This CPB has been revised to state that denosumab (Xgeva) is considered medically necessary for bone metastases from solid tumors.  This CPB has been revised to state that denosumab is considered experimental and investigational for multiple myeloma because of insufficient evidence of its effectiveness. The criteria for denosumab (Prolia) for osteoporosis is revised to require a trial of either two oral bisphosphonates, or one oral bisophosphonate and one selective estrogen receptor moduator (SERM), unless contraindicated. The title of this CPB has been changed to "Denosumab (Prolia and Xgeva)".