A strong adult skeleton starts in childhood with a healthy diet, exercise, and adequate calcium and vitamin D. Even when we don’t achieve our full skeletal potential, we can keep our bones healthy and strong. There is no single “silver bullet” remedy. It takes a whole-person approach. Get enough dietary calcium, take vitamin D, participate in regular exercise, fall-proof at home, and avoid smoking and excess alcohol. And, if you have had fractures or are diagnosed with osteoporosis, talk with your healthcare provider about medication options. There are more choices out there every year. You and your provider can work out a plan that keeps you on your feet and active throughout your long and healthy life.

Choosing the Right Osteoporosis Medication

There are many things to think about when choosing the right osteoporosis medicine. You and your healthcare provider may want to look at:

Your sex

Some osteoporosis medications are approved for both men and women, while some are approved for women only.

Both Women and Men

Bisphosphonates:

  • Alendronate (brand name Fosamax, Binosto)
  • Risedronate (brand name Actonel)
  • Zoledronic acid (brand name Reclast )

Rank Ligand inhibitor:

  • Denosumab (brand name Prolia)
  • Parathyroid Hormone (anabolic):
  • Teriparatide (brand name Forteo )

Women Only

Bisphosphonates:

  • Ibandronate (Brand name Boniva)
    Parathyroid Hormone Related-Protein agonist (anabolic)
  • Abaloparatide (Brand name Tymlos)

Hormones:

  • Menopausal Hormone therapy (multiple brands)
  • Estrogen agonist/antagonist (also called Selective estrogen receptor modulator (SERM)) – Raloxifene (brand name Evista)
  • Tissue Specific Estrogen Complex – estrogen/basedoxifene (brand name Duavee)
  • Calcitonin (brand names Fortical, Miacalcin)

Your age. Some medicines are more appropriate for younger postmenopausal women while others are more appropriate for older women.
Osteoporosis medication is not recommended for healthy premenopausal women. However, young women who take medications or have disorders known to cause bone loss and fractures may benefit from osteoporosis treatment. This could be the case in a premenopausal woman experiencing low-trauma fractures while on long-term high-dose corticosteroids to manage an autoimmune disease such as lupus.

How much bone you’ve lost. Osteoporosis medicines work in different ways. A person with more severe bone loss or multiple broken bones may be recommended a different medicine than a person with less bone loss or no fractures.

Your overall health. Your healthcare provider will consider other health problems you have when recommending a medicine. If you have had breast cancer or blood clots, for example, you should not take estrogen. Also, if your bones have been exposed to radiation treatment, you should not take teriparatide (Forteo®) or abaloparatide (Tymlos).

Your personal preferences. Do you prefer a pill, liquid, or medicine that is given as an injection? Does it work better for you to take your medicine every day, once a week, once a month, twice a year, or once a year? Do you have negative feelings about a particular drug?
These factors can influence your treatment decision. No two people are the same. How well a medicine works, or what side effects it will have, can vary from one person to the next.

Paying for Medications and Understanding Your Health Insurance

Paying for Your Medication

Osteoporosis medications require a prescription from your healthcare provider. How much your insurance company pays for an osteoporosis medication depends on the type of insurance plan you have. You may have a co-pay and this copay may vary depending on the drug you are prescribed and whether a generic form is available. To find out what your insurance company covers, call or check their website.

Prescription Assistance

Medicare Part D Prescription Drug Benefit

Medicare pays for prescription drugs through the Medicare Prescription Drug benefit, also called “Medicare Part D.” This benefit is available to everyone with Medicare and may help lower the cost of your prescription drugs. If you’d like Part D drug benefits, you must sign up for them. You can do this during the yearly open season between November 15th and December 31st. You can also sign up the year you turn 65 (3 months before or after your birthday).
Review the Medicare Prescription Drug Annual Open Enrollment Q&A for answers to important questions that will help you during the Annual Open Enrollment Period.

Part D Low-Income Subsidy (LIS)

If you have Medicare and limited income and resources, the Social Security Administration (SSA) may be able to help you cover the costs of your Medicare prescription drug plan. SSA can also help you find organizations in your community to help you to enroll in a Medicare prescription drug plan. Contact the SSA at 1-800-772-1213 or visit www.socialsecurity.gov.

Partnership for Prescription Assistance

The Partnership for Prescription Assistance (PPA) is a free online service that connects uninsured or underinsured Americans to programs providing low-cost or no-cost prescription drugs. The PPA website also shares information on more than 100,000 free health care clinics throughout the United States.
For additional information on the PPA, call 1-888-477-2669 or visit their website. For real-time information on PPA and other consumer health initiatives, read the PPA blog and follow the program @PPArx on Twitter. Download this fact sheet to learn more about PPA.

Additional Resources

RxAssist is a nationally recognized, web based medication assistance resource center. You can search the RXAssist website to find discounts or assistance programs available for the medications you take.

Another resource is www.NeedyMeds.com, which provides information on Medicare state programs and more.

Patient Access Network (PAN) Foundation has funding to support underinsured patients with their osteoporosis treatment up to $500 per year. Check out their website, www.panfoundation.org, for more information.

And finally, the Patient Advocate Foundation provides copayment assistance to certain insured patients who qualify. To find out if you are eligible, www.copays.org or call the Patient Advocate Foundation toll free at: (866) 512-3861.

For more information, please download Patient Tools: What You Need to Know about Paying for Your Osteoporosis Medications.

Medications Administered by a Healthcare Professional

Most insurance companies cover medications administered by a healthcare professional in a medical office or hospital (such as a drug that is given by intravenous infusion). The amount you pay for the prescribed medication is different from what you might pay for a medication you pick up at the pharmacy. If your provider prescribes an osteoporosis medication that must be given in a healthcare professional’s office through an intravenous infusion or injection, check with your insurance company to find out how much of the cost they will cover.
Types of medication given in a healthcare provider’s office or infusion center may include ibandronate (Boniva®), denosumab (Prolia®), and zoledronic acid (Reclast®)

FDA Warning: Buying Medication Online

While many people shop online for their medicines to save money, the FDA warns that the practice is risky. It sometimes costs more than generic medications that are available at pharmacies in the U.S.
The FDA stresses that taking a prescription medicine without a prescription is unsafe. People taking prescription medicines need to be monitored by a healthcare provider. With some medicines, a person’s life can be at risk without proper monitoring.
Safety concerns about buying medicines online include:

  • Medicines may be counterfeit (fake) or not the drug ordered.
  • Medicines may be made under conditions that are not clean or sterile.
  • Medicines may contain harmful substances.
  • Labels may not have information that is needed for the medicine to be used safely.
  • Doses may be different from those used in the U.S.

The FDA provides guidelines to help people decide whether a website selling medicines is safe. Websites selling medicines should:

  • Be located in the U.S.
  • Be licensed by the state board of pharmacy where the Web site is operating. Visit www.nabp.info for a list of state boards of pharmacy.
  • Have a licensed pharmacist available to personally answer questions.
  • Require a prescription from your doctor or other healthcare provider who is licensed to prescribe medicines.
  • Provide contact and/or customer service information.

The FDA recommends looking for the VIPPS® Seal on web sites selling medicines. Legitimate pharmacies that carry the VIPPS® seal are listed at www.vipps.info. The National Association of Boards of Pharmacy (NABP) gives a seal of approval to internet pharmacy sites that apply and meet state licensure requirements and other VIPPS® requirements. VIPPS® stands for Verified Internet Pharmacy Practice Sites.
For additional information, read the FDA’s article on The Possible Dangers of Buying Medicine Online. Read this article.

Last Reviewed 02/26/2018

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