Romosozumab-aqqg

Coverage for romosozumab‑aqqg (Evenity) for treatment of postmenopausal women with osteoporosis at high risk for fracture—such as those with prior osteoporotic fractures, multiple fracture risk factors, or BMD T‑score ≤ −2.5 (commonly ages 55–90) and those who have failed or are intolerant to other osteoporosis therapies. Coverage is limited to a maximum of 12 monthly doses, is contraindicated in patients with MI or stroke within the prior 12 months, and requires dosing and indications consistent with FDA labeling or recognized compendia/peer‑reviewed evidence per the member’s benefit plan (applies to HCSC Ohio members).

"Drug therapy that is proven effective for the relevant diagnosis or procedure."

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