Parsabiv® (Etelcalcetide) – Commercial Medical Benefit Drug Policyopen_in_new

Parsabiv (etelcalcetide) is covered for adult patients with secondary hyperparathyroidism on hemodialysis and is excluded for primary hyperparathyroidism, parathyroid carcinoma, and CKD patients not on hemodialysis; it must not be used concomitantly with cinacalcet. Coverage requires documentation of diagnosis and dialysis, prior failure/contraindication/intolerance to ≥1 phosphate binder and ≥1 vitamin D analog (and to cinacalcet where specified), prescribing or consultation by an endocrinologist/nephrologist, FDA‑label dosing, initial and reauthorization limited to ≤12 months, reauthorization showing a reduction in serum calcium from baseline, and discontinuation of cinacalcet ≥7 days before starting Parsabiv.

"Documentation that prescribing or consultation was by an endocrinologist or nephrologist."

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