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Insurers begin to review coverage of costly cholesterol drugs
Modern Healthcare

Now that the Food and Drug Administration has given the OK to two pricey drugs that treat high cholesterol, health insurers and pharmacy benefit managers are evaluating if one drug should receive preferred coverage over the other.

In exchange for the preferred designation, drugmakers offer price discounts on their products. A flurry of these types of deals occurred this year with high-cost hepatitis C drugs.

This week, the FDA approved Repatha, an injectable drug made by Amgen that lowers a person’s “bad” cholesterol level. It can be used only for patients who have certain inherited conditions or a history of serious heart ailments. Estimates put that patient base at around 5 million to 10 million people. These types of cholesterol drugs are called PCSK9 inhibitors.