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Key takeaways
Forteo, a brand-name prescription osteoporosis treatment, has a generic form called teriparatide.
It is possible to switch from brand-name Forteo to generic teriparatide, and the transition should not require a dosage or delivery adjustment.
Get medical advice from your healthcare provider if you’re interested in switching from Forteo to teriparatide.
Forteo is a brand-name drug approved for the treatment of osteoporosis in postmenopausal women, men with a high risk of fracture, and any adult with osteoporosis linked to glucocorticoid use. It’s an injectable form of synthetic parathyroid hormone (PTH), which stimulates bone formation.
An estimated 10 million Americans live with osteoporosis, according to the Office of Disease Prevention and Health Promotion. Forteo isn’t the only osteoporosis treatment, but it is an effective one. It’s also expensive, costing over $5,000 per month without insurance. Given the high price, many people turn to insurance for generic drugs to help lower the cost of treatment.
Is a generic for Forteo available?
Yes, a generic form of Forteo was approved in November 2023. It is called injectable teriparatide, which is the active ingredient in Forteo. Brand-name Forteo is only produced by Eli Lilly, but generic teriparatide injections are made by various drug manufacturers, including Teva Pharmaceuticals and Apotex.
Teriparatide vs. Forteo: Is there a difference?
Generic and brand-name Forteo are biosimilar. That is, they have the same active ingredients, FDA-approved uses, and dosages administered with a prefilled pen. Biochemically, they are the same.
In general, generic drugs and brand-name drugs have the same therapeutic effects because they contain the same active ingredients. Generics are cheaper, but they are only available after the brand-name drug is no longer protected by a patent.
Uses
Forteo and teriparatide are both FDA approved to treat osteoporosis in the following populations:
- Postmenopausal women with a high risk of bone fracture or who have failed other osteoporosis therapies
- Men with certain types of osteoporosis and a high risk of bone fracture or who have failed other osteoporosis therapies
- Men and women with glucocorticoid-linked osteoporosis and a high risk of bone fracture or who have failed other osteoporosis therapy
Dosage and administration
Both brand-name Forteo and generic teriparatide are available in reusable self-injection pens. They are administered via once-daily subcutaneous injections and prescribed at the same dosage of 20 micrograms (mcg).
“The only potential differences I’ve seen have more to do with the delivery device,” says Barbara Sparacino, MD, a triple board-certified physician and founder of The Aging Parent Coach. “Some patients notice the pen feels different or takes a bit of getting used to.”
Side effects
The brand-name and generic versions of Forteo cause the same side effects because they have the same active ingredient. Both brand-name and generic Forteo are administered subcutaneously, but Dr. Sparacino says she has not observed any difference in injection site reactions between these drugs.
The most frequently reported side effects of Forteo in clinical studies were:
- Joint pain
- Headache
- Dizziness
- Tiredness or weakness
- Nausea
This is not a complete list of potential side effects. It’s important to talk to a healthcare professional about the possible side effects of this drug before taking it for the first time.
Contraindications
Brand-name and generic Forteo are contraindicated in people who have had an allergic reaction to another teriparatide product. These drugs are also not recommended for people with high blood calcium levels (hypercalcemia), as hypercalcemia is one of the serious side effects of teriparatide. Since hyperparathyroidism can cause hypercalcemia, both drugs are also contraindicated for people with this parathyroid condition.
To avoid drug interactions, it’s also important to tell your prescriber about any other prescription drugs, over-the-counter medications, or supplements you take before using Forteo for the first time.
Clinical studies
Generic and brand-name drugs contain the same active ingredients and are approved for the same uses. Most healthcare providers consider them to be the same drug. That said, a 16-year population-based study in Taiwan found that brand-name antidepressant users had significantly lower risks of psychiatric hospitalization than generic antidepressant users. This suggests the possibility of a difference in generic and brand-name drugs, but more research is needed. No research has shown that generic teriparatide works differently from name-brand Forteo.
Forteo (teriparatide) at-a-glance |
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How much is generic Forteo?
The retail price of teriparatide, or generic Forteo, is $5,603 per 1, 2.24 mL of 560 mcg/2.24 mL pen. That’s more expensive than brand-name Forteo, which has an average retail price of $5,125 per 1, 2.24 mL of 560 mcg/2.24 mL pen.
Although generic drugs are often less expensive than their brand-name versions, that’s not always the case, especially with newer generics. “Whenever a drug becomes generic, it takes time for insurance contracts to update and for the price to fall. It’s a quick check for us in the pharmacy to see if the generic is accepted by the insurance and if the patient will be able to save money,” says Blair Gingerich, Pharm.D., a member of the SingleCare Medical Review Board and a clinical care pharmacist in northern Indiana.
Many health insurance plans, including Medicare and some Medicaid policies, cover generic Forteo. However, coverage can vary dramatically from policy to policy.
If you are uninsured or underinsured, you can reduce the out-of-pocket cost of prescription osteoporosis treatment by using a SingleCare discount card or coupons at the pharmacy. For instance, a SingleCare coupon reduces the price of generic teriparatide to $1,911 per pen.
Brand vs. generic Forteo prices |
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| Brand-name Forteo | Forteo generic (teriparatide) | |
| Average cost without insurance | $5,125 per 1, 2.24 mL of 560 mcg/2.24 mL pen of Forteo | $5,602 per 1, 2.24 mL of 560 mcg/2.24 mL pen of teriparatide |
| SingleCare’s lowest price* | $4,165 per 1, 2.24 mL of 560 mcg/2.24 mL pen of Forteo | $1,911 per 1, 2.24 mL of 560 mcg/2.24 mL pen of teriparatide |
| Free coupons* | Forteo coupons | Teriparatide coupons |
*Price at time of publication. Prices fluctuate and vary by pharmacy and location.
How to switch from Forteo to teriparatide
Many healthcare providers offer patients the option of a generic Forteo prescription from the start. However, if you’re currently using brand-name Forteo and want to switch to generic, you can ask your prescriber about it. Switching should be straightforward because these drugs have the same active ingredients and are administered in the same way.
“There’s no need to titrate or adjust the dose when switching from brand-name Forteo to a generic teriparatide,” Dr. Sparacino says. “That said, I always recommend patients stay a little extra attentive during the first few days after a switch.”
In some cases, a healthcare provider might want you to use brand-name Forteo, such as if you’ve had a bad reaction to the generic drug. If your healthcare provider instructs you to stick with the brand-name drug, consult with them about the reasons so that you can weigh the benefits versus the risks of switching.
Bottom line
Forteo is an expensive brand-name drug, but switching to its generic counterpart can help you save money on your osteoporosis treatment. Consult with your healthcare provider about making the switch, and always administer Forteo or teriparatide exactly as directed in the prescribing information.
- Teva announces approval of a generic version of Forteo® (teriparatide injection), in the U.S., Teva Pharmaceuticals (2023)
- Forteo (teriparatide) label, Food and Drug Administration (2021)
- Teriparatide injection label, Food and Drug Administration (2024)
- Forteo – teriparatide injection, solution, DailyMed (2024)
- Primary hyperparathyroidism, National Institute of Diabetes and Digestive and Kidney Diseases (2019)
- Brand-Name antidepressants outperform their generic counterparts in preventing hospitalization for depression: The real-world evidence from Taiwan, International Journal of Neuropharmacology (2020)