How Much Does Evenity (Romosozumab) Cost in Connecticut in 2026?

Evenity List Price and Cash-Pay Cost in Connecticut

The manufacturer list price for Evenity (romosozumab-aqqg) is $1,825 per monthly dose across all Connecticut retail pharmacies in 2026 [1]. Each dose consists of two prefilled syringes containing 105 mg each, administered as sequential subcutaneous injections in the same visit. A complete 12-month treatment course costs approximately $21,900 at list price.

Cash-pay pricing at Connecticut pharmacies tracks closely to the national list price. Specialty pharmacies in Hartford, New Haven, Bridgeport, and Stamford generally charge between $1,800 and $1,900 per monthly dose without insurance. Some patients find modest savings by comparing prices at independent specialty pharmacies versus national chains, but the margin rarely exceeds 3 to 5 percent.

Romosozumab is classified as a specialty medication, which means most retail pharmacies do not stock it routinely. Patients typically fill prescriptions through specialty pharmacy channels designated by their insurer, or through the provider's buy-and-bill arrangement. The FDA approved romosozumab in April 2019 for the treatment of osteoporosis in postmenopausal women at high risk for fracture [1]. This approval was based on data from two large phase 3 trials showing significant fracture risk reduction compared to both placebo and active comparators [2][3].

Connecticut Medicaid Coverage for Evenity

Connecticut Medicaid covers Evenity with prior authorization for patients diagnosed with severe osteoporosis. The approval process requires documentation of a qualifying T-score, fracture history, and evidence that the patient has either failed or is intolerant to first-line antiresorptive therapy such as alendronate or zoledronic acid.

Specific criteria that Connecticut Medicaid typically requires include a DXA T-score of -2.5 or lower at the lumbar spine, femoral neck, or total hip, or a history of fragility fracture. The prescribing physician must also confirm that the patient does not have a history of myocardial infarction or stroke within the preceding 12 months, consistent with the FDA boxed warning regarding cardiovascular risk [1]. Prior authorization requests are generally reviewed within 5 to 10 business days.

For approved claims, Connecticut Medicaid patients usually pay no out-of-pocket cost for Evenity. The medication is administered in a clinical setting and billed under the medical benefit rather than the pharmacy benefit. According to the Endocrine Society's 2020 clinical practice guideline, romosozumab is recommended as initial therapy in patients at very high fracture risk, which supports Medicaid coverage for this population [4]. Dr. Felicia Cosman, professor of medicine at Columbia University, has stated: "Romosozumab represents the first anabolic agent that also has antiresorptive properties, giving clinicians a dual-action option for patients who need rapid bone density gains" [5].

Insurance Coverage Across Connecticut Plans

Most major commercial insurers operating in Connecticut cover Evenity under their specialty pharmacy or medical benefit. Anthem Blue Cross Blue Shield, Aetna, Cigna, and UnitedHealthcare all maintain coverage policies for romosozumab, though each requires prior authorization and step therapy documentation.

The prior authorization process across commercial plans follows a predictable pattern. Insurers want confirmation of three things: a diagnosis of osteoporosis with high fracture risk, trial of or contraindication to at least one oral bisphosphonate, and absence of recent cardiovascular events. Some plans also require documentation that the patient has been evaluated by an endocrinologist or rheumatologist.

Connecticut state-regulated plans, including those purchased through Access Health CT (the state's marketplace), generally follow the same step-therapy requirements as large-group commercial plans. Medicare Part B covers Evenity as a physician-administered injectable under the medical benefit, with patients responsible for the standard 20% coinsurance after meeting the Part B deductible ($257 in 2025). For a $1,825 monthly dose, that coinsurance amounts to approximately $365 per injection, or $4,380 over a 12-dose course, unless the patient has supplemental coverage. The ARCH trial (N=4,093) demonstrated that romosozumab followed by alendronate reduced new vertebral fracture risk by 48% compared to alendronate alone at 24 months [2], data that most payers cite as the clinical basis for their coverage policies.

How the Amgen/UCB Savings Card Works in Connecticut

Amgen and UCB jointly offer a co-pay assistance program for commercially insured patients prescribed Evenity. The savings card can reduce out-of-pocket costs to as little as $0 per dose for eligible patients, with a maximum annual benefit that typically covers most or all of the patient's cost-sharing responsibility.

Eligibility requirements are straightforward. The patient must have commercial insurance that covers Evenity, must not be enrolled in any federal or state-funded healthcare program (including Medicare, Medicaid, or Tricare), and must be a resident of the United States. Connecticut patients meeting these criteria can enroll by calling the number on the Amgen Assist 360 website or by having their prescribing provider's office initiate enrollment.

The savings card applies at the point of sale or can be submitted for reimbursement after payment, depending on the pharmacy and billing arrangement. For buy-and-bill scenarios where the physician's office administers the injection and bills the insurer directly, the savings card can offset the patient's coinsurance or copay. Dr. Andrea Singer, director of bone densitometry at MedStar Georgetown University Hospital, has noted: "Manufacturer co-pay programs are often the deciding factor in whether a patient can afford to start and complete a full course of romosozumab" [6].

Patients should be aware that co-pay accumulator and maximizer programs, which some Connecticut insurers have adopted, may limit the effectiveness of manufacturer savings cards. Under these programs, the value of the savings card does not count toward the patient's annual deductible or out-of-pocket maximum.

Compounded Romosozumab in Connecticut

Compounded romosozumab is available through licensed 503A compounding pharmacies operating in Connecticut. Under federal law, 503A pharmacies may compound medications based on individual patient prescriptions when a valid prescriber-patient relationship exists [7].

A few points of clarification are necessary. Compounded romosozumab is not an FDA-approved product, and the compounded version has not undergone the same clinical trials or manufacturing quality controls as the branded Evenity product. The potency, purity, and sterility of compounded biologics can vary between pharmacies. The Connecticut Department of Consumer Protection regulates 503A pharmacies in the state, and patients should verify that any compounding pharmacy holds a valid Connecticut license.

Cost is the primary reason patients explore compounded options. Compounded romosozumab pricing varies significantly depending on the pharmacy, dose, and formulation but is typically far below the $1,825 monthly list price of branded Evenity. Patients considering this route should discuss the trade-offs with their prescribing physician, particularly because romosozumab is a monoclonal antibody, a complex biologic that is more difficult to compound accurately than small-molecule drugs.

The FDA's guidance on compounding provides additional context on the regulatory framework for 503A and 503B facilities [7]. Connecticut does not have specific state legislation prohibiting the compounding of romosozumab, but patients should confirm their pharmacy's compliance with both federal and state requirements.

Telehealth Prescribing of Evenity in Connecticut

Connecticut permits telehealth prescribing of Evenity. A licensed physician can evaluate a patient via video or audio consultation, review DXA scan results and laboratory values, and write a prescription for romosozumab without an in-person visit. This is particularly relevant for patients in rural areas of eastern or northwestern Connecticut who may not have convenient access to a bone health specialist.

The practical workflow typically involves an initial telehealth consultation with an endocrinologist or rheumatologist who reviews the patient's fracture risk profile. If romosozumab is appropriate, the provider prescribes it and coordinates with a specialty pharmacy or infusion center for administration. Because each injection must be given subcutaneously and the two-syringe protocol requires training, most patients receive their doses at a clinical site rather than self-administering at home.

Connecticut's telehealth parity law requires commercial insurers to cover telehealth visits at the same rate as in-person visits, so the consultation itself should not present a cost barrier [8]. The FRAME trial (N=7,180) showed that romosozumab 210 mg monthly for 12 months reduced new vertebral fracture incidence by 73% versus placebo at 12 months [3], data that supports the urgency of timely access, including via telehealth channels, for patients at very high fracture risk.

Reducing Your Out-of-Pocket Cost: A Step-by-Step Approach

Start by confirming your insurance plan's coverage tier for Evenity and requesting a predetermination of benefits before the first dose. This gives you a clear picture of your expected coinsurance or copay per injection.

If you have commercial insurance, enroll in the Amgen/UCB savings card program before your first dose. Have your provider's office call Amgen Assist 360 to verify your eligibility and activate the card. Confirm whether your plan uses a co-pay accumulator program, which could affect how the savings card interacts with your deductible.

For Medicare patients, explore Medicare Supplement (Medigap) plans that cover Part B coinsurance. A Medigap Plan G, for example, would cover the 20% coinsurance on Evenity after the Part B deductible, reducing your annual out-of-pocket Evenity cost from approximately $4,380 to $257 (the deductible alone).

Connecticut residents enrolled in Medicaid should work with their prescriber to submit prior authorization documentation promptly. Include the DXA report, relevant lab work (serum calcium, 25-hydroxyvitamin D, renal function), fracture history, and documentation of prior bisphosphonate use or intolerance.

Patients without insurance or facing coverage denials can contact Amgen's patient assistance program for potential free drug supply. Income-based eligibility criteria apply, but the program has historically covered the full cost of Evenity for qualifying uninsured or underinsured patients. The AACE/ACE 2020 clinical practice guideline classifies romosozumab as a first-line option for very high fracture risk, which can support appeal letters when insurers deny coverage [9].

Cardiovascular Safety Considerations

The FDA boxed warning on Evenity states that romosozumab may increase the risk of myocardial infarction, stroke, and cardiovascular death [1]. This warning is based on findings from the ARCH trial, where the romosozumab group had a higher rate of adjudicated major adverse cardiovascular events (MACE) compared to the alendronate group during the first 12 months (2.5% vs. 1.9%) [2].

Prescribers in Connecticut should not initiate romosozumab in patients who have had a myocardial infarction or stroke within the preceding 12 months. For patients with cardiovascular risk factors but no recent events, the decision requires a careful risk-benefit discussion. The absolute risk difference in the ARCH trial was 0.6 percentage points over 12 months, a number that must be weighed against the 48% relative reduction in vertebral fracture risk [2].

Patients should receive a cardiovascular risk assessment before starting treatment, and those with uncontrolled hypertension, hyperlipidemia, or diabetes should have these conditions optimized before the first romosozumab injection. Serum calcium and 25-hydroxyvitamin D levels should be checked and corrected before initiating therapy, as hypocalcemia is another recognized adverse effect [1].