Researchers from Duke University in Durham, North Carolina, US, found that up to a third of patients discontinue proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitor treatment due to inadequate insurance coverage. [Navar AM, et al, AHA 2017, abstract S2112]

The results were based on a web survey of nearly 800 adults who participated in pharmaceutical company-supported online patient support groups after being prescribed PCSK9 inhibitors.

Most of the participants had tried statins at some point. At the time of the survey, 31 percent of participants were on a statin, 16.7 percent were on a high-intensity statin, and 18.8 percent were taking ezetimibe.

Eighty-seven percent of respondents (n=699) began PCSK9 inhibitor therapy when prescribed. Eighty percent of these respondents received free sample medications at some point. Sixty-six percent of respondents had approved insurance coverage for treatment but while 43 percent reported no co-pay, 16.3 percent reported paying over USD 400 per month out of pocket.

Among those who began PCSK9 inhibitor therapy, 67.7 percent remained on treatment. Those who stopped did so within 1 month (9 percent), 1–3 months (36 percent), 4–6 months (15.8 percent), and after 6 months (39.2 percent), citing insurance approval or re-approval failure (30.5 percent) and high costs (25.5 percent) as reasons.