This CPB is revised to state that denosumb (Prolia) for treatment of women with post-menopausal osteoporosis who are at high-risk for fractures is considered medically necessary for those who have failed or are unable to tolerate either 2 bisphosphonates (e.g., alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel), zoledronic acid (Zometa)) or 1 bisphosphonate plus one selective estrogen receptor modulator (SERM) (e.g., raloxifene (Evista)). (The previous version of the CPB required a trial of 2 oral bisphosphonates or 1 oral bisphosphonate and one SERM.)  This CPB is revised to state that denosumab for prevention and treatment of osteoporosis in persons on aromatase inhibitors and for treatment of men with osteoporosis at high risk for fracture is considered medically necessary for those who have failed or are unable to tolerate 2 bisphosphonates. (The previous version of the CPB required a trial of two oral bisophosphonates).