Alternative to Reclast after Prolia

It’s so frustrating that insurance dictates our treatment choices. I can’t advise as I’m still on a learning curve with these options I’m interested to see what feedback you receive.

Hi! I've been on Evenity (recommended by neurosurgeon prior to spinal fusion surgery not endo) for 11 months & my dexa went from forearm -2.7 & hip -2.6 2 years ago to forearm -2.1 femur -2.5 2 wks ago. CT scan of spine showed 50 % improvement. Endo recommended Prolia, but I have autoimmune diseases & that medication can compromise immune system. Also cause hair loss. Very frightened. Speaking to neurosurgeon on Mon.

@lisaberkowitz Not sure how that relates to my question, but if it helps I have had no noticeable side effects with Prolia. I would stay on it if I were 10 years older. I don’t have immune system issues though.

Just to add, my provider’s staff have been an absolute nightmare throughout the whole almost 2 years I have seen him. Every Prolia injection but one involved multiple daily calls to them to get the prior authorization done because they either didn’t do it or did it incorrectly. I had one scheduled and found out 4 days before that the prior auth had expired. Another time they had never sent an order to the infusion center. I’ll be looking for a new provider after this, not because I don’t like him but his PA team are incompetent.

@lisaberkowitz I'm on Medicare & insurance won't pay for Prolia. There is a generic equivalent called Jubbanti but insurance only covers 60%. If your endo writes that Reclast is a medical necessity, insurance should cover it. You can also see a metabolic bone specialist (there are additional tests besides Dexa) who might have more sway than an endo. Hope that helps!

@lisaberkowitz Yeah, the whole change to Jubbonti this year was a mess as well. Luckily for my last injection Prolia was still covered, but some clueless person at the infusion center mistakenly told me they didn’t have it. After a lot of panic over that I spoke to a nurse who confirmed they did carry it. I’m on Medicare Advantage. Honestly our healthcare system is horrible. My cat gets better care — the vet who’s seen her the most gave me his personal cell and I can call or text him with any urgent issues. Her insurance pays 90% after deductible and they process claims and pay within a week or so. No prior authorization needed.

Agreed. Good luck!!

Based on what I've read about Reclast side effects, and since you already have taken Fosamax with no issues, I would go back on the Fosamax. It's a bisphosphonate, as is Reclast.

@daisy17 It’s just that I swear I had heard or read that Reclast is better at preventing rebound bone loss when going off Prolia. If that isn’t the case, if they’re equally effective, I would be fine going back on Fosamax, though it didn’t improve my bone density at all. It just kept me from getting worse.

@neesie0159 Might be something to discuss with your doctor. Maybe this website will help: https://www.drugs.com/compare/fosamax-vs-reclast