Prime Therapeutics co-prefers Praluent, Repatha to reduce cholesterol

Pharmacy benefit manager Prime Therapeutics of St. Paul, Minnesota recently added two FDA-approved cholesterol lowering drugs to its preferred national drug list.

Sanofi/Regeneron Pharmaceutical's Praluent (alirocumab) and Amgen's Repatha (evolocumab) are PCSK9 inhibitors intended for use in individuals with established cardiovascular disease or whose high cholesterol can't be lowered with statins.

Under the co-preferred arrangement, Prime's Medicaid and Medicare members will have access to both medicines, although a trial of Praluent is required for those on the latter health insurance. Additionally, Prime entered into outcome-based contracts with Sanofi/Regeneron and Amgen that protects Prime's clients from unanticipated increases in utilization and provides clients with additional payments in the event of poor adherence.

“After carefully evaluating both drugs and consulting with our payers, we’re extremely confident co-preferring the PCSK9 medicines offers the best care and competitive savings for our members and clients,” Pete Clagett, SVP for integrated care and speciality at Prime, said.

Despite the co-preferred decision, Prime still urges the use of statins before resorting to PCSK9 inhibitors as they are expensive and are still being evaluated for effectiveness in reducing and preventing heart attacks/heart disease. Moreover, Prime has found that statins are significantly underused by the majority of individuals with established heart disease.