Denosumab
Brand names: Prolia, Xgeva
At a glance
- Medicare prescriptions, 2024
- 289,131
- Medicare drug cost
- $514.1M
- Average cost per prescription
- $1,778
- Clinicians who prescribed it
- 9,335
Where it is prescribed
List the prescribers in any state, county, city or ZIP code →
What it is used for
Prolia is a RANK ligand (RANKL) inhibitor indicated for treatment: of postmenopausal women with osteoporosis at high risk for fracture to increase bone mass in men with osteoporosis at high risk for fracture of glucocorticoid-induced osteoporosis in men and women at high risk for fracture to increase bone mass in men at high risk for fracture receiving androgen deprivation therapy for nonmetastatic prostate cancer to increase bone mass in women at high risk for fracture receiving adjuvant aromatase inhibitor therapy for breast cancer
From the FDA-approved prescribing information (label dated June 2026). Full labels on DailyMed (opens in a new tab)
Boxed warning
WARNING: SEVERE HYPOCALCEMIA IN PATIENTS WITH ADVANCED KIDNEY DISEASE Patients with advanced chronic kidney disease (eGFR < 30 mL/min/1.73 m 2 ), including dialysis-dependent patients, are at greater risk of severe hypocalcemia following Prolia administration. Severe hypocalcemia resulting in hospitalization, life-threatening events and fatal cases have been reported. The presence of chronic kidney disease-mineral bone disorder (CKD-MBD) markedly increases the risk of hypocalcemia in these patients. Prior to initiating Prolia in patients with advanced chronic kidney disease, evaluate for the presence of CKD-MBD. Treatment with Prolia in these patients should be supervised by a healthcare provider with expertise in the diagnosis and management of CKD-MBD.
The FDA’s strongest warning on a label. It doesn’t mean the drug is unsafe for most people; talk to your doctor or pharmacist before stopping or changing any medicine.
Who prescribes it
- Internal Medicine 25.2%
- Family Medicine 16.8%
- Rheumatology 16.7%
- Endocrinology & Diabetes 12.8%
- Nurse Practitioners 9.9%
- Hematology & Oncology 5.1%
- Physician Assistants 4.9%
- OB-GYN (Obstetrics & Gynecology) 1.9%
- Geriatric Medicine 1.1%
- General Practice 0.8%
- Nephrology (Kidney) 0.7%
- Cardiology 0.5%
All prescribers, by place, name or specialty →
Share of Medicare prescriptions written by each specialty. Select one to list its prescribers.
Trend, 2019–2024
Medicare prescriptions rose 58% from 2019 to 2024.
Biggest change by state since 2019
- Georgia +116%
- Florida +90%
- Hawaii +79%
- Arizona +71%
- Pennsylvania +70%
- New Jersey (smallest change) +24%
- California (smallest change) +26%
From CMS’s yearly state and national Part D summaries, which count every prescriber, including those CMS leaves out of its per-clinician data (fewer than 11 prescriptions). That is why these totals are higher than the count at the top of this page. Prescriptions include refills.
What it looks like
Pills from 1 maker on file. The same medicine can look different depending on who made it, so check the imprint (the letters and numbers on the pill) with your pharmacist if a refill looks different.
Amneal Pharmaceuticals LLC
| Strength | Looks like | Imprint |
|---|---|---|
| 60 mg | white injection | |
Source: DailyMed (U.S. National Library of Medicine), from each maker’s FDA drug listing. A few makers are shown, not every one. Never take a pill you can’t identify; ask a pharmacist.
Industry payments about this drug
Drug makers reported $466,241 in payments to clinicians that named this drug in 2025 (meals, speaking, consulting and similar).
- Amgen Inc. $449,924
- Sandoz Inc. $16,317
Source: CMS Open Payments, general payments (not research), program year 2025. A payment is not evidence of wrongdoing. Payments by doctor
Recalls and shortages
Not on the FDA drug shortage list.
1 recall since 2020
- Apr 2025 · McKesson Medical-Surgical Inc. Corporate Office · Class II
CGMP Deviations; potential temperature excursions due to transit delays
Recalls usually affect specific lots from one maker, not every version of a drug. Class I is the most serious; most drug recalls are Class II. FDA recalls (opens in a new tab)
Sources: CMS Medicare Part D Prescribers by Provider and Drug (2024; prescriptions include refills, and CMS hides counts under 11 per prescriber); U.S. Food and Drug Administration, openFDA (drug labels, NDC directory, enforcement reports, drug shortages); CMS Open Payments 2025; ClinicalTrials.gov. General information only, not medical advice; not yet reviewed by our medical reviewer.