Will Physician Demand For Repatha Put Pressure On Payer Restrictions?
FOURIER outcomes data presented at the American College of Cardiology annual meeting fell short of expectations, but could increase physician demand for the PCSK9 inhibitor, making it harder for payers to say no.
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The move follows a similar price cut for Amgen's competing PCSK9 inhibitor Repatha and comes as PBMs, including UnitedHealth Group's OptumRx, are looking for ways to maintain the drug rebate status quo.
Express Scripts has agreed to give Praluent preferred access over Amgen's Repatha on its national formulary and is removing restrictions that have been a significant barrier to market access for the PCSK9 inhibitors.
A below-the-radar effort to streamline prior authorization policies could have important implications for easing access to high-priced medicines. A new consensus statement aligns large provider groups with payors on some first principles.