Difficulties getting PCSK9 drugs authorized are no surprise, but a new study covering nearly all Americans with prescription drug coverage of any type gave even more extensive evidence of .
The study published in Circulation: Cardiovascular Quality and Outcomes (and funded by manufacturers of one PCSK9 drug) examined a proprietary database on policies governing nearly everyone with public and private insurance including prescription drug coverage in 2016.
Prior authorization "requirements for PCSK9is are greater than for selected other drugs within the cardiometabolic disease area, raising concerns about whether payer policies to discourage inappropriate use may also be restricting access to these drugs in patients who need them," the group concluded, noting three- to 11-fold more prior authorization criteria or fields on forms and more policies requiring medical records for supporting documentation versus ezetimibe (Zetia) and liraglutide (Victoza).