If you’re looking at treatment options for osteoporosis or bone loss, you may want to learn more about Prolia (denosumab).
Prolia is a prescription drug that’s used to:
- treat osteoporosis in adult females who have gone through menopause and in adult males*
- treat osteoporosis in adults due to glucocorticoid use
- increase bone mass in adult females receiving specific treatments for breast cancer
- increase bone mass in males receiving specific treatments for certain prostate cancers
* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, refer to this article.
This medication comes as a solution that’s injected under your skin. A healthcare professional will give you this injection at a doctor’s office, clinic, or hospital. The active ingredient in Prolia is denosumab. (An active ingredient is what makes a drug work.)
Keep reading for details on Prolia and cost, and how to save money on prescriptions.
Note: For more details on Prolia, including its uses, refer to this in-depth article.
The price you pay for Prolia injections can vary. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and how much you’ll pay for an office visit to receive Prolia. If you have to bring the medication to your injection appointment, it may also depend on the pharmacy you use.
To find out how much you’ll pay for Prolia, talk with your doctor, pharmacist, or insurance provider.
Note: If you have insurance, you may need to get prior authorization before your insurance provider will cover Prolia.
This means your insurer and your doctor will discuss Prolia in regard to your treatment. Then the insurance company will determine whether the drug is covered. If Prolia requires prior authorization and you don’t receive it before you start treatment, you could pay the full cost of the drug.
Be sure to ask your insurance company whether Prolia requires prior authorization.
If you need help covering the cost of Prolia or understanding your insurance, check out these websites:
On these sites, you can find insurance information, details on cost assistance programs, and links to savings cards and other services.
If you have insurance, you may be eligible for copay assistance from a program called Prolia Co-pay. (A copay, or copayment, is a fixed amount you may have to pay for your medication.) For more information about this copay program, visit the drugmaker’s website or call 844-369-9962.
If you don’t have insurance, the Amgen Safety Net Foundation (ASNF) could cover the cost of your medication. To find out if you’re eligible for assistance, go to the ASNF website or call 866-264-2778.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.
Below are answers to some frequently asked questions about Prolia and cost.
Is the cost of Prolia covered by Medicare?
Whether Prolia is covered by Medicare depends on the type of Medicare coverage you have. Many different Medicare plans are available. And Prolia may be covered under some Medicare plans but not others.
If you have a Medicare plan, contact your doctor or your Medicare plan provider. Either can let you know what you’ll pay for Prolia.
Is there a manufacturer coupon available for Prolia?
No, currently there isn’t a manufacturer coupon available for Prolia.
But if you have insurance, the drugmaker has a Prolia copay card that could help lower the cost of copays. (A copay, or copayment, is a fixed amount that you may have to pay for your medication.)
This copay card is available through the drugmaker’s Prolia Co-pay Program. For information about this program, refer to the “Can I get help paying for Prolia, such as a copay card?” section above. The section also has a few other resources that may help you save on the cost of Prolia, regardless of whether you have insurance.
Biosimilars are like generic drugs. Unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs. Biologics can’t be copied exactly. But biosimilars are “similar” to the parent biologic, and they’re considered to be just as effective and safe.
Why is there such a cost difference between biologic drugs and biosimilar drugs?
Biologic drugs can be expensive because of the research and testing needed to ensure their safety and effectiveness.
The manufacturer of a biologic drug can sell it for up to
12 years. When the biologic drug’s patent expires, other drugmakers can create biosimilar versions. This competition in the market may lead to lower costs for biosimilars. And because biosimilars are very similar to biologic drugs, they don’t need to be studied again. This can also lead to lower costs for biosimilars.
If you take Prolia long term, you may be able to lower your costs by using a mail-order pharmacy to get your medication. This applies if you need to bring the medication to your injection appointments.
Using a mail-order pharmacy might help lower your cost for Prolia. Plus, you could get your medication without leaving home. Some Medicare plans may help cover the cost of mail-order drugs.
If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.
If you still have questions about the cost of Prolia, talk with your doctor or pharmacist. They may be able to give you a better idea of what you’ll pay for this drug. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you’d pay for Prolia.
Examples of questions you may want to ask your doctor or insurance provider include:
- What other treatment options are available if I can’t afford Prolia?
- What savings programs may I qualify for that apply to my Prolia prescription?
- Will there be a biosimilar available soon for Prolia?
To learn more about Prolia, refer to these articles:
To get information on different conditions and tips for improving your health, subscribe to some of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s where people with certain conditions can find support and connect with others.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.