Many patients don't fill cholesterol drug prescriptions due to high out-of-pocket costs, study finds

Many patients forgo PCSK9 inhibitors therapy — which is designed to help reduce cholesterol — primarily due to out-of-pocket costs, according to a study published in JAMA Cardiology.

For the study, researchers used pharmacy data to examine more than 45,000 patients who were prescribed the therapy between Aug. 1, 2015, and July 31, 2016. More than half of the patients had health coverage through the federal government.

The study found 20.8 percent of patients prescribed PCSK9 inhibitors therapy received insurance approval on the first day, and 47.2 percent received approval at any point.

Researchers said a majority of patients who received approval (65.3 percent) filled the prescription, meaning 30.9 percent of those prescribed the therapy never received it.

They added, "patients who were older, male, and had atherosclerotic cardiovascular disease were more likely to be approved, but approval rates did not vary by patient low-density lipoprotein cholesterol level nor statin use." Type of insurance coverage and type of pharmacy also were factors as far as whether the patient received approval, according to the study.

Additionally, researchers noted "approval rates varied nearly three-fold among the top 10 largest pharmacy benefit managers," and that the primary reason patients didn't fill their prescriptions was copay costs. The study found the prescription abandonment rate was 7.5 percent for those with no copay cost and more than 75 percent for copays higher than $350.

"In the first year of availability, only half of patients prescribed a PCSK9i received approval, and one-third of approved prescriptions were never filled owing to copay," the study authors concluded.


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