Insurers begin to review coverage of costly cholesterol drugs

Modern Healthcare
Insurers begin to review coverage of costly cholesterol drugs

By Bob Herman
August 28, 2015

Observers view the cholesterol drugs as potential budget-busters for public and private insurers. The hepatitis C drugs that made it to the market last year created an industrywide stir with their lofty price tags. Gilead Sciences’ Harvoni costs $94,500 for a 12-week treatment. But in most instances, hepatitis C patients are cured after treatment. High cholesterol has to be managed continuously, and PCSK9 inhibitors hypothetically could be used indefinitely.

The cholesterol drugs have a lower initial price compared with the hepatitis C drugs, but the costs could balloon over time. Many believe that’s drug companies trying to gouge the marketplace. “With several game-changing medications in the pipeline, we need to address the underlying issue of how these prices are set from the start before they hit the market,” John Rother, president of the National Coalition on Health Care and leader of the Campaign for Sustainable Rx Pricing, said in a statement.

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