A national data supplier reviewed PCSK9 inhibitor claims for managed care organizations in Texas from January 2017 through December 2017.
Of health plans that received at least 400 claims for PCSK9 inhibitors, the following had the highest rates of rejections:
• Federal Employee Benefit Plan – 82%
• Tricare Military Health SVC SYS – 44%
• United Health Group – 41%
• Express Scripts – 39%
The following had the lowest rates of rejection:
• Aetna – 18%
• Humana Health Plan – 12%
