Osteoporosis Injection (Prolia/Evenity) Cost Calculator

Osteoporosis Injection (Prolia/Evenity) Cost Calculator helps estimate Korea-related chronic treatment, biologic drug, dialysis, obesity medication, and long-term management assumptions in English.

Health cost scenario inputs

Enter Korea-related chronic care, eldercare, therapy, procedure, fertility, diagnostic, or medical tourism assumptions. Results are simplified planning estimates.

Treatment cost over period

₩35,554,176

Monitoring or support cost

₩0

Increase reserve

₩10,666,253

Planning window cost

₩46,220,429

12 months

This English page explains Korea osteoporosis injection therapy costs, centered on Prolia (denosumab) and Evenity (romosozumab). Osteoporosis drugs split into anti-resorptives that stop bone breakdown and bone-forming (anabolic) agents that build new bone. Anti-resorptives: Prolia (denosumab), a RANKL inhibitor, 60 mg subcutaneously every 6 months, benefit-ceiling price about KRW 108,290 (about KRW 216,580/year); zoledronic acid (Aclasta) 5 mg IV once a year, about KRW 163,259; ibandronate (Bonviva) IV every 3 months. Bone-forming agents cost far more: Evenity (romosozumab), a sclerostin inhibitor, 210 mg (two 105 mg syringes at about KRW 123,452 each) monthly for up to 12 months only, about KRW 2.96 million/year; Forteo (teriparatide) 20 mcg self-injected daily (pen about KRW 228,158) for up to 24 months; Teribone (teriparatide) 56.5 μg weekly. Coverage requires central-bone (spine/femur) DEXA T-score ≤ -2.5 or a confirmed osteoporotic fracture; anti-resorptives are covered for 1 year (up to 3 with a fracture), with follow-up in the -2.5 < T-score ≤ -2.0 range adding up to 2 more years (from 2024-05-01), and Prolia has no explicit maximum. Evenity is limited to postmenopausal women 65+ with prior bisphosphonate failure, T-score ≤ -2.5, and 2+ fractures, for 12 months, then switched to an anti-resorptive. Crucially, osteoporosis (ICD M80/M81) is NOT a special-case (sanjeong-teukrye) condition — among bone diseases only Paget’s (M88) is — so ordinary benefit self-pay applies (30% at a clinic, 40% hospital, 50% general, 60% tertiary, 20% inpatient), not a reduced 5%/10% rate. The annual out-of-pocket ceiling still refunds covered self-pay above the income-tier cap (about KRW 900,000–8,430,000 in 2026), and medical expenses of those 65+, the disabled, or the taxpayer have no KRW 7,000,000 cap on the medical-expense tax credit (Income Tax Act Article 59-4). The basis is the MOHW notice “Detailed Criteria for Reimbursement (Drugs)” (No. 2026-133, effective 2026-07-01). Consultation, injection, and DEXA fees are separate; prices vary by product and generic. It is planning guidance based on 2026 Korean rules, not medical advice or an insurer decision.

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What is the osteoporosis injection (Prolia/Evenity) cost calculator?

This calculator estimates the annual drug cost and real out-of-pocket burden of osteoporosis injectables such as Prolia (denosumab), Evenity (romosozumab), and Forteo (teriparatide).
Pick a drug and it applies the drug class (bone-forming vs anti-resorptive), dosing interval, coverage status, the annual out-of-pocket ceiling, private indemnity insurance, and the medical-expense tax credit, step by step.

Osteoporosis weakens bone so that even minor impacts cause fractures, and it is common in postmenopausal women and older adults.
For the same injection type the cost varies more than tenfold — Prolia runs about KRW 216,000 a year (every 6 months) while Evenity runs about KRW 2.96 million (monthly for 12 months) — so compare by real out-of-pocket burden, not the sticker drug price.

Korea-based estimate. This calculator is built on Korean National Health Insurance rules for 2026 (osteoporosis drug coverage criteria, the annual out-of-pocket ceiling, private indemnity insurance, and the medical-expense tax credit). Unlike cancer, osteoporosis (ICD M80/M81) is NOT a special-case (sanjeong-teukrye) condition, so ordinary benefit self-pay rates apply. Drug prices are 2026 benefit-ceiling figures from the Korea Pharmaceutical Information Center; actual prices vary by product, dose, and generic. It is an educational estimate, not medical advice, and does not replace diagnosis, a hospital quote, or an insurer/benefit decision.

Injection types — bone-forming vs anti-resorptive

Osteoporosis drugs split into anti-resorptives, which stop bone from breaking down, and bone-forming (anabolic) agents, which build new bone.
Injectables are widely used for patients with poor adherence or gastrointestinal issues with oral drugs.

Anti-resorptives (stop bone loss)

  • • Prolia (denosumab): RANKL inhibitor, 60 mg subcutaneously every 6 months; the standard first-line injectable; benefit-ceiling price about KRW 108,290 (2 doses/year)
  • • Zoledronic acid (Aclasta): bisphosphonate, 5 mg IV once a year; lowest dosing burden
  • • Bonviva (ibandronate): bisphosphonate, 3 mg IV every 3 months

Bone-forming (anabolic) agents

  • • Evenity (romosozumab): sclerostin inhibitor (builds bone and reduces resorption), 210 mg (two 105 mg syringes) monthly, up to 12 months only
  • • Forteo (teriparatide): PTH analog, 20 mcg self-injected daily (pen), up to 24 months (one lifetime course)
  • • Teribone (teriparatide): PTH analog, 56.5 μg once weekly, up to 24 months

Bone-forming agents are powerful for severe osteoporosis at very high fracture risk, but cost more than 10× the anti-resorptives.
They are used only for a set period (Evenity 12 months, Forteo/Teribone 24 months) and must be followed by an anti-resorptive to preserve the bone-density gain, so plan sequential therapy with your physician.

When is it covered? (T-score ≤ -2.5)

Coverage for osteoporosis injectables is decided by bone-density testing.
If you don’t meet the criteria, you pay 100% of the drug cost as non-covered, even for the same drug.

Coverage criteria (summary)

  • • Bone density: covered when central-bone (spine/femur) DEXA T-score is ≤ -2.5, or a radiographic osteoporotic fracture is confirmed
  • • Anti-resorptive duration: 1 year on entry at T-score ≤ -2.5 (up to 3 years with a fracture). From 2024-05-01, follow-up in the -2.5 < T-score ≤ -2.0 range adds 1 year at a time, up to 2 more years
  • • Prolia: no explicit maximum duration (rebound bone loss on stopping), so it continues while the T-score stays in the covered range
  • • Evenity: postmenopausal women 65+ with prior bisphosphonate failure/intolerance, T-score ≤ -2.5, and 2+ osteoporotic fractures (very-high-risk), monthly up to 12 months
  • • Forteo/Teribone: severe osteoporosis at high fracture risk, up to 24 months (one lifetime course)

The basis is the Ministry of Health and Welfare notice “Detailed Criteria for Reimbursement (Drugs)” (Notice No. 2026-133, effective 2026-07-01), the osteoporosis-drug general principle, and Annex 2 of the Enforcement Decree of the National Health Insurance Act.
Osteopenia (T-score -1.0 to -2.5) is generally non-covered, and actual coverage depends on the density value, fracture history, and age — confirm with your physician and HIRA.

Osteoporosis is NOT a special-case condition

Many assume osteoporosis cuts the copay like cancer does, but osteoporosis (M80/M81) is not a special-case (sanjeong-teukrye) condition.
The special case applies only to cancer (5%), cerebrovascular/cardiac disease, rare and chronic refractory diseases (10%), severe burns, and so on — among bone diseases, only Paget’s disease (M88) is included.

How the copay works

  • • Ordinary benefit self-pay: with no special-case reduction (5%/10%), the rates are 30% at a clinic, 40% at a hospital, 50% at a general hospital, 60% at a tertiary hospital, and 20% inpatient
  • • Self-injection pens: Forteo and Teribone are dispensed at a pharmacy by outpatient prescription at 30%
  • • Low drug price helps: Prolia and bisphosphonates have low drug prices, so the annual out-of-pocket is modest
  • • Ceiling still applies: if the annual covered copay exceeds your income-tier cap, the excess is refunded through the out-of-pocket ceiling

In short, osteoporosis therapy has no special case, but the low drug price keeps the real burden small while you are covered.
The problem arises when the density is above the covered threshold (T-score > -2.5) or the covered duration is exceeded and treatment becomes non-covered at 100%.

Price and interval differ by class

Osteoporosis injectables differ widely in dosing interval and price, so annual costs vary a lot.
Below are annual drug costs at 2026 benefit-ceiling prices (Korea Pharmaceutical Information Center).

  • • Prolia: 60 mg about KRW 108,290, every 6 months (2/year) → about KRW 216,580/year
  • • Evenity: 105 mg about KRW 123,452 × 2 = KRW 246,904/dose, monthly for 12 months → about KRW 2.96 million/year
  • • Forteo: pen (28 days) about KRW 228,158, daily self-injection → about KRW 2.97 million/year (24-month course about KRW 5.95 million)
  • • Teribone: 56.5 μg about KRW 43,606, weekly (52/year) → about KRW 2.27 million/year
  • • Zoledronic acid (Aclasta): 5 mg about KRW 163,259, once a year → about KRW 163,259/year
  • • Bonviva: 3 mg about KRW 48,777, every 3 months (4/year) → about KRW 195,108/year

These are drug prices (insurer share + patient copay), not what the patient pays.
Because osteoporosis has no special case, the patient copay when covered is about 30% of the above (clinic outpatient), plus separate consultation, injection, and DEXA test fees.

Out-of-pocket ceiling and medical-expense tax credit

Osteoporosis therapy often runs for several years, so the annual out-of-pocket ceiling and the medical-expense tax credit further lower the real burden.
Both are based on the covered copay and the burden remaining after private-insurance reimbursement.

Two programs — key points

  • • Annual out-of-pocket ceiling: if annual covered copay exceeds the income-tier cap (about KRW 900,000–8,430,000 in 2026), the excess is refunded, and it applies again every year
  • • Medical-expense tax credit: 15% of medical spending above 3% of gross salary, excluding private-insurance reimbursement
  • • No KRW 7,000,000 cap: medical expenses of the taxpayer, those 65+, the disabled, and serious-illness patients have no annual cap on the tax credit (Income Tax Act Article 59-4) — most osteoporosis patients are 65+
  • • Offsetting high-cost anabolics: multimillion-KRW drugs like Evenity and Forteo are cushioned by the 65+ uncapped credit combined with the ceiling

Non-covered drug cost is not eligible for the ceiling refund, and any amount already refunded by the ceiling must be excluded from the tax credit to avoid double-counting.

How to use this calculator

Step 1: Drug and coverage

Pick a drug (Prolia, Evenity, Forteo, etc.) to auto-fill class, interval, and annual drug cost, then set coverage status and treatment period (a typical period is preset per drug).

Step 2: Copay conditions

Set the care setting (self-pay rate), income tier, and the out-of-pocket ceiling.
Osteoporosis has no special case, so ordinary benefit rates (30–60%) apply.

Step 3: Insurance and tax credit

Enter your private indemnity insurance generation and gross annual salary, and select whether you (or the patient) are 65+ or disabled for the uncapped tax credit.

Step 4: Review results

See annual copay, bone-forming vs anti-resorptive comparison, covered vs non-covered, the ceiling refund, private-insurance reimbursement, the tax credit, and the final real burden at a glance.

Frequently asked questions (FAQ)

Q. Does osteoporosis cut the copay like cancer through the special case?

A. No. Osteoporosis (M80/M81) is not a special-case condition, so ordinary benefit self-pay rates (30% at a clinic, etc.) apply.
But Prolia and bisphosphonates have low drug prices, so the annual burden is small when covered, and you can still get an out-of-pocket ceiling refund.

Q. How different are Prolia and Evenity in cost?

A. Prolia is every 6 months at about KRW 216,000/year, while Evenity is monthly for 12 months at about KRW 2.96 million/year — more than 10× the difference.
But Evenity is a bone-forming agent covered for only 12 months in very-high-risk patients, so the choice depends on fracture risk, not just cost.

Q. My T-score is -2.3 — is the injection covered?

A. Without a fracture it is generally non-covered. The criterion is central-bone DEXA T-score ≤ -2.5 or a confirmed osteoporotic fracture.
There are exceptions — follow-up in the -2.5 < T-score ≤ -2.0 range can add covered time — so confirm with your physician.

Q. Can I stop Prolia partway through?

A. Stopping Prolia (denosumab) on your own raises the risk of rebound bone loss and multiple vertebral fractures.
If you need to stop, you must plan a switch to a bisphosphonate, so don’t stop on your own — discuss it with your physician.

Q. Can private insurance reimburse the injection cost?

A. Therapeutic osteoporosis injections and drug costs are eligible for private indemnity insurance.
It reimburses the covered copay and non-covered drug cost at your generation’s coinsurance rate, subject to per-visit and annual limits — check your policy.

Important notes

  • Reference estimate: prices vary with actual transaction price, product, and dose; this calculator uses 2026 public benefit-ceiling prices. Consultation, injection, and DEXA test fees are separate from the drug cost.
  • Coverage is individual: whether the criteria (T-score ≤ -2.5, fracture history, etc.) are met depends on the patient, so confirm with your physician and HIRA.
  • No special case: osteoporosis (M80/M81) is not a special-case condition, so ordinary benefit self-pay rates apply.
  • Rules change: drug prices, coverage criteria, covered duration, and the out-of-pocket ceiling can change yearly — check the latest notice.

Estimate your osteoporosis injection cost now

Enter the drug, coverage status, and income tier to see the annual real burden of Prolia, Evenity, and other injectables.

Compare bone-forming vs anti-resorptive cost and the out-of-pocket ceiling refund in one place.