Teriparatide Injection — United Healthcare

Preferred products

• Teriparatide Injection

Initial criteria

• Diagnosis of glucocorticoid-induced osteoporosis
• History of prednisone or its equivalent at a dose ≥ 5 mg/day
• Patient is at high risk of fracture (e.g., recent fracture within the past 12 months, fractures while on approved osteoporosis therapy, multiple fractures, fractures while on drugs causing skeletal harm, very low T-score less than −3.0, high risk for falls or history of injurious falls, or very high fracture probability by FRAX tool — major osteoporosis fracture >30%, hip fracture >4.5%) OR patient has a history of failure, intolerance, or contraindication to other available osteoporosis therapy (e.g., alendronate, denosumab, risedronate, zoledronate)
• Treatment duration has not exceeded a total of 24 months of cumulative use of parathyroid hormone analogs (e.g., Teriparatide Injection, Forteo, Tymlos) OR patient is currently or previously treated with parathyroid hormone analogs AND prescriber attests that patient remains at or has returned to having a high risk for fracture

Reauthorization criteria

• Prescriber attests that the patient remains at or has returned to having a high risk for fracture despite 24 months of cumulative use of parathyroid hormone analogs (e.g., Teriparatide Injection, Forteo, Tymlos)
• Prescriber attests that the risk versus benefit of use greater than 24 months of cumulative parathyroid hormone analogs has been reviewed with the patient

Approval duration

24 months initial, 12 months reauthorization