OBJECTIVES: The objective was to analyze current trends in consumption as well as prescription practice pattern of the new anti-RANKL monoclonal antibody denosumab in the treatment of osteoporosis since its introduction onto the market in the Czech Republic in 2011. METHODS: The prescription-based database of the General Health Insurance Company (VZP) of the CR that covers approximately 62% of the Czech population was used as the data source. An insured person with a recorded prescription for denosumab in the period of interest was defined as a patient. The obtained epidemiological and costing data were also confronted with the prediction in the budget impact analysis in the public reimbursement dossier accessible in the State Institute for Drug Control files.  RESULTS: 3119 (158) patients (men) treated with denosumab were identified in the first year, i.e. between August 2011 and July 2012. The median age of patients was 73 years. Of the patients prescribed denosumab in the first half-year, 84% received the second dose within the observed period of one year, of which 85% within the authorized period of 6 months (+-1 month). This new drug was most often prescribed by physicians trained in internal medicine (47%) and rheumatology (30%). The cumulative costs for VZP of the drug were CZK 27.3 mil (EUR 1.1. mil) in the first year. CONCLUSIONS: The uptake of denosumab has been rapid and agrees with the predictions presented by the manufacturer before the launch of the drug. This preliminary data also suggest that both the prescribing doctors and the patients filling the prescriptions follow the dosing schedule.