Evenity is Amgen’s brand of romosozumab-aqqg, an osteoporosis drug that both builds bone and slows bone loss. It is given by a health professional as two 105 mg prefilled syringes at the same visit, once a month, and the FDA label caps treatment at 12 monthly doses.
That 12-dose ceiling is unusual and it changes how you should budget. Most drug pricing questions are about a monthly cost that runs indefinitely. With Evenity there is a defined finish line, so the number that matters is the total for the course, not the price of one shot. The drug also carries a boxed warning about myocardial infarction, stroke and cardiovascular death, and the label says it should not be started in someone who has had a heart attack or stroke in the past year. That is a conversation for your prescriber, not a cost question, but it is why Evenity is not a casual first choice. Everything below was researched September 3, 2026.
What Does Evenity Cost Without Insurance?
Four 2026 sources price the drug and they spread about 5%. Amgen’s own list-pricing document, accurate as of January 7, 2026, states a wholesale acquisition cost of $1,380.19 per 105 mg syringe, which is $2,760.38 for the two-syringe monthly dose. Evenity.com states a list price of $2,628.92 per month, but that page footnotes the figure as updated January 8, 2025, so it appears to be a year behind Amgen’s own pricing document. Medicare’s Part B payment limit file for July 1 through September 30, 2026 pays $12.732 per milligram under HCPCS code J3111, which is $2,673.72 for a 210 mg dose. Drugs.com lists a cash price of $2,704.23 for the 2-pack.
| Evenity (romosozumab-aqqg) cost item | Low | Typical | High |
|---|---|---|---|
| One monthly dose (2 syringes, 210 mg), drug only | $2,628.92 | $2,704.23 | $2,760.38 |
| One syringe, drug only | $1,314.46 | $1,352.12 | $1,380.19 |
| Full 12-month course, drug only | $31,547.04 | $32,450.76 | $33,124.56 |
| Injection administration, CPT 96372, Medicare national rate | $15.36 | $15.36 | $15.36 |
| Medicare Part B coinsurance per dose (18.176%) | $485.94 | $485.94 | $485.94 |
| Amgen SupportPlus co-pay program (commercial insurance required) | $0 | $0 | $0 |
Because the published sources disagree, treat the whole $2,629 to $2,760 band as the honest answer for one dose and roughly $31,500 to $33,100 for the course. For a reality check on what this actually bills at, CMS’s Medicare Part B spending data for 2024 shows average Medicare spending of $2,236.29 per Evenity claim and $12,261.22 per beneficiary for the year, across 52,146 beneficiaries and $639.4 million in total spending. Per-beneficiary spending is well below a full course because most people in any given calendar year are partway through their twelve doses.
The administration fee is a separate bill, twelve times
Each monthly visit generates its own administration charge under CPT 96372, the code for a therapeutic subcutaneous or intramuscular injection. Medicare’s July 2026 relative value file assigns that code 0.46 total non-facility relative value units, which at the $33.4009 conversion factor is about $15.36 nationally in a physician office.
That is Medicare’s rate, and a self-pay clinic is not bound by it. Most practices will also bill an office visit each month, and a hospital outpatient department will usually charge more than a physician office for the same work. Twelve visits is where a small per-visit markup turns into real money, so negotiate the visit charge once, up front, for the whole course rather than month by month.
What Drives the Price
Two syringes, not one. A 210 mg dose only comes as 105 mg syringes, so every dose is two injections. CMS’s July 2026 crosswalk lists the Evenity package as a 2-pack billing 210 units under J3111. Any price you see quoted “per syringe” is roughly half the real monthly cost, which is the most common way people underestimate this drug.
It is a medical-benefit drug, not a pharmacy drug. Evenity is bought and billed by a clinic and administered on site. There is no retail counter price to shop, no discount card that meaningfully applies, and no pharmacy comparison to run. Where you get the injection is the closest thing to a shopping decision you have.
No biosimilar, no generic. CMS’s July 2026 Part B crosswalk lists exactly one romosozumab product, Amgen’s, under J3111. Contrast that with denosumab, where the same file carries four separate marketed biosimilars at lower payment limits than the brand. Nothing structural is pulling Evenity’s price down.
No direct-to-patient cash program. AmgenNow, Amgen’s cash-pay coupon program, currently covers Aimovig, Amjevita, Enbrel, Otezla and Repatha. Evenity is not on the list, so there is no published cash price to point a clinic at.
The 12-dose cap works in your favor. Unlike most specialty injectables, this is a finite course. Once you finish twelve doses the Evenity spending stops, though your prescriber will usually move you to a maintenance therapy afterward, which has its own cost.
Cash Price vs. Insurance
Insurance wins here by a very wide margin, and it is worth being blunt about that on a bill this size. Amgen states that Medicare Part B typically covers 80% of therapies received in a doctor’s office and that 89% of patients pay $0 out of pocket for each dose of Evenity after meeting their deductible, a figure that explicitly excludes office visit and administration costs.
Under traditional Medicare, the July 2026 CMS file sets the beneficiary coinsurance for J3111 at an inflation-adjusted 18.176% rather than the usual 20%, which is about $485.94 on a $2,673.72 allowed amount. Over twelve doses that is roughly $5,831 in coinsurance, so people on traditional Medicare without a supplemental plan still face a substantial bill. Medicare Advantage cost sharing varies by plan.
The Amgen SupportPlus Co-Pay Program can bring commercially insured patients to as little as $0 per dose, with eligibility criteria and annual program maximums that apply. It is not available to uninsured patients or to anyone on Medicare, Medicaid or another federal program. For uninsured patients, Drugs.com lists the Amgen Safety Net Foundation as the assistance route for Evenity, which requires having lived in the U.S. or its territories for six months or longer and meeting the foundation’s income guidelines.
How to Pay Less
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Apply to the Amgen Safety Net Foundation before you pay for a single dose. It is the only route that gets an uninsured patient to $0 on this drug, and a 12-month course is a big enough number that it is worth the paperwork. Applying after you have started does not recover what you already spent.
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Negotiate the administration and visit charges once, for all twelve months. The drug price barely moves, but twelve office visits and twelve injection fees are a real line item. Our guide to negotiating medical bills covers how to open that conversation, and the negotiation script tool gives you the wording.
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Use a physician office rather than a hospital outpatient department. Same drug, same billing code, different price structure. If a health system is your only option, our guide to hospital price transparency explains how to pull that facility’s posted cash rate first, and hospital charity care can wipe out the balance entirely if you qualify.
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Get an itemized quote and check it every month. Twelve identical visits means twelve chances for a coding error to repeat. Our guide to reading an itemized hospital bill shows what to look for, and the fair price checker helps you judge whether the visit portion is reasonable.
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Check the independent charitable foundations. Osteoporosis funds at organizations like the HealthWell Foundation and the PAN Foundation cover cost sharing for people who do not qualify for the manufacturer program. Funds open and close during the year, so apply as soon as one opens.
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Price the whole shelf before you commit. Prolia is $1,806.06 per syringe at Medicare’s July 2026 Part B allowance, given twice a year, and it now has cheaper denosumab biosimilars behind it. Tymlos and Forteo are the other anabolic options, generic alendronate is the cheapest oral, and yearly Reclast is the cheapest infusion. A free or sliding-scale clinic can handle the prescribing visits and the DEXA scan that goes with monitoring.
Bottom Line
Budget roughly $2,629 to $2,760 for each monthly dose of Evenity as of September 2026, plus a clinic charge each visit that Medicare prices at about $15 but a self-pay practice will set higher. Across the full 12-dose course that is about $31,500 to $33,100 in drug cost alone.
On a pure cash basis Evenity is the most expensive osteoporosis drug in common use, and it is the only one in the category with no biosimilar competition on the horizon. If you are uninsured and your prescriber has recommended it, the Amgen Safety Net Foundation application is not an afterthought, it is the plan. If you are shopping the category on price, the denosumab biosimilars behind Prolia and the hormone therapy options are where the money is.