CVS Health has just published an argument against the unclear protocols in evaluating patients at risk of heart disease and who have abnormal cholesterol level as a new class of effective but more expensive cholesterol drugs has just been approved by the Food and Drug Administration.
In an article published in Journal of the American Medical Association on August 10, 2015, CVS, through Drs. William Shrank, Jane Barlow, and Troyen Brennan, disclosed to be all employees of the company, contends that it's time for heart specialists to change guidelines in managing and treating high cholesterol.
A long time ago, patients with hyperlipidemia, a condition with high cholesterol and triglyceride, were diagnosed and treated based on a targeted cholesterol level. In 2013, this was changed by the American Heart Association and American College of Cardiology, in which patients would be provided with a high-dose treatment using a potent drug as soon as the doctors see an elevated risk of heart disease.
Before the approval of the new class of drug, statin is the only effective treatment. However, since it's cheap, it doesn't have any major financial impact.
The introduction of PCSK9 inhibitors, however, changes the landscape. These drugs have the ability to keep LDL cholesterol (or the bad cholesterol) in the bloodstream only. The first drug is called Praulent (alirocumab), which has been approved in July 24, 2015. Another one, Repatha, is expected to be approved this month.
Administered through an injection, these drugs can cost as much as $15,000 a year-a huge difference from only $50 per month in statins. The lack of clarity in the guidelines therefore may compel payers and patients to pay excessive drug costs that they may not necessarily need in the first place. The financial burden may also extend for a long time as there's a huge chance these drugs would have to be taken chronically.
They then call on an evaluation of guidelines for treatment so both doctors and patients will know where this new expensive drug is going to fit in their plan.