- Prior Authorization: Osteoporosis: Post Menopausal Women:
Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 24 Month(s)
- Osteoporosis: Post Menopausal Women:
Duration: 24 Month(s)
Medical Test Required: Yes
Reauthorization Required: No
Duration of Reauthorization: N/A
History of Fracture Required: Variable
USA specific WHO fracture (FRAX) assessment criteria positive: Variable
BMD T-score at neck, total hip, or lumbar spine: <= -1
Self-Administration Allowed: No
Multiple fractures required: No
Documented Diagnosis: Yes
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