Background By lowering LDL cholesterol (LDLC) ∼60% beyond statins, PCSK9s have the potential to profoundly improve primary and secondary prevention of atherosclerotic coronary artery (CAD), peripheral (PAD), and carotid artery disease.
Purpose In 189 patients referred to a regional Cholesterol Center for diagnosis and treatment of hypercholesterolemia, who had initial LDL cholesterol (LDLC) ≥130 but <160 mg/dl, our specific aim was to determine how many would be eligible for PCSK9 therapy by extant preferred commercial insurance criteria.
Methods Current preferred commercial insurance criterion for PCSK9 therapy consisted of ≥1 of the following 3 conditions:
Heterozygous familial hypercholesterolemia (previous LDLC >190 mg/dl and Tendon Xanthomas),
Atherosclerotic cerebral-cardio-peripheral vascular disease.
Failure to tolerate 2 or more statins.
Results At entry, in the 189 patients, mean±SD and median LDLC were 144±9 mg/dl and 143 mg/dl respectively. Of the 189 patients (96 female and 93 male with median age 53) 16 (8%) were diagnosed as having heterozygous FH, with median LDLC of 139 mg/dl, and 32 (17%) had sustained a cerebral-cardio- peripheral vascular event with median LDLC on treatment of 146 mg/dl. Of the 189 patients, in 44 (23%) the maximum tolerated statin dose was zero (complete statin intolerant), with median LDLC of 145 mg/dl. Of the 44 statin intolerant patients, 18 (41%) had either HeFH or an atherosclerotic event, and 26 (59%) had neither positive. Altogether 73 of 189 (39% of patients with entry LDLC ≥130 but <160 were eligible for PCSK9 therapy from commercial carriers.
Conclusion Of 189 patients referred to a regional Cholesterol diagnosis and treatment center with initial LDLC ≥130 but <160 mg/dl, 73 (39%) met current commercial insurance carrier preferred criteria for PCSK9 drug coverage.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.