I think coverage through pharmacy benefit is minor, most Prolia Rx up to now should be covered under Medical benefit.
Sales have been slow because a) buy-and-bill model doesn't appeal very much to generalists, while specialists (rheums) are making more money buy-and-billing Reclast; b) overly-restrictive label with all sorts safety signals in it is too scary for some physicians; c)BMD is tested only once every two years, making it difficult to see efficacy benefit of Prolia (and see efficacy shortcomings of oral BPs).
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