Comprehensive medication guide to Evenity including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$500 per monthly dose depending on insurance type and plan. Medicare Part B covers 80% after deductible for in-office administration (J-code J3111); Medigap plans can cover the remaining 20%. Part D Tier 4-5 specialty coinsurance is 25-33%, subject to the 2026 $2,100 annual out-of-pocket cap. Commercial plans vary; prior authorization and step therapy requirements apply.
Estimated Cash Pricing
$2,600–$3,400 per monthly dose (two 105 mg prefilled syringes) at list price; over $31,500 for the full 12-month course. No biosimilar currently available. With the Amgen SupportPlus Co-Pay Program, commercially insured patients may pay as low as $0 per dose.
Medfinder Findability Score
65/100
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Evenity (romosozumab-aqqg) is a humanized monoclonal antibody — a biologic medication — approved by the U.S. FDA in April 2019. It is manufactured by Amgen in collaboration with UCB Pharma. Evenity is classified as a sclerostin inhibitor, representing a first-of-its-kind mechanism in osteoporosis treatment.
Evenity is indicated for the treatment of osteoporosis in postmenopausal women at high risk for fracture — defined as a history of osteoporotic fracture, multiple risk factors for fracture, or failure or intolerance to other available osteoporosis therapies. It is given as two subcutaneous injections (210 mg total dose) monthly for a 12-month course, administered by a healthcare provider.
Evenity's unique dual mechanism — simultaneously increasing bone formation and decreasing bone resorption — sets it apart from all other osteoporosis medications. Because it must be administered in a clinical setting and requires prior authorization from most insurers, Evenity is distributed through specialty pharmacy channels rather than standard retail pharmacies.
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Evenity works by inhibiting sclerostin, a small protein produced by osteocytes (mature bone cells). Sclerostin normally acts as a brake on bone formation by blocking the Wnt/β-catenin signaling pathway — the key pathway that activates osteoblasts (bone-building cells). By neutralizing sclerostin, Evenity removes this inhibitory brake, freeing osteoblasts to build new bone tissue.
Simultaneously, sclerostin blockade decreases RANKL expression and increases osteoprotegerin (OPG), reducing osteoclast activity and slowing bone resorption. This dual anabolic-antiresorptive effect is unique to Evenity among all FDA-approved osteoporosis medications.
Clinical trials demonstrated that Evenity produces rapid and significant increases in bone mineral density. In the pivotal ARCH trial (4,093 women with severe osteoporosis), Evenity followed by alendronate reduced vertebral fracture risk by 48%, nonvertebral fracture risk by 19%, and hip fracture risk by 38% compared to alendronate alone.
105 mg/1.17 mL — Subcutaneous injection (prefilled syringe)
Two syringes administered consecutively for a total dose of 210 mg once monthly for 12 months. Administered by a healthcare provider.
Evenity is not in an official FDA or ASHP drug shortage as of 2026. However, it is significantly harder to access than standard retail medications because it is a specialty biologic distributed exclusively through specialty pharmacy channels and must be administered by a healthcare provider. Standard retail pharmacies (CVS, Walgreens, Rite Aid) typically do not stock Evenity on their shelves.
Access barriers include: prior authorization requirements (2-4 weeks processing), step therapy requirements (many plans require bisphosphonate trial first), specialty pharmacy coordination requirements, cold-chain storage and delivery logistics, and a list price exceeding $2,600 per monthly dose. These structural factors — not a supply shortage — create the access difficulties patients experience.
If you're having trouble locating Evenity, medfinder calls pharmacies near you to find which ones can source and fill your Evenity prescription, saving you hours of phone calls. The Amgen SupportPlus program (1-844-AMGEN-11) is also an essential resource for navigating specialty pharmacy access.
Evenity is not a controlled substance, so there are no DEA scheduling restrictions on who can prescribe it. Any licensed prescriber can write a prescription. In practice, due to the clinical complexity and specialty pharmacy coordination required, Evenity is most commonly prescribed by specialists with osteoporosis expertise.
Endocrinologists (most common specialty for Evenity prescribing)
Rheumatologists
Primary Care Physicians (PCPs) experienced in osteoporosis management
OB/GYNs and Gynecologists (for postmenopausal women)
Orthopedic surgeons (particularly in fracture liaison service settings)
Nurse Practitioners (NPs) and Physician Assistants (PAs) in relevant specialty practices
Telehealth is available for consultations and prescription — a provider can evaluate your DXA results and clinical history virtually and write a prescription. However, the monthly Evenity injections must be administered in person at a healthcare facility by a qualified provider or trained clinical staff.
No. Evenity (romosozumab) is not a controlled substance and is not scheduled under the DEA Controlled Substances Act. There are no special DEA prescribing, dispensing, or refill restrictions associated with Evenity.
Any licensed prescriber — including MDs, DOs, NPs, and PAs — can prescribe Evenity without DEA scheduling restrictions. The medication does require insurance prior authorization and must be dispensed through specialty pharmacy channels due to its biologic nature and cold-chain storage requirements — but these are logistics requirements, not controlled substance restrictions.
The most commonly reported side effects in clinical trials (5,000+ patients) were:
Joint pain/arthralgia (8–13% of patients)
Headache (5–7%)
Injection site reactions (pain, redness, swelling — ~5%)
Nasopharyngitis (cold-like symptoms)
Back pain
FDA Boxed Warning: Evenity may increase the risk of heart attack (myocardial infarction), stroke, and cardiovascular death. Do not use in patients with MI or stroke within the preceding 12 months.
Hypocalcemia (low blood calcium) — must be corrected before starting therapy
Osteonecrosis of the jaw (ONJ) — rare; dental exam required before starting
Atypical femoral fractures — rare; report thigh/groin pain promptly
Serious hypersensitivity reactions (angioedema, erythema multiforme)
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Teriparatide (Forteo)
PTH analog anabolic agent; daily subcutaneous self-injection for up to 24 months. No cardiovascular boxed warning. Generic available, reducing cost significantly.
Abaloparatide (Tymlos)
PTHrP analog anabolic agent; daily subcutaneous self-injection for up to 24 months. FDA-approved for postmenopausal and male osteoporosis at high fracture risk.
Denosumab (Prolia)
Anti-RANKL monoclonal antibody antiresorptive; subcutaneous injection every 6 months. Commonly prescribed after Evenity course to preserve bone density gains.
Alendronate (Fosamax)
Oral bisphosphonate antiresorptive; once-weekly tablet. First-line therapy for most patients. Widely available as affordable generic. Many plans require trial before Evenity.
Zoledronic Acid (Reclast)
IV bisphosphonate; once-yearly infusion. Option for patients who cannot tolerate oral bisphosphonates. Antiresorptive only (not anabolic).
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Bisphosphonates (alendronate, zoledronic acid, ibandronate, risedronate)
majorConcurrent use significantly increases risk of osteonecrosis of the jaw (ONJ). Should not be used simultaneously with Evenity.
Denosumab (Prolia)
majorConcurrent use increases ONJ risk. Denosumab is appropriate as sequential therapy AFTER Evenity, not simultaneously.
Corticosteroids (prednisone, methylprednisolone, dexamethasone)
moderateConcurrent use increases risk of osteonecrosis of the jaw.
Chemotherapy agents
majorMany chemotherapy drugs elevate ONJ risk when combined with bone-targeted therapies.
Angiogenesis inhibitors (bevacizumab, sunitinib, sorafenib)
majorSignificantly elevate ONJ risk when combined with bone-targeted therapies.
Loop diuretics (furosemide)
moderateIncrease urinary calcium excretion; may worsen Evenity-associated hypocalcemia risk.
Proton pump inhibitors (omeprazole, pantoprazole)
minorMay reduce dietary calcium absorption; monitor calcium levels during Evenity therapy.
Evenity (romosozumab) represents one of the most significant advances in osteoporosis treatment in decades. Its unique dual mechanism — simultaneously building bone and reducing bone loss — makes it particularly valuable for postmenopausal women at very high fracture risk who need rapid bone density gains. The 12-month treatment course, followed by an antiresorptive agent, provides a powerful sequencing strategy that can dramatically reduce fracture risk.
The primary challenges with Evenity are financial and logistical, not clinical. The high list price and specialty-only distribution create real barriers, but multiple support programs exist to address them — particularly the Amgen SupportPlus Co-Pay Program for commercially insured patients and the Amgen Safety Net Foundation for uninsured/underinsured individuals.
If you're having trouble locating a pharmacy that can source Evenity near you, medfinder can help. medfinder calls pharmacies in your area to identify which ones can fill your Evenity prescription, saving you hours of phone calls and helping you stay on your treatment schedule.
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