Cost of Prolia in 2025: Discounts and Extra Savings Opportunities
In the realm of treating osteoporosis, Prolia has emerged as a popular choice for certain adults. This brand-name prescription medication, administered as a subcutaneous injection every six months, is used to strengthen bones and reduce the risk of bone fracture [1]. However, Prolia's high price point, categorised as a specialty medication, can pose a financial burden for many patients.
Luckily, several avenues of financial assistance are available for those in need.
Firstly, the manufacturer of Prolia, Amgen, offers a Patient Assistance Program. Eligible patients can receive the medication free of charge for up to one year [3]. Additionally, the Amgen Safety Net Foundation provides cost assistance for those without insurance or if insurance doesn't cover Prolia [2].
Insurance coverage also plays a significant role in determining the cost of Prolia. Some insurance plans place Prolia under specialty tiers, which may require copayments or prior authorization [1][4]. To better understand your specific coverage, it's advisable to contact your insurance provider or your doctor's office.
For those with government-funded insurance like Medicare or Medicaid, the cost of Prolia can vary based on various factors such as the specific Medicare plan and fees charged by the doctor's office.
Beyond insurance coverage, copay cards and manufacturer or nonprofit assistance programs can help reduce the financial burden. For instance, the Prolia Co-pay Program, offered by the manufacturer, provides support for those with commercial insurance [5].
Moreover, organisations like the HealthWell Foundation offer grants to help cover copays, premiums, deductibles, and out-of-pocket expenses for essential treatments like Prolia, provided you have some form of health insurance, meet income criteria (within 500% of the federal poverty level), and receive treatment in the U.S. or its territories [2].
It's important to note that Prolia is available only as a brand-name biologic drug and does not have a biosimilar version currently. The cost of biologic drugs, including Prolia, can be high due to the research needed to test their safety and effectiveness.
In the quest for affordable healthcare, resources like the Medicine Assistance Tool and NeedyMeds can provide valuable information about drug assistance programs, ways to make the most of insurance coverage, and links to savings cards [6].
For the most accurate and personalised cost details, it's recommended to check with your insurance provider and Amgen’s support programs. By doing so, you can navigate the costs of Prolia and focus on what truly matters - maintaining your health.
[1] National Osteoporosis Foundation. (n.d.). Prolia. Retrieved from https://www.nof.org/patients/treatment/medication-therapy/prolia/
[2] HealthWell Foundation. (n.d.). Prolia. Retrieved from https://www.healthwellfoundation.org/diseases/prolia/
[3] Prolia Co-pay Program. (n.d.). Retrieved from https://www.proliacopay.com/
[4] GoodRx. (n.d.). Prolia. Retrieved from https://www.goodrx.com/prolia
[5] Amgen Safety Net Foundation. (n.d.). Retrieved from https://www.amgensafetynetfoundation.org/
[6] Medicine Assistance Tool. (n.d.). Retrieved from https://www.matthomas.org/
[7] NeedyMeds. (n.d.). Retrieved from https://needymeds.org/
- Some health insurance providers may cover Prolia, but certain plans might require copayments or prior authorization, making it essential to contact your insurance provider or doctor's office for understanding your specific coverage.
- The HealthWell Foundation offers grants to help cover copays, premiums, deductibles, and out-of-pocket expenses for essential treatments like Prolia, including medicare and Medicaid beneficiaries who meet income criteria and have some form of health insurance.
- The manufacturer of Prolia, Amgen, provides a Patient Assistance Program that offers the medication free of charge for eligible patients who require it for up to one year, in addition to the Amgen Safety Net Foundation that provides cost assistance for uninsured patients or those whose insurance does not cover Prolia.
- For those with chronic diseases like osteoporosis, organizations such as the HealthWell Foundation, Medicine Assistance Tool, and NeedyMeds can provide valuable information about drug assistance programs, ways to make the most of insurance coverage, and links to savings cards to help reduce the financial burden of expensive medications like Prolia and other medical-conditions treatments.
