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Support For Those Quitting Prolia

Osteoporosis & Bone Health | Last Active: Mar 2 8:42pm | Replies (266)

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@teardrop, you really are in the thick of it and I'm sorry for all these converging troubles.
You might call the practitioner's office to secure a cancellation. I would email and health message the NP.
Your insurance co may well know that appeals take so long that you would opt for a protective drug in the interim. You could though choose an oral medication like alendronate (Fosamax), for a few months and wait to see if the approval is successful, as I suspect it would be with an aggressive appeal. While it is terrible to be left in this position, going off Prolia could prove advantageous, especially with the possimle impending surgery for the bulging disc.

Your scores look really good and may be even better since 2024, so congratulations on that.
Sometimes bulging discs resolve on their own, but there are minimally invasive procedures like microdiscectomies to resolve the the pain.
The drawback with Prolia is that the bone it creates has a difficult time repairing itself. If you were to need a disc replacement or fusion, it isn't the best medication for maintaining hardware. Your insurance isn't trying to do you any favors, but may have inadvertently done so.
You are, no doubt, in grief. That loss makes everything unbearably difficult.
I hope your dad's moving in provides a wonderful opportunity to be closer to him. I had that kind of miracle in my 60's. What I wouldn't give for another day with him.
Bless your struggles with some luck.
https://www.sciencedirect.com/science/article/pii/S1297319X25001162

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Replies to "@teardrop, you really are in the thick of it and I'm sorry for all these converging..."

@gently
Thank you for your feedback! I would actually really like to come off Prolia anyway as it is such an expensive drug and there is the constant threat of being cut off it. I was hoping the transition would be more smooth than it is turning out to be. Insurance has a way of throwing a wrench in everything doesn't it!? I have thought about asking about alendronate since even if insurance doesn't cover it it is much cheaper to pay for out of pocket (or with a discount coupon). Its good to know at least that is an alternative if the Reclast is denied by insurance also. I work as a medical coder (one of my specialties is infusions) and I have seen a lot of denials for Reclast or zoledronic acid as well as Prolia for a variety of reasons, the biggest being dxa scores that are too high. Its such a paradox for Prolia, because going off it inevitably means those scores are going to plummet, but it will not continue to be approved once you reach a certain score over an extended time on it. It would be nice if there was a standard protocol followed when denied Prolia after so many years, instead of being left to figure out what to do and facing insurance issues! I'm definitely looking forward to having my Dad here!