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Student Name:______________________________________________


Ruby Dierks (DOB 12-26-71) presents a new prescription to the pharmacy in-window for Steglatro 5 mg, Take 1 tablet PO once daily in the morning, #30 with 2 refills. Ruby was recently diagnosed with type 2 diabetes mellitus. While processing and adjudicating the claim to her prescription insurance plan you receive the following rejection: Nonformulary Drug—Prior Authorization Required.

  • Make a specific recommendation related to how the patient can afford the medication. (If recommending a change in the medication, include drug name, dose, route, directions, frequency, and duration.)

  • Provide rationale (include two reasons) as to why the recommendation listed above is the best choice for this patient.

  • List the reference(s) utilized to support the recommendation listed above.

*Answer Sheet developed by Miranda Wilhelm, PharmD.

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