This week the Food and Drug Administration approved the second powerful anti-cholesterol drug known as a PCSK9 inhibitor. Modern Healthcare reports that
The FDA approved Repatha, an injectable drug made by Amgen that lowers a person's “bad” cholesterol level. It can be used only for patients who have certain inherited conditions or a history of serious heart ailments. Estimates put that patient base at around 5 million to 10 million people. These types of cholesterol drugs are called PCSK9 inhibitors.Oh joy. Insurers and PBMs are evaluating their coverage rules for these expensive drugs and the existence of competition should be helpful. Nevertheless, according to an Aon Hewitt survey reported by Fierce Health Payer
Repatha's approval came about a month after Praluent, another cholesterol drug in the same class. Sanofi and Regeneron Pharmaceuticals make Praluent, which costs $14,600 a year for a normal course of treatment. Repatha is slightly cheaper at $14,100 a year.
Observers view the cholesterol drugs as potential budget-busters for public and private insurers.
In closing, here's a link to a useful NARFE article on the self plus one enrollment type which is new for 2016. The FEHBlog agrees with NARFE's reminder that "you must actively change from a Self and Family to a Self Plus One option; your agency or OPM will not automatically change your enrollment."[P]harmacy cost trends will rise by 10 percent when employers renew their health insurance plans for next year. That's up from 6.3 percent at renewal last year.What's particularly noteworthy is that increase in pharmacy costs includes an almost 23 percent rise in specialty drug prices, especially medications for cancer and cholesterol. That's up from an 18 percent increase in 2014.