Has anyone had an increase in the cost of Tymlos in 2026?

I am waiting to hear back from my endocrinologist office regarding what my insurance Blue Shield is going to cover for Tymlos as I chose that as my treatment plan followed by three years of reclast. Of course I have a deductible as well, but your amount gave me an idea. That’s terrible if it went up that much in price! I would love to hear your experience with this drug and others as well. I am debating whether to inject in the morning or in the evening as both have pros and cons, I guess.

My wife just started on Tymlos. Because she is not yet on Medicare, she is able to use the manufacturer's copay assistance card. I believe it is worth up to $6000/year. It's not covering the full cost, but anything helps.

Her insurance charges her $500 for a specialty drug. The copay card paid $500, so she owed nothing for her first pen.

@njx58 Thank you, I am waiting to hear back from Blue shield regarding approval, cost etc. We do have a high deductible. I am going on medicare in June so I need to go through my current isurance unless I want to delay treatment which I'm not crazy about. Medicare will be so much more reasonable as far as cost for me

@cpog It will, but you'll still have the Part D OOP max, so that first pen is probably going to cost you $2000. 🙁

Geez...that's a hard question, since every insurance, Medicare and prescription plan is different.

My TYMLOS is covered 100% for the two year period. It puts me in the catastrophic category with our healthcare plan. January 1st, each year I'm charged $100 and from there on, I pay $0 for any additional prescriptions, testing, etc. for the remainder of the year. I do have Medicare but again it depends on which plan you choose.
I believe the out of pocket cost, with no insurance is around $2500 a month. But don't let that stop you from taking it. There are many discounts available that bring the cost way down.
Get your cost IN WRITING from your provider ahead of time.
So this brings me back to the question I always ask....a lot of people on this forum say they start out at much smaller doses than the full dose. If you don't take the full dose, you are still putting out a lot of money every month, not getting the full benefit and using up your allotted time to be on it. You are not supposed to use the pen longer than 30 days. So I don't think you can take a half dose and the pen will last two months. You aren't getting the full benefit of the TYMLOS if you aren't taking the full dose. Also, your insurance may not continue to cover the cost, if you are not taking it as prescribed. Why put yourself in the position that you may not benefit at all after two years? You will have wasted time, possibly have more bone loss and spent a lot of money.
I recommend taking it at bedtime, until you know you have no side effects. The first few weeks, I sat on the edge of the bed, took the shot, put the pen on the night table, got comfy and went to sleep. Once I knew there were no side effects, I started taking it about the same time every night.
Good luck...go into this with an open mind and knowing it could very well be a medication that could save your life. Be positive, be strong and if the first dose hurts, don't give up, take it again the next day and the next day until you convince yourself "I CAN DO THIS"....
WE ARE HERE TO SUPPORT YOU!!

Curious what doctors say about the benefit of taking a lower dose and for how long they recommend it. Do you eventually work your way up to a full dose and over what amount of time do you increase to get to the the full amount?

@njx58 Wow! I'm still waiting back to hear details of what my insurance will cover....I wonder if the manufacturers copay assistance card applies when one is on medicare :\

If you are 300% below the federal poverty level Radius offers assistance. I was not able to get assistance and I am on Medicare. I believe 300% below is about $65000/ yr for a family of 2.

On Medicare Part D. Mine is $950 for the first two months of the year and then I have hit the $2000 so nothing after that.

I think, and I could certainly be wrong, if you have Medicare, you cannot use the discount coupons.
Usually Medicare pays first, whatever their portion is. Then your supplemental coverage picks up whatever their portion is. Then you pay the rest until you have met your deductible.
These posts mention Blue Shield and Aetna so they may pick up the entire cost minus your co-pay to start?? Then when you go on Medicare, Medicare will pay their portion first then your supplemental coverage will pay their portion, then you pay your deductible. No matter which route you go...coupons, insurance coverage, out of pocket or Medicare, I don't think you would have to pay the full amount......Lets hope.
I don't think this is one of the Medicare drugs that is being cost negotiated. Most of those are more common and taken by large groups of patients. TYMLOS is not a well-known, highly prescribed medication yet.
During a hospital stay and two different doctors visits, I was asked for a list of my medications. All three asked "what is TYMLOS" Now I save the information that comes every month with my Pen so that all my doctors have it in my records.

When you are on Medicare Part D, make sure the formulary includes Tymlos