MOA of PCSK9i

PCSK9 Inhibitors

PCSK9i Therapies

PCSK9i: Dosage and Administration

PCSK9i CVOTs

PCSK9i CVOTs

Maximum approximately 15 weeks

PCSK9i CVOTs

FOURIER: LDL-C

PCSK9i CVOTs

PCSK9i CVOTs

ACC/AHA Guidelines

IfPA Report Card

Initial PCSK9i Rejection Rates

“High initial rejection rates are deeply troubling. Health plans are using prior authorization to block tens of thousands of heart patients from the medication that their physician prescribed. These are patients who don’t respond adequately to traditional statins, yet health plans are cutting costs at their expense.”

-Brian Kennedy, Executive Director, Global Alliance for Patient Access

NLA Survey Results

NLA 2016 Survey Results

NLA Survey Results

PCSK9i Pricing Update

Economics of PCSK9 Inhibitors

Improving Patient Access

Facilitating Patient Access to PCSK9 Inhibitors

Improving Patient Access

Facilitating Patient Access to PCSK9 Inhibitors

  • If appeal is denied, request a peer-to-peer consult
  • Act on the decision of the peer-to-peer consult
  • Keep fighting for your patient
  • Don’t give up!

Improving Patient Access

Resource for Increasing PCSK9i Approval

Improving Patient Access

Prior Authorization Form and Repeal Request Letter Template

Summary

  • Addition of a PCSK9i to statin regimen may help to further lower LDL-C levels by 43%-64%
  • Recent outcomes trials demonstrate that PCSK9i therapy significantly reduces CV events
  • PCSK9i agents have the potential to fill an important treatment gap for patients at residual CV risk despite taking maximally tolerated statin therapy
  • Recent data indicate that the majority of PCSK9i prescriptions are initially denied by insurance providers, and many are still ultimately rejected upon appeal
  • Tools are available to help clinicians improve patient access to PCSK9i therapy