Forteo vs teriparatide and Original Medicare Drug Plan (Part D)

Posted by leeosteo @leeosteo, Nov 5 4:36am

I've been on Forteo (brand) since April 1 2024. By year end this year I will be on Forteo for 21 months. I just had my 18 month bone biomarker tests (CTX and P1NP) and I'm still seeing good benefit from Forteo. So my doctor and I have agreed to stay on Forteo for the full 24 months. So this leaves me with just 3 months into 2026 to use Forteo.

I'm on Original Medicare with a Part D drug plan. My current drug plan is AARP UHG. Their formulary has included Forteo (brand) all this time. AARP UHG is dropping Forteo (brand) in 2026 and replacing it with Teriparatide.

My questions:
- Is it ok to switch from Forteo to Teriparatide? I noticed that Forteo is 600mcg, 2,4ml and Teriparatide is 560mcg, 2,24ml.

- Has anyone here switched from Forteo (brand) to Teriparatide more than half way through a 24 month use?

- Has anyone used Humana Original Medicare Part D Drug Plan? It is the only Original Medicare Part D Drug Plan available to me in 2026 that includes Forteo (brand). They have a poor reputation for customer satisfaction and a record of denials in my area.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

njx58 | @njx58 | Nov 5 8:01am

You're fine with the generic version.

Are there more choices for Part D if you use teriparatide instead of Forteo?

gently | @gently | Nov 5 8:43am

The difference between 560mcg and 600mcg comes from a labeling change initiated by the FDA to reflect the actual dosage intended for delivery. The extra 40mcg previously listed is factory overfill in the pen. The part that is left when you can no longer turn the dial. With the label change on Forteo the mcg listing will be the same, but there will be other minor differences between generic and original Forteo.
There are three generics approved in the US. Teva's, Apotex's and Alvogen's- Bonsity. The active ingredient PTH1-34 is exactly the same. But there will be differences in excipients. While it these differences don't change the bone growth and repair, you may have a different response to the excipients.
There was one person commenting here that had side effects with Bonsity, that weren't common to Forteo.
I'd risk switching supplementary insurance if it were for more than 3 months use. If you or your doctor are considering a third year of Forteo, I'd consider switching, except that would be easier for the insurance to deny.
Do you know which generic Humana is providing.

leeosteo | @leeosteo | Nov 5 12:43pm

In reply to @njx58 "You're fine with the generic version. Are there more choices for Part D if you use..." + (show)

@njx58
I'm offered 9 drug plans to choose from. 8 list teriparatide and 1 Forteo. Of the 8 offering teriparatide the monthly premiums are all over the board from high to low cost. Each of the 8 have basically the same osteoporosis medications.

leeosteo | @leeosteo | Nov 5 12:46pm

In reply to @gently "The difference between 560mcg and 600mcg comes from a labeling change initiated by the FDA to..." + (show)

@gently
Of the 9 drug plans available to me, only Humana is offering Forteo (brand). All the others are offering Teriparatide. They list Teriparatide as (brand). I guess that's Teriparatide vs a generic e.g. Bonsity.

bswpb | @bswpb | Nov 5 7:50pm

Isn’t Forteo Teriparatide?

gently | @gently | Nov 6 1:24am

In reply to @gently "The difference between 560mcg and 600mcg comes from a labeling change initiated by the FDA to..." + (show)

The ingredient list on Bonsity and Forteo are the same.
The additives to teriparatide (the 1-34 sequence of the pth hormone) may be in slightly different amounts.
The main difference is in the medium used for obtaining PTH 1-34. Bonsity teriparatide uses a strain of Pseudomonas fluorescens modified by recombinant DNA technology.
Forteo teriparatide is manufactured using a strain of Escherichia coli modified by recombinant DNA technology.
The FDA considers them bioidentical.

gently | @gently | Nov 6 1:59am

In reply to @bswpb "Isn’t Forteo Teriparatide?" + (show)

@bswpb, yes. Forteo is the original patented teriparatide.

leeosteo | @leeosteo | Nov 6 5:49am

In reply to @gently "The ingredient list on Bonsity and Forteo are the same. The additives to teriparatide (the 1-34..." + (show)

@gently , thank you for the differences between Bonsity and Forteo. Where did you find this information? I'd like to read more.

gently | @gently | Nov 7 4:58am

leosteeo,
remember when we were both just starting. Seems like forever ago.
I was happy to find someone on the same path.
The information comes from scattered articles on each medication. Most comparisons gloss over the differences but maybe the differences are insignificant.
I could give you this link on Forteo https://pmc.ncbi.nlm.nih.gov/articles/PMC5219817/ for now.

yvettenie | @yvettenie | Nov 8 6:53am

I have WellCare Part D coverage(premium is $9.60 a month for 2026) Terapartitide is the generic for Forteo. WellCare covers %100 percent after $2000 deductible, so I pay 1 1/2 months of the drug and then all drugs are paid in full for the remainder of the year. Hope this helps!