Yorvipath (palopegteriparatide subcutaneous injection - Ascendis) — Cigna

Chronic Hypoparathyroidism

Initial criteria

Patient cannot be well-controlled on calcium supplements and active forms of vitamin D according to the prescriber; AND
Patient has sufficient 25-hydroxyvitamin D stores (at baseline before initiating Yorvipath therapy) according to the prescriber; AND
Patient meets ONE of the following (a or b): a) Patient has an albumin-corrected serum calcium concentration ≥ 7.8 mg/dL at baseline before initiating Yorvipath therapy; OR b) Patient has an ionized serum calcium ≥ 4.4 mg/dL at baseline before initiating Yorvipath therapy; AND
The medication is prescribed by or in consultation with an endocrinologist or a nephrologist

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

1 year