Evenity® (Romosozumab-Aqqg) – Commercial Medical Benefit Drug Policyopen_in_new

Evenity (romosozumab-aqqg) is covered for postmenopausal osteoporosis in patients at high risk for fracture when used per FDA labeling and is authorized for up to 12 months; continued use beyond 12 months is considered unproven and not medically necessary. Coverage requires documentation of postmenopausal osteoporosis and high fracture risk (e.g., prior osteoporotic fracture, multiple risk factors, or failed/intolerant to other therapies), dosing per FDA labeling, objective risk measures (DXA T-score and/or FRAX) and prior therapy history, and is subject to member-specific plan terms and applicable law.

"Evenity is proven for the treatment of osteoporosis in postmenopausal patients at high risk for fracture when all of the following criteria are met: Diagnosis of postmenopausal osteoporosis; and Pa..."

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