When the Latest Treatments are Out of Reach, Familial Hypercholesterolemia Patients Suffer

According to a story from FHM Pakistan, a recent study revealed the familial hypercholesterolemia patients are at a greater risk of stroke, heart attack, and other cardiovascular problems when they cannot afford the latest drugs. The study found that this effect was noticeable over the course of just a single year. The new drugs in question are called PCSK9 inhibitors. These drugs are highly effective at reducing LDL cholesterol and are especially useful for patients who do not sufficiently reduce their cholesterol on statins alone.

About Familial Hypercholesterolemia

Familial hypercholesterolemia is a condition of elevated, abnormally high levels of LDL cholesterol that is caused by a hereditary genetic mutation. The mutation that causes the condition affects the LDLR gene which normally codes for a protein that removes LDL from the bloodstream. The primary symptoms are elevated LDL cholesterol, deposits of cholesterol in certain areas of the body (eyelids, iris, and tendons of the arms and legs), and early onset cardiovascular issues, such as coronary artery disease, strokes, heart attack, and atherosclerosis. While once considered rare, it is likely that many people with the condition live undiagnosed. Treatment may include statins or other medications, liver transplant, or other surgical operations. The true prevalence of family hypercholesterolemia remains unknown. To learn more about familial hypercholesterolemia, click here.

Costs Are Too High and Insurers Fail

The downside to PCSK9 inhibitors is that they are more expensive than more commonplace medications such as statins. The annual cost of treatment with these drugs in the US is around $14,000 annually. These costs can be a barrier even with health insurance. The researchers drew from a data pool of 139,036 patients with high cholesterol. From this group, 2,899 of them (2.1 percent of the total) had familial hypercholesterolemia. The scientists found that insurance companies rejected coverage of treatment two thirds of the time. In addition, 15 percent of patients chose not to fill their prescriptions at all, most likely because of the cost.

Patients whose claims were rejected saw a 16 percent increase of a life-threatening cardiovascular event compared to patients that used PCSK9 inhibitors for 338 days; for patients who opted not to fill the prescription, the risk was 21 percent higher.

Regardless of how effective a treatment, its impact will always be diminished by barriers to access. The study highlights the grim reality that the bottom line of insurance companies regularly endangers its customers when insurers choose to get in the way of treatment access.


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