Hope that price cuts will unblock poor access to PCSK9 inhibitors

Across the USA, insurers denied access to the new cholesterol-lowering medications known as a PCSK9 inhibitors, for as many as one in three high-risk heart patients in 2018.

This was despite the patients meeting the criteria for coverage, says the non-profit group Institute for Patient Access (IfPA), which revealed the rejection rates in a new Health Plan Coverage Report Card.

The data, captured from January to December 2018, reflects PCSK9 inhibitor claims for Medicare, Medicaid, Medicaid managed care and commercial managed care organizations. Overall, more than 88,000 on these plans were blocked from receiving these breakthrough drugs.