New cholesterol drugs could cost $ 120B a year in USA
Many insurers won’t let patients use them
Promising new cholesterol- lowering drugs, priced at $ 14,000 a year per person, could add $ 120 billion annually to the USA’s health care costs if taken by all eligible patients, according to an economic analysis published Tuesday in JAMA.
The new drugs, called PCSK9 inhibitors, can reduce LDL cholesterol, which can contribute to heart attacks, by up to 60%, said Dhruv Kazi, assistant professor of medicine at the University of California- San Francisco and lead author of the new study.
About 9 million Americans ages 35 to 74 could be eligible for the drugs, which the Food and Drug Administration approved last year for people with a strong family history of extremely high cholesterol, as well as those who have suffered heart attacks or strokes due to cholesterol buildup in their arteries.
PCSK9 inhibitors are approved for those who either cannot tolerate statins because of muscle pain or liver problems or who cannot sufficiently lower their levels on statins alone. The drugs — Praluent, made by Sanofi and Regeneron Pharmaceuticals, and Repatha, made by Amgen — pack a onetwo punch when it comes to costs, Kazi said. Unlike cancer therapies, which can cost $ 100,000 a year or more but may be used by only a few thousand people, the new drugs could be used by millions.
And unlike new drugs for hepatitis C, which cost $ 1,000 a pill but are used for 12 weeks, these cholesterol drugs are meant to be taken for life, Kazi said. Treating all eligible patients with Repatha or Praluent would increase annu- al health spending in the USA, now at $ 2.8 trillion, by 4%, an “astronomical” amount for a single medication, Kazi said.
Hala Mirza, a Regeneron spokesperson, said the analysis overestimates the cost of the new drugs. Insurers have blocked access to Praluent for about 75% of patients whose doctors wrote prescriptions for it, Mirza said.
Insurer Cigna covers Praluent and Repatha and reached agreement in May with both of the drugs’ manufacturers to get a “very competitive discount” that would be slashed even more if the drug doesn’t perform as well as it did in clinical trials, said Christopher Bradbury, senior vice president of Cigna Pharmacy.