Specialty Pharmacy Continuum: UMass Medical School pharmacist says PCSK9 value-based contracts will make them more affordable and put focus on adherence

June 07, 2016

A UMass Medical School clinical consultant pharmacist says value-based contracts for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a new class of cholesterol-lowering drugs, will lead to lower prices and help patients decrease cholesterol levels, according to an article in Specialty Pharmacy Continuum about an agreement Cigna has reached with Amgen and Sanofi/Regeneron.

The valued-based contract “is a positive trend in that it ideally will make the drugs more affordable and make sure there’s a focus on attaining cholesterol goals,” Mark Tesell, PharmD, BCPS, a clinical consultant pharmacist in Clinical Pharmacy Services, a unit within UMass Medical School’s Commonwealth Medicine division, told Specialty Pharmacy Continuum.

The agreement covers both Amgen’s evolocumab (Repatha) and Sanofi/Regeneron’s alirocumab (Praluent). Manufacturers’ reimbursement will be based on how well the patients respond to the medications, according to the June 6 article.

Value-based contracts help patients achieve cholesterol goals because manufacturers will want to make sure patients take the medication properly, Tesell told Specialty Pharmacy Continuum. “In the trials of these drugs, most patients have substantial drops in their LDL cholesterol. When a patient isn’t responding, it’s likely because they are not adherent or not taking the drug properly,” Tesell said.

Though Tesell told Specialty Pharmacy Continuum use of PSCK9s has been slow initially, he expects it will increase as more evidence-based data is collected.

“In the handful of patients we have had on these drugs, we’ve definitely seen the significant drops in LDL cholesterol that you’d expect given the trial findings. But I think providers and payors are still awaiting the outcomes data expected to come out later this year and early next year. Once we have more confirmatory data that these drugs do decrease the risk of heart attack and stroke, I think we’ll slowly see increased use, starting with the most complex patients,” Tesell said.

Tesell presented on using PCSK9 for managing uncontrolled cholesterol at Asembia's 2016 Specialty Pharmacy Summit last month in Las Vegas.

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