Hmmm, maybe but I wouldn’t expect a sea change myself. The reason insurance is able to get away with not covering pcsk9 inhibitors is because statins in theory provide a similar benefit for a fraction of the price, and so they can gatekeep access by requiring patients to take statins first before providing prior authorization.
Now, structurally Repatha is straight up more expensive to manufacture and deliver to patients than a peptide like enlicitide, as the former is a biologic. And if a competitor decides to manufacture a biosimilar when Repatha comes off patent in 2030 that could also help cut the price of drugs in this category. But there’s really nothing cheaper than statins, so I would expect insurance agencies to continue to withhold prior authorization.
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Hmmm, maybe but I wouldn’t expect a sea change myself. The reason insurance is able to get away with not covering pcsk9 inhibitors is because statins in theory provide a similar benefit for a fraction of the price, and so they can gatekeep access by requiring patients to take statins first before providing prior authorization.
Now, structurally Repatha is straight up more expensive to manufacture and deliver to patients than a peptide like enlicitide, as the former is a biologic. And if a competitor decides to manufacture a biosimilar when Repatha comes off patent in 2030 that could also help cut the price of drugs in this category. But there’s really nothing cheaper than statins, so I would expect insurance agencies to continue to withhold prior authorization.