Yes, it is hard but when it is done like with Fosamax, long-term efficacy data are one thing that made it the leading bisphosphonate.
I think we agree docs will go on prescribing oral bisphosphonate in 1st line primarily due to cost and switch to 2nd line due to tolerability and convenience (in this order, imo).
Reclast goes generic in the US in about 9 months, so things will be even harder for Prolia and odacatinib.
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