| Diabetes Mellitus, Non-Insulin-Dependent

Rybelsus vs Steglujan

Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.
Deep comparison between: Ozempic vs Steglujan with Prescriber.AI
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Safety signalsSteglujan has a higher rate of injection site reactions vs Ozempic based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Steglujan but not Ozempic, including UnitedHealthcare
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Ozempic
Steglujan
At A Glance
Oral
Daily
GLP-1 receptor agonist
Oral
Once daily
SGLT2 inhibitor + DPP-4 inhibitor
Indications
  • Diabetes Mellitus, Non-Insulin-Dependent
  • Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Diabetes Mellitus, Non-Insulin-Dependent Starting dose 1.5 mg orally once daily for 30 days (not effective for glycemic control); escalate to 4 mg once daily days 31-60; maintain at 4 mg or increase to 9 mg once daily if additional glycemic control is needed. Take on an empty stomach in the morning with up to 4 oz water; wait at least 30 minutes before eating, drinking, or taking other oral medications.
Diabetes Mellitus, Non-Insulin-Dependent Starting dose 5 mg ertugliflozin/100 mg sitagliptin orally once daily in the morning, with or without food; may increase to 15 mg/100 mg once daily for additional glycemic control; not recommended if eGFR less than 45 mL/min/1.73 m2; withhold at least 4 days before surgery or procedures associated with prolonged fasting.
Contraindications
  • Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Prior serious hypersensitivity reaction to semaglutide or any excipient in OZEMPIC tablets
  • Severe renal impairment (eGFR less than 30 mL/min/1.73 m2), end-stage renal disease (ESRD), or on dialysis
  • Hypersensitivity to sitagliptin, ertugliflozin, or any excipient in STEGLUJAN
Adverse Reactions
Most common (>=5%) nausea, abdominal pain, diarrhea, decreased appetite, vomiting, constipation
Serious risk of thyroid C-cell tumors, acute pancreatitis, diabetic retinopathy complications, hypoglycemia with concomitant insulin secretagogues or insulin, acute kidney injury due to volume depletion, severe gastrointestinal reactions, hypersensitivity reactions, acute gallbladder disease, pulmonary aspiration during general anesthesia or deep sedation
Postmarketing acute and necrotizing pancreatitis, ileus, intestinal obstruction, anaphylaxis, angioedema, rash, urticaria, cholecystitis, cholelithiasis requiring cholecystectomy, dizziness, dysesthesia, dysgeusia, headache, pulmonary aspiration, acute kidney injury, alopecia
Most common (>=2%) Female genital mycotic infections, male genital mycotic infections, urinary tract infections, headache, vaginal pruritus, increased urination, nasopharyngitis, back pain, weight decreased, thirst
Serious Diabetic ketoacidosis, pancreatitis, lower limb amputation, acute renal failure, volume depletion, urosepsis and pyelonephritis, heart failure, hypoglycemia (with insulin or insulin secretagogues), necrotizing fasciitis of the perineum (Fournier's Gangrene), hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid
Postmarketing Necrotizing fasciitis of the perineum, angioedema, rash, anaphylaxis, urticaria, cutaneous vasculitis, Stevens-Johnson syndrome, pruritus, hepatic enzyme elevations, acute pancreatitis, worsening renal function, severe and disabling arthralgia, myalgia, rhabdomyolysis
Pharmacology
Semaglutide is a GLP-1 receptor agonist (GLP-1 analogue with 94% sequence homology to human GLP-1) that selectively binds to and activates the GLP-1 receptor, stimulating glucose-dependent insulin secretion and inhibiting glucagon secretion to lower blood glucose, with a minor delay in early postprandial gastric emptying; its long half-life results from albumin binding and stabilization against DPP-4 degradation.
STEGLUJAN combines ertugliflozin, an SGLT2 inhibitor that reduces renal reabsorption of filtered glucose and increases urinary glucose excretion, and sitagliptin, a DPP-4 inhibitor that slows inactivation of incretin hormones (GLP-1 and GIP), thereby increasing insulin release and decreasing glucagon secretion in a glucose-dependent manner.
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Most Common Insurance
Anthem BCBS
Ozempic
  • Covered on 5 commercial plans
  • PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
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Steglujan
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (7/12) · Qty limit (9/12)
View full coverage details ›
UnitedHealthcare
Ozempic
  • Covered on 4 commercial plans
  • PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
View full coverage details ›
Steglujan
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Humana
Ozempic
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
View full coverage details ›
Steglujan
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Ozempic.
No savings programs available for Steglujan.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.