Alabama Health Plans deny treatment for high cholesterol

The Institute for Patient Access released a new Health Plan Coverage Report Card claiming that Alabama insurers deny patients coverage for advanced cholesterol-lowering drugs known as PCSK9 inhibitors 53 percent of the time. The report card reveals that health plans reject more than one out of every two claims submitted for coverage of prescribed PCSK9 inhibitors. The data, collected from August 2015 to July 2016 by a national data supplier, reflects PCSK9 inhibitor claims for Alabama managed care organizations, including commercial plans, Medicare and managed Medicaid.

Read more at the Alabama Political Reporter

Cholesterol-Slashing Drug Can Protect High-Risk Heart Patients, Study Finds

The first rigorous test of an expensive new drug that radically lowers cholesterol levels found that it significantly reduced the chance that a high-risk patient would have a heart attack or stroke. These were men and women who had exhausted all other options.

The results of the study, which cost about $1 billion and was paid for by Amgen, maker of the drug, were published on Friday in The New England Journal of Medicine and presented at the annual meeting of the American College of Cardiology.

Read more at The New York Times. 

New Collaboration Improves Access to Treatment for Familial Hypercholesteremia (FH) Patients Most at Risk for Early Heart Attacks and Death

PASADENA, Calif., March 15, 2017 /PRNewswire-USNewswire/ -- The FH Foundation, a patient-centered non-profit dedicated to research, advocacy, and education of all forms of familial hypercholesterolemia (FH), today announced its collaboration with Express Scripts, a leading pharmacy benefit manager, to improve pharmacy coverage for patients with FH, an inherited genetic disorder that causes high LDL-cholesterol from birth. With a more comprehensive set of diagnostic criteria, a broader group of patients will have access to cutting-edge PCSK9 inhibitor treatment, as appropriate.

Read more at PRNewswire. 

Dr. Keith Ferdinand: Together, We Can Save Hearts

Good health is the cornerstone of progress, and since 1974, the Association of Black Cardiologists (ABC) has been dedicated to lowering the high rate of cardiovascular disease, including stroke, especially in minority populations.  As an ABC member and Chairman of the ABC Access to Healthcare Working Group, I have spent my career pursuing a central goal of ABC—to eliminate the disparities related to cardiovascular disease in all people regardless of race, ethnicity, gender, geography, or socioeconomic status.

Read more at The New Orleans Tribune. 

Report: Florida HMOs slammed for denying cholesterol drugs

Florida health plans on average reject 45 percent of the claims claims submitted for coverage of prescribed advanced cholesterol lowering drugs, according to the advocacy group known as Institute for Patient Access.

The institute released a report card highlighting the rates at which Florida insurers deny patients coverage for the medications, known as PCSK9 inhibitors.

More at Politico. 

“Accessing Cholesterol Treatments” is No Simple Task, Explains New Video

On the heels of recent research confirming breakthrough drugs’ impact on patients with high cholesterol, the Partnership to Advance Cardiovascular Health has released a quick-draw videoexploring obstacles for patient access.

In “Accessing Cholesterol Treatments,” narrator and cardiologist Seth Baum, MD, describes a hypothetical patient with a family history of extremely high cholesterol. “He’s not the typical cholesterol patients,” Dr. Baum explains, “And the typical medications, known as ‘statins,’ don’t lower his cholesterol enough.”

More at Institute for Patient Access

Insurers struggling with drug data

In an effort to combat high drug prices, health insurance companies are trying to pay drugmakers for how well their medicines perform . But health plans are running into a problem all too familiar in digital health: They are having trouble gathering and interpreting the right data, Pro’s Darius Tahir reports this morning.

“The typical payer has claims data…but not the clinical data underlying the service they’re being billed for. The payer knows that a patient’s cholesterol was tested…but not whether his or her cholesterol levels improved since the last reading. Without that knowledge, an insurer can’t assess whether, say, the multi-thousand dollar PCSK9 inhibitor the company paid for is actually reducing “bad” cholesterol — or improving heart health.”

Read more at Politico

Gene therapy shows early promise against heart failure

There might be good news for millions of Americans who suffer from heart failure: A trial using gene therapy appears to have boosted patients' cardiac function.

"This type of an intervention would be the ultimate method to reconstruct damaged heart tissue so that it can be mechanically functional again," explained one expert, Dr. Justine Lachmann. She directs the Congestive Heart Failure Program at Winthrop-University Hospital in Mineola, N.Y.

More from UPI Health News

Research: Insurance key to statin use among at-risk Hispanics

Having health insurance is a key predictor of whether Hispanics at high risk for heart disease use cholesterol-lowering medications known as statins, according to new research in the Journal of the American Heart Association.

It is one of the first studies to document differences in the use of widely prescribed statins and aspirin among diverse Hispanic and Latino populations in the United States.

More from American Heart Association News

Many patients with high stroke risk don’t get needed blood thinners

Patients who have a heart rhythm disorder that can come with a high risk of stroke often don’t receive blood-thinning medications that can make this complication less likely, a U.S. study suggests.

Researchers studied almost 430,000 people with a condition known as atrial fibrillation, an irregular rapid heartbeat that can lead to stoke, heart failure and chronic fatigue.

More from Reuters Health