Tymlos cost

Posted by yogagirl57 @yogagirl57, Oct 26 8:37am

Hello! I just was recommended Tymlos from my Endo. Can anyone tell me how much or if it is covered by insurance? I have Blue Cross Blue Shield Federal. TIA.

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@yogagirl57

@oopsiedaisy Thank you for your reply. Happy the symptoms disappeared once you ended the treatment. That's great! Is teriparatide the same at Forteo?

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Yes. Forteo= teriparatide. Tymlos = abaloparatide.

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@babbsjoy

@yogagirl57
I am about three months into Tymlos. My doctor sent for approval to my commercial insurance, paving the way. I don’t know what all she sent to support her recommendation for this medicine, but after some time, it was approved and I received a letter from my insurance company stating such. My doctor did a lot of prior testing and had a lot to support the need for the med. Another doc, prior to this, just shut it down saying I would never get initial approval for Tymlos (although he agreed it would be best for my case)—that I would almost certainly have to try fosomax or something first…..so the doctor can make the difference. I have heard that if it is not first approved, the doc can go back on appeal and provide more info….so if that happens do advocate for yourself!

That being said, my out of pocket was going to be just over $500 a month. But if you go on the Tymlos website (Radius manufacturer), you can apply for their savings card, since you have commercial insurance and not Medicare. You don’t have to do much to apply, and you receive an approval number immediately . I provided that number to my doctor as well. I called my insurance company, and found out which specialty pharmacies are on their approved list—in that way making sure my copay would be the least possible. I provided those contact numbers to my doc as well.

When all was done and I knew which pharmacy my doc sent the prescription to, I called them to make sure they also had my Radius savings card number. So far, I pay nothing for my Tymlos and the needles and alcohol wipes.

I was thrilled to have access to this med, and hope all works out well for you too!

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How are you doing with the injection? My doctor is talking about this drug for me, I am scared, and I am overwhelmed. Please tell me how it is going!
Thank You
Jamie Tobbe

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@jamiebones

How are you doing with the injection? My doctor is talking about this drug for me, I am scared, and I am overwhelmed. Please tell me how it is going!
Thank You
Jamie Tobbe

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@jamiebones
Hi! Personally, I am very grateful to have the opportunity to have access to Tymlos. Like you, I was very apprehensive (to use ANY medication). Until about a year ago, I have never had to take a daily med and did not want to start another. My osteo diagnosis was a complete shock. And for my spine, pretty dire. But a daily injection, self administered into my abdomen—yikes!!!!!

I have found the shot to pretty much be a none issue. Once in about ten injections, I will somehow choose a place that stings, but nothing very dramatic. In the beginning, I did experience some light headedness and briefly a racing heart. I found that if I hydrated prior to the shot, with zero sugar Gatorade, it helped a lot. Now I might once in a while get a racing heart briefly, but that is unusual for me. I choose to do my injection at night before bed.

Other people, I have read, have a similar experience to mine. But some people have bigger side effects. You should definitely talk with your doc, and do research, to see what options are best for you and answer all your questions about potential side effects and managing them (and how long they can last). My spine at -3.6 was so concerning that I took seriously other people’s warnings on this site, about the pain and disability that they have experienced from fractures. That motivated me to carefully consider my med options and to follow through. When I’m tired at night and just want to go to bed and not mess with the injection, I remind myself of what a privilege it is to me to have access to this med and then it doesn’t seem like such a big deal. I had Covid for the first time recently and was pretty sick, but only missed one injection during the almost two weeks I was sick. It’s that easy (to me any way!). I wish you blessings on making the best decision for you! I have found that the injection is not as hard as I anticipated and I have tolerated the med very well!

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@njx58

Yes. I used Wellcare Value Script this year, but they've dropped Tymlos for 2025, so I am switching to another plan.

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Hi. New to Tymlos (4 days) and new to this thread, but a longtime Medicare provider (tho retired 16 years now, I still keep up with the rules out of self-preservation), and as CarolynK says, if your 2025 plan isn't covering Tymlos, now is the time to explore other plans. You have until Dec 7. Changing plans can be a big deal and not without problems, but saving thousands of $$ might be at stake.

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@jamiebones

How are you doing with the injection? My doctor is talking about this drug for me, I am scared, and I am overwhelmed. Please tell me how it is going!
Thank You
Jamie Tobbe

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Hi jamie bones. I was also apprehensive about injecting myself; put it off for a month while trying to research it. I couldn't talk to the Tymlos 'educator' until my doc ordered the med, which took time, but then I received a one month sample pen, saving me $700 - but when that all happened the rep was actually really helpful. Answered all my questions, understood that I was nervous about it and reminded me that if I had problems with the shots or side effects or whatever, I could always stop the treatment and shouldn't have any ill effects from doing so. I certainly don't want to go that route, but it is reassuring to know that I can bail out. She also advised things that aren't in the brochure, that made the process less daunting. Little things like 'hydrate!', don't obsess over your injection site rotation... But when it came time to do the injection, I thought maybe I'd screwed it up, cuz I didn't feel the needle at all. Truly. A 5mm 31ga needle is so thin it's almost hard to see. I only knew for sure I'd gotten it in when I was all done and I stood up and was a little dizzy. But that was momentary and not a problem. Do your research, get the free sample pen, try to chill, try it out. You have little to lose and lots to potentially gain.

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@yogagirl57

@oopsiedaisy Thank you for your reply. Happy the symptoms disappeared once you ended the treatment. That's great! Is teriparatide the same at Forteo?

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Yes, it is.

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@jamiebones

How are you doing with the injection? My doctor is talking about this drug for me, I am scared, and I am overwhelmed. Please tell me how it is going!
Thank You
Jamie Tobbe

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@jamiebones I am in the exact situation. I feel your pain. We'll figure it out. I wish I could add more to help.

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@yogagirl57

@jamiebones I am in the exact situation. I feel your pain. We'll figure it out. I wish I could add more to help.

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Hi, What I am thinking is fix the tooth with a temporary fix, wait at least 3 months to do the oral surgery. Fix any other teeth which may have old fillings and might do the same thing. Then start on a med for osteoporosis. Actually my doctor wants to start Tymlos, which is an injection every day, OMG!! I'm still searching for answers, keep in touch.
Jamiebones

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@idlehands

Hi jamie bones. I was also apprehensive about injecting myself; put it off for a month while trying to research it. I couldn't talk to the Tymlos 'educator' until my doc ordered the med, which took time, but then I received a one month sample pen, saving me $700 - but when that all happened the rep was actually really helpful. Answered all my questions, understood that I was nervous about it and reminded me that if I had problems with the shots or side effects or whatever, I could always stop the treatment and shouldn't have any ill effects from doing so. I certainly don't want to go that route, but it is reassuring to know that I can bail out. She also advised things that aren't in the brochure, that made the process less daunting. Little things like 'hydrate!', don't obsess over your injection site rotation... But when it came time to do the injection, I thought maybe I'd screwed it up, cuz I didn't feel the needle at all. Truly. A 5mm 31ga needle is so thin it's almost hard to see. I only knew for sure I'd gotten it in when I was all done and I stood up and was a little dizzy. But that was momentary and not a problem. Do your research, get the free sample pen, try to chill, try it out. You have little to lose and lots to potentially gain.

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Dear Idle
You have made me much more comfortable about the whole process!! I will call my insurance company and see what it will cost, I want to talk with a rep too!! That sounds great!! Keep me posted on how you are doing!!
Jamiebones

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@jamiebones

Dear Idle
You have made me much more comfortable about the whole process!! I will call my insurance company and see what it will cost, I want to talk with a rep too!! That sounds great!! Keep me posted on how you are doing!!
Jamiebones

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You'll want to be sitting down when they tell you the cost 🙂

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