ALEXANDRIA, Va., March 30, 2016 /PRNewswire-USNewswire/ -- Patients with high cholesterol should use proven and less expensive therapies, such as statins, before trying the new and more expensive class of specialty cholesterol drugs known as PCSK9 inhibitors, according to recommendations published in the April 2016 issue of the Journal of Managed Care & Specialty Pharmacy (JMCP).
The document also calls for developing management strategies that ensure PCSK9 inhibitors are targeted to patients who would derive the greatest benefit.
The recommendations stem from a Sept. 16, 2015, Academy of Managed Care Pharmacy (AMCP) Partnership Forum titled "Driving New Advances in Dyslipidemia Management." The event gathered more than 40 experts from health plans, pharmacy benefit management companies, specialty pharmacies and medical societies to suggest modifications to current treatment guidelines for dyslipidemia (e.g. high cholesterol) in light of the new PCSK9 inhibitors coming to market.
"It's important to use new therapeutic advances in the most efficient manner possible," says AMCP CEO Susan A. Cantrell, RPh, CAE. "The combination of a prevalent chronic condition with new expensive treatment options makes it imperative that health care decision makers have the long-term clinical, financial and real-world information they need to fully evaluate the value of drugs."
Long-term clinical benefits of PCSK9 inhibitors are not yet fully elucidated, creating a complex situation for third-party payers who must determine how to allocate limited resources, the proceedings note.
Forum participants suggested that prior authorization requirements could support the goal of ensuring proven therapies such as statins are first fully utilized. Participants also recommended greater collaboration and improved information sharing among stakeholders, as well as increased collection and evaluation of real-world evidence, and use of cost-effectiveness analyses.
Looking ahead, participants called for the development of a national database to gather more meaningful data regarding the impact of specialty medications like PCSK9 inhibitors on clinical outcomes. Such a database would be invaluable for determining the real-world impact of specialty medications, and would support the development of sensible third-party payer benefit structures, coverage decisions, medical policies and risk-sharing contracts.
The forum was sponsored by Lilly USA, LLC, MedImpact Healthcare Systems, Inc., Merck & Co., Inc., PerformRx, Pfizer Inc. and Sanofi.
Current guidelines to treat high cholesterol were created before the arrival of PCSK9 inhibitors. A February 2015 Health Affairs article estimates the new therapies could add $200 billion to annual health care spending.
The Academy of Managed Care Pharmacy is a national association of pharmacists and other health care practitioners who apply sound medication management principles and strategies to improve health care for all. AMCP's more than 8,000 members develop and provide a diversified range of clinical, educational and business management services and strategies on behalf of the more than 200 million Americans covered by a managed care pharmacy benefit. www.amcp.org.
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SOURCE Academy of Managed Care Pharmacy