Romosozumab-aqqg (Evenity)

Evenity (romosozumab‑aqqg) is covered only for osteoporosis in postmenopausal women at high risk for fracture (history of osteoporotic/fragility fracture) and is not supported for non‑FDA indications or patients who do not meet the criteria. Approval requires documentation of either a prior osteoporotic/fragility fracture OR a qualifying T‑score (≤ −2.5 or −1.0 to −2.5 with high fracture risk) plus one prior‑therapy/clinical criterion (e.g., 12‑month oral bisphosphonate trial with inadequate response, documented intolerance or inability to take oral bisphosphonates, prior IV bisphosphonate, or CrCl <35 mL/min/CKD), with dosing 210 mg SC monthly (two injections) and typical authorization for 12 months.

"Inadequate response to oral bisphosphonate is defined by examples given: 'ongoing and significant loss of bone mineral density [BMD], lack of BMD increase'."

Sign up to see full coverage criteria, indications, and limitations.