How to Help Your Patients Save Money on Evenity: A Provider's Guide to Savings Programs

The clinical case for Evenity (romosozumab) is clear for patients at very high fracture risk. The financial barrier is equally clear: Evenity's list price exceeds $2,600 per monthly dose, totaling over $31,500 for the 12-month course. Cost-driven abandonment of osteoporosis therapy is associated with increased fracture rates — and fractures in elderly women carry significant morbidity and mortality. This guide equips prescribers and their care teams with actionable tools to help eligible patients access Evenity at an affordable cost.

Understanding the Cost Landscape for Your Patients

Before identifying savings pathways, understand which coverage category applies to each patient:

Commercial insurance (employer-sponsored or private): Eligible for Amgen SupportPlus Co-Pay Program. Often the best outcome possible — costs can reach $0/dose.

Medicare Part B (in-office administration): Medicare covers 80% after deductible (Part B). Medigap or Medicare Advantage plans often cover the remaining 20%. Data suggests ~87% of Medicare Part B patients pay $0 per dose with supplemental coverage.

Medicare Part D (specialty pharmacy route): Tier 4-5 specialty. Coinsurance 25-33%. 2026 out-of-pocket cap: $2,100/year. Manufacturer co-pay cards cannot be used for Medicare patients (federal anti-kickback statutes).

Uninsured / underinsured: Amgen Safety Net Foundation provides free medication. Nonprofit foundations also available.

Program 1: Amgen SupportPlus Co-Pay Program (Commercially Insured Patients)

For commercially insured patients, the Amgen SupportPlus Co-Pay Program is the single most impactful savings tool available. The program reduces out-of-pocket costs to as low as $0 per dose for eligible patients. Prescribers can and should initiate this enrollment at the time of prescribing:

Call Amgen SupportPlus: 1-844-AMGEN-11 (1-844-264-3611)

Have patient present or on phone during enrollment (HIPAA compliance requires patient consent)

SupportPlus also handles benefits verification and prior authorization — enrolling early reduces administrative burden on your staff

Program 2: Amgen Safety Net Foundation (Uninsured or Underinsured Patients)

The Amgen Safety Net Foundation provides free Evenity to qualifying patients who are uninsured or underinsured, based on income criteria. This program delivers medication directly to the site of care or patient's provider. To initiate: contact Amgen SupportPlus at 1-844-AMGEN-11 and indicate the patient has no or limited coverage. The foundation can provide up to 12 months of free treatment for qualifying individuals.

Program 3: Optimize Medicare Part B Coverage

When administering Evenity in your office under Medicare, ensure you are set up for proper medical benefit billing (J-code J3111). Medicare Part B covers 80% of the Medicare-approved amount after the Part B deductible. Key strategies for your Medicare patients:

Confirm whether the patient has Medigap (Medicare Supplement) insurance — this typically covers the remaining 20%.

Medicare Advantage (Part C) plans have their own cost-sharing rules — verify through SupportPlus before assuming coverage.

For patients using Medicare Part D (pharmacy benefit): refer them to nonprofit foundations since manufacturer co-pay assistance is not available for Medicare Part D.

Program 4: Independent Nonprofit Foundations (Especially for Medicare Part D Patients)

For Medicare Part D patients who need cost assistance, provide referrals to:

Patient Access Network (PAN) Foundation (panfoundation.org): Provides grants for underinsured patients including Medicare beneficiaries. Has programs for osteoporosis/bone health treatment.

HealthWell Foundation (healthwellfoundation.org): Offers disease fund grants for underinsured patients with certain conditions.

Medicare Extra Help / Low Income Subsidy: Patients who meet income requirements may qualify for Medicare's Low Income Subsidy, which significantly reduces Part D cost-sharing.

PA Denial Management: Fighting for Coverage When Needed

Prior authorization denials are common on first submission. Build an efficient appeals process into your practice workflow:

File a formal written appeal with additional clinical documentation (DXA trends, FRAX scores, detailed fracture narrative).

Request a peer-to-peer review — your direct clinical conversation with the plan's medical director is often the most effective tool for overturning a denial.

Utilize Amgen SupportPlus PA support team — they have experience with plan-specific criteria and can support your appeals.

If step therapy is required, document the bisphosphonate trial duration, dose, and reason for failure or intolerance.

Helping Patients Locate Pharmacy Access

Once the financial barriers are addressed, some patients still face challenges locating specialty pharmacies that can source Evenity for their provider. medfinder for Providers can help your care team identify pharmacies in the patient's area that can coordinate Evenity sourcing and delivery to your office, saving significant staff time.

Summary: Provider Savings Toolkit for Evenity

Commercially insured → Amgen SupportPlus Co-Pay Program (up to $0/dose)

Uninsured/underinsured → Amgen Safety Net Foundation (up to 12 months free)

Medicare Part B → Bill J3111 in-office; verify Medigap coverage

Medicare Part D → PAN Foundation, HealthWell, or Medicare Extra Help

PA denials → formal appeal + peer-to-peer review + SupportPlus support