Zoledronic Acid (Reclast) Injection

Reclast (zoledronic acid) is covered for FDA‑approved indications (treatment/prevention of postmenopausal osteoporosis, treatment of osteoporosis in men, glucocorticoid‑induced osteoporosis, Paget’s disease) and compendial use for osteogenesis imperfecta; uses outside these diagnoses are not covered. Approval requires documented diagnosis plus specific criteria (osteoporotic/fragility fracture or defined T‑score thresholds), prior 12‑month oral bisphosphonate trial failure/intolerance/inability or equivalent justification (for prevention/treatment), glucocorticoid users must be on ≥7.5 mg prednisone‑equivalent and expected ≥12 months, Paget’s requires lab/symptom evidence, and dosing/frequency and documentation requirements (e.g., 5 mg IV yearly for treatment, every 2 years for prevention, infusion ≥15 minutes; reauthorization intervals) must be met.

"Treatment of osteoporosis in postmenopausal women (FDA-approved)."