Prolia® (denosumab) Non-oncology

Covers Prolia (denosumab) for FDA‑approved non‑oncology indications — postmenopausal osteoporosis and osteoporosis in men at high fracture risk, and glucocorticoid‑induced osteoporosis for patients on ≥7.5 mg/day prednisone‑equivalent expected ≥6 months — and excludes oncology uses. Initial approval requires diagnostic criteria (osteoporotic/fragility fracture or qualifying T‑score/low bone mass with high‑risk features) plus prior‑therapy or contraindication documentation (e.g., 12‑month oral bisphosphonate failure or intolerance, prior IV bisphosphonate, inability to take oral bisphosphonates, or CrCl <35 mL/min/chronic kidney disease); reauthorization is annual with evidence of stability, fracture reduction, or increased BMD, and recommended dosing is 60 mg SC every 6 months.

"Treatment of postmenopausal women with osteoporosis at high risk for fracture (defined as a history of osteoporotic fracture, or multiple risk factors for fracture; or patients who have failed or a..."