I had a similar situation with the NP at the osteoporosis clinic. I asked what might follow Evenity and her response was that we could discuss AFTER I started the program. I would have accepted being told we would evaluate the situation to make a final determination but the usual protocol is to follow with Reclast or Prolia. I had to push to get that info pointing out I could not give informed consent without being informed.

I have not raised the question of what to in 20 months when I finish Tymlos. I know that the gains won't last unless I do something, but studies are always underway and the options might change before that. I hope so anyway, because I have some concerns about the existing ones.

Fortunately my endo had a much better response when I asked what next after Tymlos.

He said he was leaning towards Reclast, though mentioned Prolia might be in the cards. (Evenity was not an option given my medical history.) He specifically asked me to discuss Reclast with my dentist. That was useful both because it will give him background that might affect his recommendation and because it gave me time to take care of any dental procedures that might be questionable with Reclast.

From my own perspective it also gives me plenty of time to learn about the options so I will be in a better position to ask questions and make an informed decision when the time comes. I can also take the potential options into account in selecting my Medicare Part D plan for next year (i.e. check Prolia coverage, but don't worry about Evenity).

I get it that things can change, but to refuse to have even a preliminary discussion would be unacceptable to me.