Indications

Prolia® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well. Read More

Prolia® is a prescription medicine used to increase bone mass in men with osteoporosis who are at high risk for fracture.

Prolia® is a prescription medicine used to treat osteoporosis in men and women who will be taking corticosteroid medicines (such as prednisone) for at least six months and are at high risk for fracture.

Prolia® is a prescription medicine used to treat bone loss in men who are at high risk for fracture receiving certain treatments for prostate cancer that has not spread to other parts of the body.

Prolia® is a prescription medicine used to treat bone loss in women who are at high risk for fracture receiving certain treatments for breast cancer that has not spread to other parts of the body. Read Less

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For women with osteoporosis after menopause at high risk for fracture

Prolia® is covered by many Medicare and Commercial plans.* Learn more about paying for Prolia®

*Individual patient out of pocket costs will vary

The majority of commercial and Medicare plans cover Prolia®. The list price for Prolia® is $1,786.12†,‡ per injection every six months. Most patients do not pay the list price. Your actual cost will vary. Talk to your insurance provider.

The guide below will help you find the insurance coverage most like yours.

†List price is also referred to as wholesale acquisition cost or WAC. WAC is the price at which Amgen sells its products to wholesalers. Prolia® is an injection administered by a healthcare professional once every six months. ‡Updated on June 27, 2024. Patients may need to pay a higher price due to additional doctor administration or pharmacy charges.

  • I am on Medicare

    Prolia® is an injection administered by a healthcare professional and is covered by both Medicare Part B and Medicare Part D

    What you pay will depend on your Medicare plan and whether your doctor orders Prolia® from a distributor (medical benefit) or gets it from a pharmacy (pharmacy benefit).

    Ask your doctor how you can get Prolia®

    Example of Medicare Health Insurance card

    If you are a Medicare Part B patient

    100%

    of Medicare Part B patients have access to Prolia® as initial therapy*

    • No step edit required
    • No prior authorization required

    Most Medicare Part B patients have additional insurance and could pay $0 per syringe of Prolia after meeting deductible†,‡

    • After you meet your deductible, Medicare Part B covers 80% of therapies you receive in your doctor’s office
    • You can obtain an additional insurance (e.g., Medicare Supplement Plan or Medigap, commercial, TRICARE) to pick up the additional 20%§
      - You may need to pay additional monthly premiums with these additional insurances.
    • Out-of-pocket costs do not include costs related to office visits or administration of Prolia®.

    What you pay for Prolia® will depend on the type of Medicare plan you have. Talk to your insurance provider to find out what you will pay for Prolia®.

    *All Medical Lives associated with Coverage Restriction for Prolia in MMIT coverage data snapshot as of January 2024 are included in this analysis.

    †Amgen's SupportPlus insurance verification data for January 2023 to December 2023 was analyzed to determine the OOP Distribution. Prolia prospective patients are only included in the analysis.

    ‡The co-pay may depend on coverage of additional insurance plan(s).

    §You should be enrolled in Medicare Part A and Part B. Medicare patients with supplemental coverage (e.g., Medigap) may require additional premiums.

    If you are a Medicare Advantage (Medicare Part C) patient

    Medicare Advantage is another way to get Medicare services and is offered by private health insurance companies.

    • Cost and coverage vary by plan so it’s important to verify your insurance benefits and out-of-pocket costs for Prolia®
    Example of Medicare Advantage card

    If you are a Medicare Part D patient

    95%

    of Medicare Part D patients*
    have access* to Prolia®†

    Prescription pad

    Pharmacy patients: Some Medicare Part D plans have a preferred specialty pharmacy and some commercial plans require a specific specialty pharmacy for filling your Prolia® prescription.

    Preferred Specialty Pharmacies‡ Pharmacies

    Some Medicare Part D plans have a preferred specialty pharmacy for filling prescriptions

    MEDICAL AND/OR PRESCRIPTION PLAN PREFERRED SPECIALTY PHARMACY
    Aetna CVS Specialty
    Express Scripts Accredo Health Group
    Cigna Accredo Health Group
    CVS Caremark CVS Specialty
    Highmark Accredo Health Group
    Humana CenterWell Specialty Pharmacy

    The pharmacies listed above are for information purposes only and may not be comprehensive of all available mandated specialty pharmacies for a particular plan. The information provided is not a guarantee of fulfillment. Information as of 01/20/2023. For the most up-to-date and complete information, please refer to a patient’s health plan regarding specific policies, instructions, and requirements.

    Example of Medicare Part D Prescription Drug Plans card

    If you have a limited income: Medicare beneficiaries may qualify for Extra Help, a program to help pay for medication costs through Medicare Part D. Visit the Medicare website to learn more about Extra Help.

    Dual eligibility: Medicare Part D is the primary source of drug coverage for “dual eligible” beneficiaries covered under both Medicare and Medicaid.

    • *Access is defined as the ability of a patient to obtain Prolia®, although patient OOP cost and insurance requirements may vary.
    • †All Medicare Part D Pharmacy Lives associated with Coverage Restriction for Prolia in MMIT Coverage data snapshot as of January 2024 are used.
    • ‡The information is provided as a courtesy only and Amgen does not guarantee the accuracy of the information.
    To learn more call 1-866-264-2778

  • I have commercial insurance (e.g. self-purchased or through an employer)

    Amgen® SupportPlus

    Helping eligible commercially insured patients lower out-of-pocket costs

    Amgen® SupportPlus Card

    The Amgen® SupportPlus Co-Pay Program can help eligible commercially insured patients lower their out-of-pocket prescription costs, including deductible, co-insurance, and co-payment.*

    • For Prolia®, pay as little as $25 out-of-pocket for each dose
    • Can be applied to deductible, co-insurance, and
      co-payment*

    *Eligibility criteria and program maximums apply. See www.amgensupportplus.com/copay for full Terms and Conditions.

    Help patients enroll online at www.amgensupportplus.com/copay or by phone at 1-866-264-2778

    Please see Important Safety Information below.

    prolia_patient_logo_small

  • I am uninsured

    Amgen® SupportPlus Representatives can provide information about independent nonprofit foundations that may be able to help.‡

    Please contact Amgen SupportPlus for more information at 1-866-264-2778

    ‡Eligibility for resources provided by independent nonprofit patient assistance programs is based on the nonprofit’s criteria. Amgen has no control over these programs and provides information as a courtesy only.

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Important Safety Information

What is the most important information I should know about Prolia®?
If you receive Prolia, you should not receive XGEVA® (denosumab). Prolia contains the same medicine as XGEVA®.
Prolia® can cause serious side effects (including):
Increased risk of severe low calcium levels in your blood (hypocalcemia). Prolia may lower the calcium levels in your blood. If you have low blood calcium before you start receiving Prolia, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia. Talk to your doctor before starting Prolia. Your doctor may prescribe calcium and vitamin D to help prevent low calcium levels in your blood while you take Prolia. Take calcium and vitamin D as your doctor tells you to.
If you have advanced chronic kidney disease (may or may not be on kidney dialysis), Prolia may increase your risk for severe low calcium levels in your blood, which could result in hospitalization, life-threatening events and death. A mineral and bone disorder associated with kidney disease called chronic kidney disease mineral bone disorder (CKD-MBD) may increase your risk for severe low calcium levels in blood. Before you start PROLIA and during treatment, your doctor may need to do certain blood tests to check for CKD-MBD.
Most people with low blood calcium levels do not have symptoms, but some people may have symptoms. Call your doctor right away if you have symptoms of low blood calcium such as:
Serious allergic reactions have happened in people who take Prolia®. Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble breathing; throat tightness; swelling of your face, lips, or tongue; rash; itching; or hives.
Severe jaw bone problems (osteonecrosis) may occur. Your doctor should examine your mouth before you start Prolia® and may tell you to see your dentist. It is important for you to practice good mouth care during treatment with Prolia®.
Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bone. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.
Increased risk of broken bones, including broken bones in the spine, after stopping, skipping or delaying Prolia®. Talk with your doctor before starting Prolia® treatment. After your treatment with Prolia® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine. Do not stop, skip or delay taking Prolia® without first talking with your doctor. If your Prolia® treatment is stopped, talk to your doctor about other medicine that you can take.
Serious infections in your skin, lower stomach area (abdomen), bladder, or ear may happen. Inflammation of the inner lining of the heart (endocarditis) due to an infection may also happen more often in people who take Prolia®. You may need to go to the hospital for treatment.
Prolia® is a medicine that may affect the ability of your body to fight infections. People who have weakened immune systems or take medicines that affect the immune system may have an increased risk for developing serious infections.
Skin problems such as inflammation of your skin (dermatitis), rash, and eczema have been reported.
Bone, joint, or muscle pain. Some people who take Prolia® develop severe bone, joint, or muscle pain.
Do not take Prolia® if you: have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®.
Before taking Prolia®, tell your doctor about all of your medical conditions, including if you:

What are the possible side effects of Prolia®?

It is not known if the use of Prolia® over a long period of time may cause slow healing of broken bones. The most common side effects of Prolia® in women being treated for osteoporosis after menopause are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

The most common side effects of Prolia® in men with osteoporosis are back pain, joint pain, and common cold (runny nose or sore throat).

The most common side effects of Prolia® in patients with corticosteroid-induced osteoporosis are back pain, high blood pressure, lung infection (bronchitis), and headache.

The most common side effects of Prolia® in patients receiving certain treatments for prostate or breast cancer are joint pain, back pain, pain in your arms and legs, and muscle pain. Additionally, in Prolia®-treated men with nonmetastatic prostate cancer receiving ADT, a greater incidence of cataracts was observed.

These are not all the possible side effects of Prolia®. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. 

Indications

Prolia® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.

Prolia® is a prescription medicine used to increase bone mass in men with osteoporosis who are at high risk for fracture.

Prolia® is a prescription medicine used to treat osteoporosis in men and women who will be taking corticosteroid medicines (such as prednisone) for at least six months and are at high risk for fracture.

Prolia® is a prescription medicine used to treat bone loss in men who are at high risk for fracture receiving certain treatments for prostate cancer that has not spread to other parts of the body.

Prolia® is a prescription medicine used to treat bone loss in women who are at high risk for fracture receiving certain treatments for breast cancer that has not spread to other parts of the body.

Please see Prolia® full Prescribing Information and Medication Guide.

Important Safety Information

What is the most important information I should know about Prolia®?
If you receive Prolia, you should not receive XGEVA® (denosumab). Prolia contains the same medicine as XGEVA®.
Prolia® can cause serious side effects (including):
Increased risk of severe low calcium levels in your blood (hypocalcemia). Prolia may lower the calcium levels in  
Read More