetes indication), most payers require: Confirmed type 2 diabetes diagnosis with recent HbA1c level (typically above 7.0%) Documentation of current diabetes medications and their inadequacy (most plans require failure of metformin unless contraindicated) Step therapy documentation showing the patient has tried first-line agents before progressing to tirzepatide Prescriber specialty (some plans restrict initial prescribing to endocrinologists or require specialist consultation) The PA request uses the tirzepatide dosing schedule as part of the clinical rationale

Published Phase 2 clinical trial data used doses of 1mg, 4mg, 8mg, and 12mg administered weekly via subcutaneous injection

Littlejohn G, Guymer E