PatientViewpoint on PCSK9 Inhibitors
November 30, 2017
• American College of Cardiology: travel expenses
• American Board of Internal Medicine: travel expenses
• Yale Center for Outcomes Research and Evaluation:
consulting fee for serving on a stakeholder advisory
committee for developing a performance measure under a
contract with CMS
An FH patient on PCSK9 inhibitors:
We are rejected and/or forced through step therapy in
order to get access.The copay program helps, but my first
copay before it kicks in is $1000. Monthly copay is around
$400 as its now a tier 4 drug on my formulary. … But it
works. It works very well. And if I don’t take it, then I have
no other options, besides apheresis.
Prior authorization practices and high copays
are limiting use of PCSK9 inhibitors
• During the first year of availability, 47.2% of patients prescribed a PCSK9
inhibitor received approval.
• Of those approved, 65.3% filled the prescription, resulting in 30.9% of those
prescribed a PCSK9 inhibitor ever receiving therapy.
• Copays varied widely, from $0 for the lowest quartile of patients to more than
$300 per month for the highest quartile.
• Prescription abandonment by patients was most associated with copay costs,
with abandonment rates ranging from 7.5% for those with $0 copay to more
than 75% for copays greater than $350.
Navar AM, Taylor B, Mulder H, et al. Association of Prior Authorization and Out-of-pocket Costs With Patient Access to PCSK9 Inhibitor Therapy. JAMA Cardiol.
Relationship Between Copay and Prescription Abandonment for
Patients Approved for PCSK9 Inhibitors
NavarAM,Taylor B, Mulder H, et al. Association of PriorAuthorization and Out-of-pocket CostsWith PatientAccess to PCSK9 InhibitorTherapy. JAMA
Medicare Part D plans and annual out-of-
pocket costs for PCSK9 inhibitors
• Alirocumab and atorvastatin 80 mg.: $4997
• Evolocumab and atorvastatin 80 mg.: $4968
Kazi DS, Lu CY, Lin GA, et al. Nationwide Coverage and Cost-Sharing for PCSK9 Inhibitors Among Medicare Part D
Plans. JAMA Cardiol. 2017;2(10):1164-1166.
Out-of-Pocket Costs for PCSK9 InhibitorTherapy
Under Medicare Part D
Kazi DS, Lu CY, Lin GA, et al. NationwideCoverage and Cost-Sharing for PCSK9 InhibitorsAmong Medicare Part D Plans. JAMA Cardiol.