Kombiglyze XR

Generic: Saxagliptin-Metformin

Tablet

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 15 hours, 49 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via Saxagliptin-Metformin	Tier 1 - Generic	—	—	✓	QL

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 15 hours, 49 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	—	—	None
NC Medicaid Preferred Drug List 2026 via Saxagliptin-Metformin	Non-Preferred	—	—	—	None