PAD Refills

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Osteoporosis medication table update

This is a 2022 update to the BC Provincial Academic Detailing (PAD) Service’s 2011 table “Bisphosphonate Medications for Osteoporosis,” which includes all medications for osteoporosis that are approved in Canada. For complete details on PharmaCare coverage of medications for osteoporosis in British Columbia, please see the PharmaCare Special Authority web page.

Osteoporosis Medications Currently Available in Canada¹
Generic Name, Brand Name, Available Strengths	Health Canada Osteoporosis Indications	Dosage and Annual Cost^†		PharmaCare Coverage
BISPHOSPHONATES
alendronate FOSAMAX, generics 5, 10, 70 mg tabs alendronate + vitamin D3 FOSAVANCE 70 mg/2800, 70 mg/5600 IU tabs	Postmenopausal women Men Glucocorticoid induced osteoporosis	5 mg PO once a day	$410	Non-benefit
		10 mg PO once a day	$160	Limited Coverage
		70 mg PO once a week	$120
		70 mg/5600 IU PO once a week	$115
		70 mg/2800 IU PO once a week	$210	Non-benefit
risedronate ACTONEL, ACTONEL DR, generics 5, 35, 150 mg tabs 35 mg delayed-release (DR) tabs	Postmenopausal women Men Glucocorticoid induced osteoporosis	5 mg PO once a day	$695	Limited Coverage
		35 mg PO once a week	$110	Limited Coverage
		35 mg DR PO once a week	$565	Non-benefit
		150 mg PO once a month	$530	Non-benefit
zoledronic acid ACLASTA, generics 5 mg/100 mL vial	Postmenopausal women Men Glucocorticoid induced osteoporosis	5 mg IV infusion once a year	$360	Limited Coverage
DENOSUMAB rank ligand inhibitor
denosumab PROLIA 60 mg single prefilled syringe	Postmenopausal women Men Glucocorticoid induced osteoporosis Nonmetastatic breast cancer receiving adjuvant aromatase inhibitor therapy Nonmetastatic prostate cancer receiving androgen deprivation therapy	60 mg subcut every 6 months	$860	Limited Coverage
RALOXIFENE selective estrogen receptor modulator
raloxifene EVISTA, generics 60 mg tabs	Postmenopausal women	60 mg PO once a day	$405	Limited Coverage
ROMOSOZUMAB sclerostin inhibitor
romosozumab EVENITY 105 mg single prefilled syringe	Postmenopausal women	210 mg subcut once a month maximum treatment: 12 months	$8510	Non-benefit
TERIPARATIDE synthetic parathyroid hormone
teriparatide FORTEO, generics OSNUVO biosimilar 250 mcg/mL multidose prefilled pen or cartridge	Postmenopausal women Men Glucocorticoid induced osteoporosis	20 mcg subcut once a day maximum treatment: 24 months	$7960	Non-benefit
tabs tablets; PO by mouth; IU international units; IV intravenous; subcut subcutaneous; †Cost without mark-up, professional fee or administration; calculated from McKesson Canada (accessed April 7, 2022)