Teriparatide products — Medical Mutual
Chronic hypoparathyroidism, Natpara naive
Initial criteria
- Natpara is not available
- AND not well controlled on calcium supplements and active vitamin D alone
- AND 25-hydroxyvitamin D stores sufficient
- AND serum calcium >7.5 mg/dL before initiation
- AND creatinine clearance >30 mL/min (two measurements) OR >60 mL/min AND serum creatinine <1.5 mg/dL
- AND age ≥18 years
- AND history of hypoparathyroidism >18 months
- AND prescribed by or in consultation with an endocrinologist
- AND no history of Paget’s disease or unexplained alkaline phosphatase elevation
- AND no open epiphyses
- AND no hereditary disorders predisposing to osteosarcoma
- AND no prior skeletal radiation therapy
Reauthorization criteria
- Reauthorization up to maximum 2 years lifetime use allowed if criteria remain satisfied
Approval duration
1 year (initial); 1 year (reauth); max 2 years total