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Conexxence (denosumab-bnht) — Highmark

osteopenia

Preferred products

  • Prolia (denosumab)

Initial criteria

  • The member is at high or very high risk for a fracture as defined by one of the following: (i) history of a previous hip fracture (ICD-10: M84.359) or vertebral fracture (ICD-10: S22.0), OR (ii) diagnosis of osteoporosis (ICD-10: M80-81) defined as a T-score ≤ -2.5, OR (iii) diagnosis of osteopenia defined as a T-score between -1.0 and -2.5 AND one of the following: (A) 10-year risk of major osteoporotic fracture ≥ 20% using the FRAX calculator.