Women, Southerners, and Black and Hispanic Patients Denied Cholesterol-Lowering Medication More Often, Data Show

 New Report on Insurance Barriers for PCSK9 Inhibitors Featured at National Cardiovascular Health Policy Summit

WASHINGTON -- New data show that health plans reject prescriptions for cholesterol-lowering medication for women, southerners, and Black and Hispanic patients more often than for white patients. The findings appear in "Rejected: How Life-Saving Heart Medication Eludes Women, Southerners, and People of Color," a new policy brief from the Partnership to Advance Cardiovascular Health.

Key Findings

The report details 2019-2021 commercial insurance claims data for cholesterol-lowering PCSK9 inhibitors, which show that:

• Women are rejected 21% more often than men are
• Rejection rates in Arkansas are 67% higher than the national average, while rejection rates in Mississippi and Oklahoma are 29% higher than the national average 
• Black patients face a 20% higher rejection rate than white patients
• Hispanic patients face a 25% higher rejection rate than white patients

Certain health plans reject a disproportionate number of claims. Of plans with at least 500 claims for PCSK9 inhibitors:

Some plans rejected three-fourths or more of claims:

• Moda Health Plan (87%)
• Maxor Plus (86%)
• Federal Employee Benefit Plan (75%)

Several plans rejected about half of claims:

• Blue Cross Blue Shield Arizona (51%)
• Blue Cross Blue Shield Mississippi (36%)
• Blue Cross Blue Shield Arkansas (45%)

READ THE FULL REPORT

"This information is concerning," says cardiologist Dharmesh Patel, MD. "We see higher denial rates in communities that are already high risk for deadly cardiovascular events. Heart disease is the leading cause of death in the United States, and yet patients who most need FDA-approved medications to prevent adverse events are being denied."

Patel is president of the Partnership to Advance Cardiovascular Health.

About PSCK9 Inhibitors

PCSK9 inhibitors, which first came to clinic in 2015, are:

• Injectable drugs designed to lower high LDL cholesterol
• Typically prescribed to patients who cannot get their LDL cholesterol down enough through statins alone
• Shown to decrease LDL cholesterol by up to 70% and cut the risk of a heart attack by almost one-third

Manufacturers slashed the drugs' price by 60% in 2019, yet some insurers continue to block access.

The findings were announced during the fifth annual Cardiovascular Health Policy Summit hosted by the Partnership to Advance Cardiovascular Health. Patient advocates, clinicians, and policymakers gathered to discuss the barriers patients face in accessing these cholesterol-lowering drugs.

Original source can be found here.