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NOVEMBER 29, 2017

Most Insurers Denying Claims for PCSK9 Inhibitors

By Marie Rosenthal

Insurance companies are more likely to deny a claim for prescriptions of PCSK9 inhibitors than approve it, according to new research (Circulation 2017 Oct 30. [Epub ahead of print]). 

PCSK9 inhibitors, such as evolocumab (Repatha, Amgen) and alirocumab (Praluent, Sanofi-Regeneron), have been shown to reduce low-density lipoprotein by 60% and decrease major cardiac events, but cost much more than other cholesterol-lowering drugs, with an average cost of $14,300 per year.