Does Medicare Cover Forteo?

Osteoporosis, which is the progressive loss of bone mass, makes an individual’s bones weak and prone to fractures. It’s a condition that affects the lives of thousands of people every year. Among those that suffer from the disease most frequently are postmenopausal women over 50 and men over 70. In recent years, however, the number of men diagnosed with osteoporosis aged 50 and up has increased.

Despite the fear the disease causes, medicine today offers treatments that may reverse the condition or some symptoms and ensure a higher quality of life for people diagnosed with osteoporosis. One of the most effective treatments on the market today is Forteo, a unique medicine for osteoporosis treatment. 

Does Medicare Cover Forteo?

Medicare Part B can help pay for osteoporosis drugs and drug injections for eligible women.

Since Forteo is a prescription drug authorized by the FDA in the treatment of osteoporosis, many Medicare Part D prescription drug plans and Medicare Advantage (Part C) plans that include prescription drug coverage may cover Forteo.

According to GoodRx, 74% of these types of Medicare prescription drug plans cover Forteo.

It’s important to check if your plan covers Forteo and how much it will cost you before seeking treatment. Also be sure to talk to your doctor to find out if the treatment is right for you and if your Medicare coverage will help pay your costs.

How Does Forteo work?

The drug Teriparatide, marketed under the brand name Forteo, is prescribed to postmenopausal women with a high risk of bone breakage as well as men diagnosed with primary osteoporosis. Primary osteoporosis is the most common type of osteoporosis and is common with aging. 

The medication helps ensure healthy bone growth, decrease bone loss and reduce the chance of fractures, especially in the spine. It’s a subcutaneous injection of 20mcg, usually applied once a day in the thigh or abdomen. 

Forteo injections must be stored in a refrigerated environment at a temperature between 36-46°F. Because of this, it’s important to apply the medication as soon as it’s removed from refrigeration.

Forteo Side Effects

Among the most common side effects of Forteo are general pain, nausea and joint pain. Some individuals can also experience rapid heartbeat and dizziness, though this normally occurs during the first few applications.

Generally, any negative side effects of Forteo appear around 4 hours after application and disappear within the same day. For individuals who do experience these side effects, sitting or lying down in a comfortable position helps ease the discomfort until the symptoms subside. If the side effects persist, it’s important to consult your physician as soon as possible.

Forteo Side Effects

In addition to these more common symptoms, those taking Forteo should also pay attention to other serious but rare side effects, such as:

• Lesions, bruises or ulcers on the skin
• Vomiting 
• Fainting 
• Sudden mood swings or mental confusion
• Constipation 
• Muscle weakness
• Excessive lethargy

If you experience these side effects, it’s important to cease taking Forteo and contact your prescribing physician immediately.

Bone Cancer Risk

In research carried out with Forteo, cases of bone cancer, known as osteosarcoma, were found in rats. However, it is still uncertain whether the drug can produce osteosarcoma in humans.

Regardless, if you experience persistent pain in your bones or any part of the body or any other symptoms common in cases of osteosarcoma, such as the appearance of nodules near the joints, joint swelling or compromised joint movement, seek immediate medical attention.

Precautions Before and After 

Use of Forteo should be carried out under the supervision of a healthcare professional, especially if you have other health problems that could interfere with the drug's performance.

If you have kidney stones, for example, it’s necessary to monitor calcium levels in your urine during the use of Forteo to ensure your condition isn’t worsening. It’s also important to inform your doctor if you have allergies to components present in Forteo injections. In this case, use is not recommended.

The same warning goes for people who have a history of bone disorders, have already been treated for bone cancer or have people in the family who have had the disease. If you’ve already undergone treatments involving radiation or have a high quality of calcium in your blood, a prescribing doctor must make a careful evaluation before prescribing Forteo.

How to Use Forteo

Forteo is sold with 28 individual injections containing 20 micrograms of the drug. You should only apply it once per day, injected in either your thigh or abdomen, as prescribed by your doctor. To avoid pain and swelling, you can alternate application sites within the guidelines outlined by your doctor. 

Forteo does have expiration dates and should never be used once expired. It’s also important to maintain Forteo in a refrigerated state, though if the medication is frozen, it should be discarded immediately. It’s also not recommended to transfer dosages from one syringe to another to avoid the risk of inaccurate dosing.