Calcitriol, Etelcalcetide, and Paricalcitol Injections

Aetna covers calcitriol injection for hypocalcemia and/or secondary hyperparathyroidism in CKD patients on hemodialysis and paricalcitol (Zemplar) for prevention/treatment of secondary hyperparathyroidism in CKD on hemodialysis, while etelcalcetide (Parsabiv) is covered only for secondary hyperparathyroidism in CKD on hemodialysis (corrected serum calcium ≥8.3 mg/dL) and other uses are considered experimental/investigational. Key requirements: Parsabiv requires precertification and documented contraindication, intolerance, or therapeutic failure to ≥2 phosphate binders (≥2 months each), ≥2 vitamin D analogs (≥2 months each), and a ≥6‑month trial of cinacalcet (Sensipar) at maximum tolerated dose; concurrent use of cinacalcet and etelcalcetide or initiation within 7 days of stopping cinacalcet is investigational.

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