Product Details
Osnuvo
Teriparatide250 mcg/mL
Solution for Injection
3-mL Cartridge Pack
DIN/PIN/NPN
02495589
Manufacturer
Avir Pharma Inc.
Formulary Listing Date
2022-09-29
Unit Price
565.2600
Amount MOH Pays
565.2600
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
H05AA02
Interchangeable Products
NOLU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
635 | 2 years | For the treatment of osteoporosis in patients at a high risk of fragility fractures who meet ALL the following criteria: - 65 years of age or older; AND - Has a documented bone mineral density [BMD] T-score of less than or equal to 3; AND - Has a history of prior fragility fracture(s); AND - Has used an anti-resorptive agent for osteoporosis which resulted in osteonecrosis of the jaw and/or an atypical femur fracture. Note: The maximum lifetime exposure to teriparatide for an individual patient is 24 months |