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.

You are now leaving Prolia.com
This information is intended only for U.S. healthcare professionals. If you are a healthcare professional, click "I Agree" to continue.
Please know that the sponsors of this site are not responsible for content on the site you are about to enter.
This site is for U.S. residents only.

The majority of commercial and Medicare plans cover Prolia®. The list price for Prolia® is $1,477.16†,‡ 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 July 01, 2022. Patients may need to pay a higher price due to additional doctor administration or pharmacy charges.

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®

If you are a Medicare Part B patient

93%

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 you meet your deductible, Medicare Part B typically 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 Medicare FFS, Medicare Advantage, and Commercial Coverage Restriction for Prolia® in DRG Coverage snapshot as of 6/2021 included in this analysis.

First Coast Service Options-Jurisdiction N (MAC B) requires a prior authorization and step edit.

Analysis includes Amgen Assist® insurance verification data for Prolia® prospective patients only from 11/2021 to 4/2022.

§The co-pay may depend on coverage of additional insurance plan.

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®

If you are a Medicare Part D patient

99%

of Medicare Part D patients have access* to Prolia®

Prescription

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

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 Retail Lives associated with Medicare Part D coverage Restriction for Prolia® in DRG Coverage data snapshot as of Q2 2021 are included in this analysis.
  • **The information is provided as a courtesy only and Amgen does not guarantee the accuracy of the information.

For eligible commercially insured patients

LOWER YOUR OUT-OF-POCKET COSTS WITH THE PROLIA® CO-PAY PROGRAM

Prolia_copay_card

How do I get started?

Follow these steps to enroll:

1

Visit ProliaSupport.com
or call 1-844-369-9962

2

Answer a few short questions to find out if you’re eligible and complete the Patient Authorization Form

Eligible patients will receive a letter in the mail welcoming them to the Prolia® Co-pay Program.

Eligible patients pay as little as

$25

per dose of Prolia®

  • Pay as little as $25 for each dose of Prolia® up to an annual Maximum Program Benefit per calendar year*
  • Applies to deductible, co-insurance, or co-pay for Prolia® but not costs associated with office visit for the administration of Prolia®.
  • No income eligibility requirement
  • Other restrictions apply. Visit ProliaSupport.com or call 1-844-369-9962 for more information about this program, including the Maximum Program Benefit and full Terms and Conditions.

How do I get started?

Follow these steps to enroll:

1

Visit ProliaSupport.com
or call 1-844-369-9962

2

Answer a few short questions to find out if you’re eligible and complete the Patient Authorization Form

Eligible patients will receive a letter in the mail welcoming them to the Prolia® Co-pay Program.

Safety

Amgen Safety Net Foundation (ASNF) is an independent, nonprofit patient assistance program that provides Prolia® at no cost to qualifying patients who have a financial need and who are uninsured or have insurance that excludes Prolia®.

Hear from real people taking Prolia®

Stay informed with courtesy reminders, recipes and so much more

Close

Important Safety Information

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®.
What is the most important information I should know about Prolia®?
If you receive Prolia®, you should not receive XGEVA®. Prolia® contains the same medicine as XGEVA® (denosumab).
Prolia® can cause serious side effects:
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.
Low blood calcium (hypocalcemia). Prolia® may lower the calcium levels in your blood. If you have low blood calcium, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia®.
Take calcium and vitamin D as your doctor tells you to help prevent low blood calcium.
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.
Before taking Prolia®, tell your doctor about all of your medical conditions, including if you:
  • Take the medicine XGEVA® (denosumab)
  • Have low blood calcium
  • Cannot take daily calcium and vitamin D
  • Had parathyroid or thyroid surgery (glands located in your neck)
  • Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)
  • Have kidney problems or are on kidney dialysis
  • Are taking medicine that can lower your blood calcium levels
  • Plan to have dental surgery or teeth removed
  • Are pregnant or plan to become pregnant
    Females who are able to become pregnant:
    • Your healthcare provider should do a pregnancy test before you start treatment with Prolia®.
    • You should use an effective method of birth control (contraception) during treatment with Prolia® and for at least 5 months after your last dose of Prolia®.
    • Tell your doctor right away if you become pregnant while taking Prolia®.
  • Are breast-feeding or plan to breast-feed

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

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®.
What is the most important information I should know about Prolia®?
If you receive Prolia®, you should not receive XGEVA®. Prolia® contains the same medicine as XGEVA® (denosumab). 
Read More