Teriparatide Injection — United Healthcare
postmenopausal osteoporosis
Preferred products
- Teriparatide Injection
Initial criteria
- Diagnosis of osteoporosis (see subtypes below)
- For postmenopausal osteoporosis: patient is female AND diagnosis of postmenopausal osteoporosis
- For male osteoporosis: patient is male AND diagnosis of osteoporosis
- 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 such as long-term glucocorticoids, 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