Prime suggests limited PCSK9 coverage

Pharmacy benefit manager Prime Therapeutics LLC (Eagan, Minn.) suggested Tuesday it may limit access to PCSK9 inhibitors to patients with familial hypercholesterolemia based on an analysis of its claims data that showed there may be opportunities to first optimize statin use and adherence in the majority of patients with cardiovascular disease.

Prime analyzed claims from 3 million members over four years and found that among the 54,000 with established cardiovascular disease, only 20% were taking a high dose statin regularly to treat the disease and only 25% had tried a second statin. The PBM concluded that a majority of patients with CV disease "significantly underuse" statins. ...