Natpara (parathyroid hormone subcutaneous injection − Shire-NPS/Takeda) — Cigna

Initial criteria

• Patient cannot be well-controlled on calcium supplements and active forms of vitamin D alone; AND
• Patient’s 25-hydroxyvitamin D stores are sufficient (before initiating Natpara therapy) according to the prescriber; AND
• Patient’s serum calcium concentration is > 7.5 mg/dL before initiating Natpara therapy; AND
• Medication is prescribed by or in consultation with an endocrinologist or a nephrologist

Reauthorization criteria

• Patient cannot be well-controlled on calcium supplements and active forms of vitamin D alone; AND
• Patient’s 25-hydroxyvitamin D stores are sufficient (during Natpara therapy) according to the prescriber; AND
• Patient is responding to Natpara therapy, according to the prescriber (examples of response include reduction in the patient’s oral calcium dose, reduction in the patient’s active vitamin D dose, maintenance of a stable albumin-corrected total serum calcium concentration)

Approval duration

1 year