Evenity and Cost: What You Need to Know

Evenity (romosozumab-aqqg) is a prescription drug that’s used to treat postmenopausal osteoporosis. Evenity’s cost may depend on factors such as your dosage, whether you have health insurance, and the pharmacy you use.

If you have postmenopausal osteoporosis, you may want to learn more about Evenity (romosozumab-aqqg).*

Evenity is a prescription drug used in adult females† after menopause who have a high risk of bone fractures. It’s also used when other medications for postmenopausal osteoporosis can’t be used or haven’t worked well.

Evenity comes as a liquid solution inside prefilled syringes. It’s given as an injection under the skin. You’ll receive the injections at your doctor’s office.

For more details on Evenity, see this in-depth article.

* The reason “-aqqg” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.
† In this article, we use the term female to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Fears over not being able to afford health insurance or medical care are among the top reasons why Americans are delaying retirement. From 2000 to 2016, the number of Americans 65 and older working full-time or part-time rose by six% to include almost 9 million people, according to the Pew Research Center.

The price you pay for Evenity can vary. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. It will also depend on how much you have to pay for an office visit with your doctor to receive Evenity.

To find out how much you’ll pay for Evenity, talk with your doctor or insurance provider.

Note: If you have insurance, you may need to get prior authorization before your insurance provider will cover Evenity. This means your insurer and your doctor will discuss Evenity in regard to your treatment. Then the insurance company will determine whether the drug is covered. If Evenity 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 Evenity requires prior authorization.

Below are answers to some frequently asked questions about Evenity and cost.

Is Evenity covered by Medicare?

It’s possible. There are different Medicare plans, and each plan can vary in its drug coverage. Medicare coverage for Evenity will depend on the benefits of your specific plan.

For example, most of the cost to receive Evenity at your doctor’s office may be covered by Medicare Part B. And if you also have a supplemental Medigap plan, it may cover your out-of-pocket costs to receive Evenity.

To find out if your Medicare plan covers Evenity, call your plan provider. They can tell you the cost of Evenity based on your plan benefits.

You can also talk with your doctor about Medicare coverage for Evenity.

How does the cost of Evenity compare with the cost of Prolia?

Your cost for either Evenity or Prolia may depend on certain factors. For example, it may depend on:

• whether you have health insurance or are paying out of pocket
• the specific benefits of your health insurance plan
• any additional savings programs available to you
• the pharmacy you use

Usually, the cost of either drug is lower with health insurance than without insurance. And if you have private insurance, both Prolia and Evenity currently have a copay savings program available.

Your cost could also depend on how much you need to pay for an office visit to receive Evenity or Prolia injections. For Evenity, you’ll receive an injection once per month for 12 months. For Prolia, you’ll receive an injection once every 6 months for as long as suggested by your doctor.

Your doctor can tell you more about the exact cost of Evenity versus Prolia based on your situation. And to learn more about how these drugs compare, see this article.

Evenity is a biologic drug, which means it’s made from parts of living organisms. It doesn’t come in a biosimilar form. Biosimilars are like generic drugs. Unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.

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 drugmaker 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 Evenity 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 Evenity to your doctor’s office for your injections.

Using a mail-order pharmacy might help lower your cost for Evenity. 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 need help covering the cost of Evenity or understanding your insurance, check out these resources:

• Paying for Evenity
• NeedyMeds
• Medicine Assistance Tool

On these sites, you can find insurance information, details on drug assistance programs, and links to savings cards and other services. The Evenity website provides resources for people with and without insurance.

If you don’t have insurance, a program called the Amgen Safety Net Foundation could cover the cost of your medication. To learn if you’re eligible for assistance, call 866-264-2778 or visit the program website.

If you have questions about how to pay for your prescription, talk with your doctor.

If you still have questions about the cost of Evenity, 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 Evenity.

Examples of questions you may want to ask your doctor or insurance provider include:

• How does the cost of Evenity compare with other medications for osteoporosis?
• Would the cost of Evenity be lower with Medicare or private insurance?
• What options do I have if I cannot afford Evenity?

To learn more about Evenity, see these articles:

• All About Evenity
• Evenity vs. Prolia: What You Should Know

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Disclaimer: Austra Health 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.

Last medically reviewed on March 29, 2023