The insurance process for Forteo & Tymlos

Posted by guinivere @guinivere, Aug 5 3:55pm

I have had fairly bad osteoporosis for quite a while now due & have been ditering back & forth on what to do. Have finally decided on either Foreto or Tymlos. I have applied for ffnancal help from the Univ of Wisconsin where my endocrinologist is but today was told that would take MANY months!! On reading the sites for both Forteo & Tymlos, it looks as tho both of them offer the means for financial help.
Has anyone gone this route & if so please let me know!!!!

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Windy, I had the app from Radius Assist. There were two forms, one for me & one for "prescribing physician." I knew she would not sign it & I would never know - she never communicated with me at all! So I dithered. I fnally decided to go for it but then found out how long getting aid from UW would take & considering that my bone density test that started all this was Soway back in October, I figure I was running out of town before I broke something more than just a wrist!

So I went ahead & got the Prolia. There are two upsides: I am finally getting treatment & the other is I am going to switch out of UW Madison & get into UW Sauk Prairie which is much closer to me & involves a different doctor.

I would like to give you the name of that doctor I have had just in case someone else here ends up with her. But don't want to write it here.

I will definitely be around tho. Maybe in the next 6 months if I am still alive (am 86 now!) a way to switch effectively from Prolia to Forteo or Tymlos will be found!

Again many thanks. Too bad you're not in south central WI!!!

REPLY
@guinivere

Windy, I had the app from Radius Assist. There were two forms, one for me & one for "prescribing physician." I knew she would not sign it & I would never know - she never communicated with me at all! So I dithered. I fnally decided to go for it but then found out how long getting aid from UW would take & considering that my bone density test that started all this was Soway back in October, I figure I was running out of town before I broke something more than just a wrist!

So I went ahead & got the Prolia. There are two upsides: I am finally getting treatment & the other is I am going to switch out of UW Madison & get into UW Sauk Prairie which is much closer to me & involves a different doctor.

I would like to give you the name of that doctor I have had just in case someone else here ends up with her. But don't want to write it here.

I will definitely be around tho. Maybe in the next 6 months if I am still alive (am 86 now!) a way to switch effectively from Prolia to Forteo or Tymlos will be found!

Again many thanks. Too bad you're not in south central WI!!!

Jump to this post

If you are 86 maybe you can stay on Prolia! You have had such a hard time!

REPLY

We'll see. Longevity runs in my family & I am definitely not an old lady! Depending on how things go, there may be options for something else other than Tymlos or Forteo from Prolia.

REPLY

Hi! I hope you are able to get some financial help on whichever med you choose. I was able to get a coupon for Forteo and it only cost me $4/month. Unfortunately the coupon only lasted 5 months and then it was going to cost me around $4600.00/month. Couldn't get any other financial help, so I had to stop taking it. I did really well on the Forteo! The only side affect I had was some belly fat!
Good luck with your journey.

REPLY
@guinivere

Windy, I had the app from Radius Assist. There were two forms, one for me & one for "prescribing physician." I knew she would not sign it & I would never know - she never communicated with me at all! So I dithered. I fnally decided to go for it but then found out how long getting aid from UW would take & considering that my bone density test that started all this was Soway back in October, I figure I was running out of town before I broke something more than just a wrist!

So I went ahead & got the Prolia. There are two upsides: I am finally getting treatment & the other is I am going to switch out of UW Madison & get into UW Sauk Prairie which is much closer to me & involves a different doctor.

I would like to give you the name of that doctor I have had just in case someone else here ends up with her. But don't want to write it here.

I will definitely be around tho. Maybe in the next 6 months if I am still alive (am 86 now!) a way to switch effectively from Prolia to Forteo or Tymlos will be found!

Again many thanks. Too bad you're not in south central WI!!!

Jump to this post

Hi Guinevere,
I am so sorry to read that you have had so much trouble with your doctor, and that they would not complete their portion of the Radius Assist application. It grieves me, really. Perhaps you can look for another doctor? I go to the CORE institute in Arizona. I know that this is nowhere near you. But they were very happy to complete their portion of the application and hand it back to me so that I could send it in for review and approval. I was approved within two weeks and received the medication a couple of weeks later. It was very easy. I was going to a Rheumatologist before the CORE institute and I fired them because they never even offered Tymlos to me. They said I would have to take Prolia for the rest of my life, even though it wasn't improving my T-Scores after 3 years while suffering many side effects. I wish I could help you with this. My recommendation would be to find another doctor. Prolia was horrible for me, but then again, I know everyone is different. I will keep you in my prayers...

REPLY
@georginas

Hi Guinevere,
I am so sorry to read that you have had so much trouble with your doctor, and that they would not complete their portion of the Radius Assist application. It grieves me, really. Perhaps you can look for another doctor? I go to the CORE institute in Arizona. I know that this is nowhere near you. But they were very happy to complete their portion of the application and hand it back to me so that I could send it in for review and approval. I was approved within two weeks and received the medication a couple of weeks later. It was very easy. I was going to a Rheumatologist before the CORE institute and I fired them because they never even offered Tymlos to me. They said I would have to take Prolia for the rest of my life, even though it wasn't improving my T-Scores after 3 years while suffering many side effects. I wish I could help you with this. My recommendation would be to find another doctor. Prolia was horrible for me, but then again, I know everyone is different. I will keep you in my prayers...

Jump to this post

I was able to switch clinics within the same hospital system which has the added advantage that it is closer to home (for our Wisconsin winters!). So far I have no problems at all with Prolia. Maybe by the time I am supposed to have the next injection therre will be a way to switch to Tymlos & get the greater benefit of that med. We'll see.

Thanks for your input & best of luck to you!

REPLY

@georginas and @guinivere I hope you can make sure it is safe to do Tymlos after Prolia, whether after one injection or many. McCormick's "Great Bones" book" and Ben Leder's YouYube video "Combined and Sequential Approaches to Osteoporosis" (minute 35) both warn that a bisphosphonate is needed after Prolia, and that Tymlos (Leder discusses Forteo actually) isn't effective after Prolia. In fact, bone density and strength both go down, and porosity dramatically rises, according to Leder's lecture and slides. I have no idea whether this is true after only one Prolia injection. As always, check with your doctor but maybe bring info from these resources to discuss.

I do not mean to be negative or scary. In fact, Leder says these two medications (in his case, Forteo and Prola) together work better than any medication alone, with Forteo months 0-9 and Prolia months 3-15, then either staying on Prolia (if old enough to never have to stop!) or doing a bisphosphonate to "lock in gains." McCormick says that if only 1-3 Prolia injections have been done, Fosamax can be used but otherwise Reclast.

Note: Leder says high dose Forteo plus Prolia works even better. Tymlos is 80mg vs Forteo 40mg- but a pharmacist would know if this means Tymlos is twice as strong. If so, the combo would be even more potent with Tymlos.

REPLY
Please sign in or register to post a reply.