Why don’t we do what is right

A new class of medications, called PCSK9 inhibitors, are a powerful reducer of cholesterol. These medications are ideal for people with certain hereditary high cholesterol that places them at great risk for deadly heart attacks. Yet, health insurers have raised numerous bureaucratic barriers, preventing patients from getting these potentially life-saving medicine. And the reason is very clear: money. The PCSK9 inhibitors have a list price of $14,600 per year and likely 10 million Americans would be medically eligible for these medications. So insurers have put in place every trick (prior authorizations, hoops of multiple tests and extensive documentation in order to delay and deny reimbursing for thee medications). Finally, now some insurers and manufacturers are coming together to make PCSK9 inhibitors available to some qualified patients.

Read: These Cholesterol-Reducers May Save Lives. So Why Aren’t Heart Patients Getting Them?

Recent Posts

See All

Hi from HIMSS19!

By Albert DiPiero MD MPH I am at the annual HIMSS meeting in Orlando Florida this week. HIMSS is the Healthcare Information and Management Systems Society. A few quick thoughts: The sheer volume of he

CVS explores new concepts in healthcare

By Albert DiPiero MD MPH CVS - the drug store chain which is also one of America's largest retailers - is not waiting to see what Amazon is up to. CVS is pushing ahead transforming itself from retail

Amazon health venture hires CTO

By Albert DiPiero MD MPH The joint healthcare venture between Amazon-Berkshire Hathaway-JP Morgan Chase (ABJ) just announced the hiring of Serkan Kutan as its CTO. Mr Kutan was most recently chief tec