American Association of Clinical Endocrinologists
Position Statement on IV Bisphosphonates

This statement was developed by the AACE IV Bisphosphonates Task Force comprised of:

Steven M. Petak, MD, JD, FACE, FCLM, Chair
Michael Kleerekoper, MD, MACE
Marjorie M. Luckey, MD, FACE
Michael R. McClung, MD, FACE
Nelson B. Watts, MD, FACP, MACE

IV Bisphosphonates that are FDA approved for osteoporosis should be covered for treatment of osteoporosis (733.00-733.09) when:

Bisphosphonates remain the most appropriate anti-osteoporosis intervention, and there is no class contraindication or hypersensitivity to bisphosphonates, and there exists either

• demonstrated intolerance or contraindication for FDA-approved oral bisphosphonates and oral dosing regimens; or insurmountable issues related to absorption, compliance or dosing posture; or anatomic abnormalities or motility disorders of the esophagus or stomach that could interfere with passage or absorption of the medication; or

• when adequate trials of FDA-approved oral bisphosphonates result in fallen BMD and/or failure to suppress bone turnover (e.g., persisting high bone – turnover marker measurements).