Prolia by infusion

An infusion is generally administered into a vein (like an IV). An injection is generally administered into administered into a muscle or subcutaneously (subq—under the skin).
I was referred to an infusion center to receive my injections of Evenity (subq) and now Prolia (subq). My understanding is so it can be billed under Medicare Part B.
I hope this is helpful.

I had several Prolia injections. They were administered in the doctor's office and were paid by Medicare Part B.

I do not think anyone has said they were actually infused. Prolia is an injection....a simple shot.

Rather, it seems to be how some medical providers are labeling it.....or requesting that you go to an 'infusion' center where you will receive an injection that can easily be done at a doctor's office....and billing it.

It appears there is some sort of game going on. It is probably related to Medicare payment guidelines/reimbursement rates/allowed amount to providers. And Prolia looks to be one of those situations that can be processed and paid under either Medicare Part B or Part D; it may be up to an insurer which one.

How Prolia is billed and processed can affect the amount that is the patient's responsibility. It would be nice to think providers were trying to somehow help patients manage costs by the way it labels the delivery method but I will not hold my breath.

Insurance companies, big pharma, and benefits managers are not the only game players in our overly complex medical system. Providers seek to maximize revenue as well, either for private profit or for those overpaid executives at so-called 'non-profit' institutions like hospitals.

And good luck getting reliable info about your share of the cost before treatment, especially if you are enrolled in an Advantage plan that has an incorporated drug plan.

I do not think that the use of Infusion centers is nefarious but a practical move. When having cataract surgery, I learned that the hospital/surgical center was the one ordering the lens and responsible for having the correct one at the time of the surgery. Medications like Prolia are not cheap; far more costly than flu/pneumonia/etc. vaccines that doctors may keep on hand in their offices. Instead of each endo/rheumatologist keeping them in stock or ordering for an individual, it is far more convenient for an infusion center to do the ordering for multiple doctors. They may be able to keep a small inventory in stock dispensing on the first in/first out basis. They might even be able to get discounts based on larger orders.

That's exactly what it was for me too. They probably bill it as an infusion to get more money. It's just a shot.

I'm in the same boat. I'm 57 and have been dealing with spine issues and have had neck surgery. I just found out I have osteoporosis and osteoarthritis. Im worried about my fusion holding up because it says to avoid surgery if you have Osteoporosis and mine I was told was bad. They suggested the Prolia because I have stomach issues and Esophagitis. My dentist told me to avoid Prolia if possible and stick with Fosamax because of issues he has seen with jaw bone and teeth. He also mentioned issues with the hip bone also. I'm so scared to try any of it but the doctors said I really need it. I don't know what to think or do. Please let me know what you hear and what you decided and think. I should have been on something a long time ago but I've been hesitant. God Bless

You’re dealing with a lot! The options aren’t ideal. I’m sticking with Prolia for now but I don’t see it as a long-term option. I hope you find something you’re comfortable with.

Thank you. It is good to know there might be medically related reasons for referrals to infusion centers.

My Prolia injection is given at an infusion center . I have never heard of Prolia being infused.