the Family Heart Foundation welcomes Sanofi and Regeneron’s announcement today to lower the list price of its LDL cholesterol lowering treatment, the PCSK9 inhibitor Praluent, to $5,850 annually. This brings the list price of Praluent in line with Amgen’s PCSK9 inhibitor, Repatha, which was lowered to $5,850 last October 2018.
the Family Heart Foundation welcomes the pricing transparency and lower list price. We believe this lower list price will benefit individuals who have Familial Hypercholesterolemia (FH) if it translates into improved Prior Authorization (PA) criteria for FH, a streamlined PA process, higher rates of approval for appropriate patients prescribed a PCSK9 inhibitor by their doctor, and affordable out-of-pocket costs.
Unfortunately, the Family Heart Foundation continues to hear from individuals with FH who are on Medicare Part D plans that they face out-of-pocket costs over $500 per month and as high as $1,379. This suggests that Medicare Part D insurance plans have not yet adopted the newer lower price available for Repatha and continue to charge patients a coinsurance based on the previous higher list price. In addition, this is compounded by the insurance plan’s use of Prior Authorization criteria for FH patients that effectively exclude many who have FH from drug coverage for PCSK9 inhibitors, both in commercial and Medicare plans.
the Family Heart Foundation encourages insurance plans and pharmacy benefit managers will adopt the lower list price as soon as possible and pass savings on to patients. Lives depend on it.