- CVS Health has chosen to put the PCSK9 inhibitor Repatha (evolocumab from Amgen) on its formulary instead of Praluent (alirocumab from Sanofi/Regeneron). Both drugs have powerful cholesterol-lowering capabilities and are priced in the $14,000-per-year range.
- According to the chief medical officer of CVS Health, Dr. Troyen Brennan, once CVS Health determined that Repatha and Praluent were therapeutically equivalent, it became all about price negotiations. It should also be noted here that Repatha has an easier dosing schedule than Praluent.
- The decision by CVS Health is in direct contrast to the decision by mega-PBM Express Scripts to put both drugs on the formulary.
Several months before either of the available PCSK9 inhibitors were approved, CVS Health publicly declared its intention to rein in costs associated with these drugs, which reduce LDL-C levels by roughly 60%. At that time, CVS claimed that the estimated costs of the soon-to-be approved PCSK9 inhibitors would cost between $7,000 to $12,000 per year and that total costs will reach $150 billion per year.
As it turned out CVS's estimates were on the low side; however, CVS was at the forefront of a movement to rein in related costs by carefully vetting patients and reverting to use of high-potency statins---which cost hundreds of dollars per year---whenever possible.
CVS Health will start covering use of Repatha in selected patients on December 1.