One Step Forward, Two Steps Back for Heart Patients

A money-back deal for cholesterol-lowering PCSK9 inhibitors doesn’t cut costs enough, claims a new analysis from a University of Pittsburgh researcher.  The drug’s manufacturer says the numbers used to calculate her cost figures don’t reflect reality.  But the voice that’s missing from this public debate is the one that arguably has the most to lose – patients, who already struggle to access breakthrough cardiovascular therapies.

Access to PCSK9 Inhibitors

Approved by the FDA to treat patients with genetic high cholesterol and those who have already experienced a cardiac event, PCSK9 inhibitors can lower stubborn “bad” cholesterol for patients who’ve found few results with existing treatments.  But the drugs’ price point has led health plans to establish extensive prior authorization processes to limit costs.  A national IfPA health plan report card found that 43 percent of patients are denied access to the PCSK9 inhibitor their doctor prescribes.  

Read more at Institute for Patient Access. 

ICER Report Could Intensify Barriers for Heart Patients

Accessing innovative cardiovascular drugs may soon get harder.

A new publication from the Institute for Clinical and Economic Review, a drug price analysis group, assigns a C+ effectiveness grade to cholesterol-lowering drugs known as PCSK9 inhibitors.  The lukewarm valuation sets the stage for increased health plan barriers, despite the drugs’ effectiveness in reducing heart attack and stroke risk.

PCSK9 inhibitors work by preventing the PCSK9 protein from destroying a receptor on the liver that clears bad cholesterol. The receptor “lives” longer, clearing more LDL cholesterol for the patient.  For some patients who don’t sufficiently respond to traditional statin therapy, the drugs have offered unprecedented improvement.

Read more at Institute for Patient Access