CVS Health Announces Formulary and Therapy Strategy for PCSK9 Inhibitors

CVS Health

announced today that Repatha™ (evolocumab) from Amgen Inc. will be added as the only PCSK9 inhibitor on the CVS/caremark commercial formularies. The decision comes after a thorough evaluation of two new PCSK9 inhibitor therapies, which were approved by the FDA earlier this year. "CVS Health is committed to providing high-quality medications for our clients and their members at the lowest possible cost. We have determined that choosing a single PCSK9 inhibitor for our commercial formularies allows us to get the best price possible for clients and preserves our commitment to deliver the best care available," said Troyen A. Brennan, MD, MPH, executive vice president and Chief Medical Officer, CVS Health. Per the company's standard approach, the CVS/caremark national Pharmacy and Therapeutics (P&T) Committee carefully evaluated both of the currently available PCSK9 inhibitors and determined the drugs to be therapeutically equivalent, a decision that has been corroborated by consultation with board-certified specialists in both cardiology and endocrinology. The P&T Committee is composed of independent, external experts, including clinical pharmacists and physicians, who evaluate the clinical appropriateness of formulary changes on a regular basis. "We believe patients should have access to the right medication, at the right time and for the right reason. We anticipate that for most members with high cholesterol, statins will remain the standard of care, given long-standing evidence that they prevent heart disease and the fact that they are extremely cost-effective," Brennan added. While PCSK9 inhibitors represent a clinical breakthrough for people with very high cholesterol, the CVS/caremark cholesterol management approach starts with statins, the backbone of treatment for millions of American adults who have high levels of low-density lipoprotein cholesterol (LDL-C). For the small percentage of patients with high cholesterol who do not achieve their treatment goals with a statin or other alternative therapies, PCSK9 inhibitors may be necessary. CVS/caremark recommends utilization management strategies to clients to ensure appropriate patient access while helping to contain cost.