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    Bisphosphonates

    Drugs - Bisphosphonates

    December 2012

    Therapeutic area - Osteoporosis

    PDL Status

    Musculoskeletal/Osteoporosis

    Bisphosphonates

    Preferred Nonpreferred
    alendronate Actonel/ibandronate PA
    Atelvia (risedronate) PA
    Binosto PA
    Boniva tablets and injectable PA
    Fosamax PA
    Fosamax Plus D

    Approval criteria

    Actonel, branded Fosamax or Boniva/ibandronate tablets

    • Patient has had intolerable side effects from alendronate (Fosamax) after having been instructed to stand or sit upright for at least 30 minutes
    • If patient is to receive Boniva or ibandronate, patient must be informed to stand or sit upright for at least 60 minutes after taking it

    Atelvia

    • Patient must have tried and failed by intolerance BOTH alendronate generic and Actonel AND
    • Prescriber must provide rationale why new formulation of risedronate in Atelvia will provide better results

    Bonisto

    • Patient must have tried and failed alendronate, ibandronate and Actonel OR
    • Intolerance to alendrondate, ibandronate or Actonel, defined as moderate or severe upper GI tract irritation due to the tablet formulation OR
    • Diagnoses of dysphagia

    Boniva Infusion

    • Boniva infusion is approved for use only after the prescriber or pharmacy provides a reasonable explanation of why the patient cannot take a bisphosphonate by mouth (e.g., Roux-en-Y Bariatric Surgery)

    Questions?

    MHCP Provider Call Center 651-431-2700 or 800-366-5411

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