Does the patient have a
Prolia® (denosumab) Co-pay Card?
Yes
Please enter the following information to verify the card and check patient registration.
No
Please click the button below to begin the registration process.
Prolia® Co-pay Card is verified.
However, the patient must register.
Please click the button below to begin the registration process, which must be completed before the card is ready to use.
Need help? Call the Prolia® Co-pay Program at 1-844-369-9962 for assistance.
Enrolling Your Specialty Pharmacy
Just fill out the fields below and click submit. Once your pharmacy is successfully enrolled, call 1-844-369-9962 between 9 am and 8 pm ET and submit your merchant ID to register your credit card terminal for Prolia® co-pays. All fields are required unless noted otherwise.
Need help for this form? Call the Prolia Copay Program at 1-844-369-9952 for assistance.
form? Click here for help.