Xgeva (denosumab)
Patient Assistance Program Guide — Amgen Safety Net Foundation
Do You Qualify?
Income
Up to $75,300 for a single person
Insurance
Must be uninsured or underinsured (insurance does not cover the drug). Medicare Part D patients may qualify if they meet specific financial criteria and have no other coverage options.
Residency
U.S. resident or resident of U.S. territories with a valid address.
Income Limits (500% FPL)
Amgen Safety Net Foundation typically utilizes a 500% FPL threshold for oncology medications like Xgeva.
Based on 2025 HHS Federal Poverty Level guidelines.
# Getting Xgeva (Denosumab) at No Cost: Your Guide to the Amgen Safety Net Foundation
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Who Qualifies for the Amgen Safety Net Foundation?
If you have been prescribed Xgeva and cannot afford it, the Amgen Safety Net Foundation may be able to provide it to you at no cost. This program is designed specifically for patients who lack adequate insurance coverage for this medication. For a single-person household, your annual income must be at or below $75,300 to meet the income requirement. You must also be either uninsured or have insurance that does not cover Xgeva. If you meet these two core criteria — income and insurance status — you are likely a strong candidate for free medication through this program. Your doctor's office will also need to participate by completing part of the application.
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About Xgeva (Denosumab)
Xgeva is an injectable prescription medication made by Amgen. It belongs to a drug class called RANK ligand (RANKL) inhibitors. It is FDA-approved to treat bone metastases from solid tumors, giant cell tumor of bone, and hypercalcemia of malignancy. Xgeva is typically administered by a healthcare provider and is not available at a retail pharmacy. Without insurance or assistance, the out-of-pocket cost of Xgeva can be extremely high — often thousands of dollars per dose — placing it out of reach for many patients. The Amgen Safety Net Foundation exists to help eligible patients access this medication at no charge when insurance does not provide coverage.
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Income Eligibility: Full Breakdown
The Amgen Safety Net Foundation uses an income threshold that is approximately 500% of the Federal Poverty Level (FPL). The table below shows the maximum annual income allowed based on household size:
| Household Size | Max Annual Income |
|---|---|
| 1 person | $75,300 |
| 2 persons | $102,200 |
| 3 persons | $129,100 |
| 4 persons | $156,000 |
If your household is larger than four people, the income limit generally continues to increase — contact the program directly at (888) 762-6436 to ask about your specific situation.
Your income is typically verified using your most recent federal tax return, W-2 forms, or three months of recent pay stubs. The program looks at your total household income, not just your own earnings.
If your income is above the limits listed, you may not qualify for the Safety Net Foundation's free medication program. However, you are not without options — see the final section of this guide for other ways to reduce your costs.
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Insurance Requirements Explained
Understanding how your insurance status affects eligibility is important before you apply.
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Step-by-Step: How to Apply
Follow these steps to apply for free Xgeva through the Amgen Safety Net Foundation:
1. Gather your documents first. You will need: a completed application form (with both a patient section and a prescriber section), proof of household income (your most recent federal tax return, W-2, or three months of pay stubs), and copies of any insurance cards you have.
2. Get the application form. You can download it or start the process online at https://www.amgensafetynetfoundation.com/. You can also call (888) 762-6436 to request a paper application by phone.
3. Complete the patient section. Fill in your personal, household, and income information. Sign the form where required.
4. Have your prescriber complete their section. Your doctor or their office staff must fill out and sign the prescriber portion. Most oncology offices are familiar with this process.
5. Submit your application. You can apply online through the website above, fax your completed documents to (866) 549-7239, or submit by mail. Your doctor's office may be able to submit on your behalf.
6. Wait for a decision. Processing typically takes 1 to 2 business days after all documents are received.
7. Receive confirmation. If approved, you and your prescriber's office will be notified of your enrollment status.
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What to Expect: Timeline and Delivery
Once your completed application and all required documents are submitted, a decision typically comes within 1 to 2 business days. Approval notifications are generally sent to the prescriber's office. If approved, Xgeva will be shipped directly to your prescriber — not to your home. You do not need to pick it up from a pharmacy. Your doctor's office will schedule your injection as part of your regular care. Your enrollment is not permanent: the program requires annual reauthorization, meaning you will need to reapply each year and confirm that you still meet the income and insurance requirements.
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Alternatives If You Don't Qualify
If you do not qualify for the Amgen Safety Net Foundation, consider these options:
1. Biosimilar alternatives: Wyost (denosumab-bbqz) is an FDA-approved biosimilar to Xgeva. Ask your doctor whether switching to a biosimilar is medically appropriate for you, as it may be available at lower cost.
2. Manufacturer savings card: If you have private insurance that covers Xgeva but still face high out-of-pocket costs, Amgen offers a copay savings card for insured patients. You can access it at https://www.xgeva.com/copay.
3. State Pharmaceutical Assistance Programs (SPAPs): Many states offer programs that help residents afford high-cost medications. Eligibility and benefits vary by state. Contact your state's health department or ask a patient advocate at your cancer center for guidance.
4. NeedyMeds.org: This free online database lists patient assistance programs, disease-based assistance funds, and other resources. Visit https://www.needymeds.org to search by drug name or diagnosis.
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*This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Amgen. Program terms may change — verify current requirements at [https://www.xgeva.com/support](https://www.xgeva.com/support) before applying.*
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Documents You'll Need
If You Don't Qualify for the Assistance Program
Biosimilar / Generic Alternatives
FDA-approved alternatives to Xgeva: Wyost (denosumab-bbqz). Ask your prescriber if one of these is clinically appropriate for your condition.
Manufacturer Savings Card (for insured patients)
Amgen offers a savings card that may reduce your out-of-pocket cost if you have commercial insurance. Ask your prescriber or pharmacist for current savings card details.
Common Questions
Once your completed application and all required documents are received, the program typically processes your request within 1 to 2 business days. Make sure both the patient and prescriber sections are fully completed and that your income documents are included to avoid delays.
No. If your application is approved, Xgeva is shipped directly to your prescriber's office, not to your home address. Your doctor's team will coordinate with you to schedule your injection as part of your ongoing treatment.
Yes. If you have insurance that covers Xgeva but you still have high costs, check the Amgen copay savings card at https://www.xgeva.com/copay. You can also ask your doctor about Wyost, an FDA-approved biosimilar to Xgeva that may cost less. NeedyMeds.org is another free resource that lists additional assistance programs.
Yes. The Amgen Safety Net Foundation requires annual reauthorization. Each year, you will need to confirm that you still meet the income and insurance requirements. Your prescriber's office may help coordinate this renewal, but it is a good idea to track your enrollment expiration date so your medication supply is not interrupted.
You can still apply and let Amgen make the final determination. Income thresholds can sometimes account for household expenses or other factors. You can also call the program directly at (888) 762-6436 to discuss your situation before submitting a full application.
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