Health plans across the country are rejecting prescriptions for cholesterol-lowering PCSK9 inhibitors at an average rate of 43 percent. And now one patient advocacy group has a message: Enough is enough.
The Partnership to Advance Cardiovascular Health, a policy advocacy group dedicated to cardiovascular health innovation, held on Friday the first in a series of state forums designed to foster dialogue – and drive action – on access barriers. Held in Birmingham, the event drew patients, advocates, physicians, and staff for state and federal lawmakers.
“Birmingham was a natural starting point for these meetings,” explained Ryan Gough, the group’s director. “Alabama health plans are saying ‘no’ to more than half of patients whose physicians want them taking PCSK9 inhibitors to lower their LDL cholesterol. For one plan, the rate is as high as 87 percent. It’s a dangerous trend.”
And it’s a trend that the Partnership to Advance Cardiovascular Health hopes to stop. To coincide with the beginning of the forum series, the group also launched a Change.org petition aimed at the National Association of Insurance Commissioners.
The petition calls for the association to “fulfill its mission to assist state insurance regulators in serving the public interest,” explaining, “That means raising awareness about the alarming rejection rates that qualifying patients face across the country.” The petition notes that plans are denying patients’ access to treatment, “despite physicians’ wishes.”
PCSK9 inhibitors extend the lifespan of a receptor on the liver that clears LDL cholesterol. The Food and Drug Administration approved the drugs to treat familial hypocholesterolemia, or genetic high cholesterol, and atherosclerotic cardiovascular disease, where plaque builds up in a patient’s arteries. Clinical data show the therapies can lower LDL cholesterol and reduce the associated risks of heart attack and stroke by 20 percent.
The Partnership to Advance Cardiovascular Health will hold its next forum in Orlando on August 5.