Maximum approximately 15 weeks
Acute coronary syndrome (ACS)
High-intensity statin therapy
Inadequate control of lipids
“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 AccessIfPA has also issued report cards for individual states, revealing final rejection rates between 25%-45% in the states listed above
97% take further
action after
getting denial for
PCSK9i
43% were
successful after all
appeals in attaining
approval ≥75%
of time for patients
with FH
96% have had
initial PCSK9i
denials for
patients with
ASCVD
36% were
successful after all
appeals in attaining
approval ≥75% of
time for patients
with ASCVD