@louise2023 what are your DEXA scores and do you have any fractures?

Your problem may be insurance coverage, and the policy is misguided in that the bone builders are covered for those who have fractured, have severe scores and/or cannot tolerate first line drugs.

If your scores are bad, you might want a second opinion. My doc won't prescribe Prolia because bone density drops off abruptly if you stop and you have to follow with another med.

I think the other issue is that you have been on Fosamax "for many years." Bone quality issues, dental issues and atypical femur fracture risks go up, I believe, after many years on anti-resorptives, and Prolia is also an anti-resorptive. I would ask your doc about this. It may be that your doc could get insurance to cover Tymlos or Forteo on the basis of your previous Fosamax use.