Magellan Rx Management reported its ability to assist employers, health plans and Medicaid programs in appropriately managing the use of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) inhibitor medications.
Repatha is the second PCSK9 inhibitor to receive FDA approval, after alirocumab (Praluent; Sanofi/Regeneron) was approved earlier this summer.
"As science continues to advance, this new class of drugs holds considerable promise for the millions of Americans battling cardiovascular disease everyday," said Mostafa Kamal, chief executive officer of Magellan Rx Management. "However, in order to ensure optimal outcomes and efficiently manage costs, payers must implement thoughtful, evidence-based strategies to effectively manage this evolving drug class. Magellan Rx Management's specialty drug division, which manages specialty drug spend for approximately 40 health plans, has worked closely with key experts in the field to develop targeted clinical programs that foster best practices, support patient adherence and encourage lifestyle interventions that can reduce cardiovascular risks."
In a release, the Company noted that in clinical studies, PCSK9 inhibitors have been well tolerated and effective in lowering low- density lipoprotein (LDL) cholesterol in multiple groups of patients with hypercholesterolemia, particularly when used in addition to statin therapy, the established standard of care. The potential target population for PCSK9 inhibitors may grow substantially, with an annual cost exceeding $14,000 per patient. Possible target treatment groups include patients with familial hypercholesterolemia - estimated to be around one in 300 individuals in the United States - and patients with atherosclerotic cardiovascular disease- estimated to be 22 million Americans.
"While statins will remain a first line therapy to reduce cardiovascular disease, certain groups of people may benefit from PCSK9 inhibitors. The fundamental components of utilization management should include identification of specific patient groups most likely to benefit from PCSK9 therapy and the development of evidence-based practices to ensure eligible patients are receiving appropriate lipid lowering therapy prior to adding on a PCSK9 inhibitor," said Dr. Maria Lopes, chief medical officer of Magellan Rx Management.
"If every patient diagnosed with familial hypercholesterolemia in the country eventually started on a PCSK9 inhibitor, the cost to the healthcare system would be roughly $16 billion annually, without factoring in other patient groups at high risk for cardiovascular disease," said Kamal. "The competition created in the market with the approval of a second PCSK9 inhibitor allows Magellan Rx Management to develop the most innovative and cost-effective formulary strategies to appropriately manage the cost of these medications for our clients."
Magellan Health specializes in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare.
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