It looked like a surefire way to make billions.
A year ago, two new drugs that used a novel mechanism to drive down cholesterol levels came on the market, and were promptly crowned as blockbusters in waiting. Analysts estimated sales at more than $3 billion a year.
But the two drugs have been commercial flops, in part due to a complicated reimbursement system that has frustrated doctors, confused patients, and left the biotech industry worried about the implications for other high-priced drugs in the pipeline.
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$14K a year? In whose universe? Yes, the AWP is about $14K a year but I’ve personally seen these meds go for over $300K a year by the time the claim got to the insurer. And that may be the real reason for the resistance to paying for them.
Still looking in the wrong areas after all these years. The whole cholesterol lowering bullshit industry is a scam. Look at the real culprits: processed food elavated blood sugars insulin resistance.
Agreed! These drugs are terrible but for some reason that thinking took hold among medical professionals. Once that “bull” gets taught in medical schools docs have a hard time letting go of the statin dispensing habit. There’s plenty of documentation out there discrediting statins but patients are afraid to stop taking that junk. Now the drug companies have come up with an “off-label” use by calling statins anti-inflammatories. After all, inflammation is bad for you. It certainly is,and is causative in coronary artery disease due to smoking, not fats. Spacedoc.com is a great website for info.
Shrinking middle class, jobs by the thousands headed to other countries, people with or without health insurance are choosing between food or NEW medications.
Statins came out with serious side effects of cooking the liver and later stripping the body of CoQ10 enzyme.
Rhabdomylosis has caused more harm than good by Statins. Hence pain management with opioids.
Hype, marketing, we have this new drug, people aren’t buying into it as there was harm. Look no further than Baycol!
Keep in mind the market demand to lower cholesterol is changing. As time passes fewer and fewer patients buy into the LDL bad cholesterol theory in heart disease. Plus memories of bad side effects from statins are still fresh in the public mind. Nobody wants to be a lab rat for these new drugs.
The article says refusal to pay will cause drug companies to not fund the cost of development of new products. However, it previously says that the high cost is due to the cost of promoting the drugs, which often outstrips the development costs. If their product performs well, it shouldn’t need hundreds of millions in promotion costs.
Isn’t that the truth—another thing the writer forgot–isn’t advertising tax deductible, so maybe they’re digging into our pockets several ways–findling ways to not pay taxes-which leaves us to basically pay for their roads or how anybody wants to think- then digging into our pockets so their CEOs can have a golden parachute
No proven life benefit. Ten times the price of statins when they were under patent. Burnt once by unreported, severe side-effects of statins. Twice shy. What’s the surprise?
If it’s not recorded, it doesn’t happen. I kept going in, and they wouldn’t do a urine test, no bun-creatine. They just put general vague muscle complaints.
Months later the doctor ordered a urine test- and he screamed what did I do to have black urine. He was putting down that I had rhamdomylisis from hiking and sent me to a specialist that sent me to PT. By that time, I couldn’t walk without assistence. Then I had a seizure in front of my PCP. He put down that I’m allergic to statins. That was removed from my chart this June. And I live in a state that is almost impossible to sue in and with liability caps.
As a sufferer of familial hyperlipidemia, PCSK9 inhibitors were an exciting development. Unfortunately, the main reason I haven’t been able to begin taking them is that my insurance provider denied coverage. Also of note is the means of administering PCSK9 inhibitors: they are injectables. This can be a turn off for some who are uncomfortable with consistent injection – although anyone with chronically high cholesterol would be used to getting blood drawn every six weeks or so.
It should also be pointed out that while two versions of generic rosuvastatin were released in the past year, Harvard Pilgrim simply priced them at the same price as Crestor and increased the cost of Crestor – resulting in no savings for opting for the generic version. Overall, the price of having high cholesterol with no control over it (as is such with genetics) has been skyrocketing over the past year.
As a retired nurse who has communicated with patients for over 35 years, I agree that the heart of medication refusal is mainly due to costs especially for the middle class who are continually being squeezed out of the Middle! Something has to give in our medical treatments that would allow these new drugs and not only the stains but many others to become more affordable for the average patient. It is sad when Medicaid patients can get them and we are paying for that as well but we can’t afford. I hope in the near future change will take place with radical Government change of power!
Medicare does not pay for everything, and we have co-pays that are sizable.. A medicine must be on the Medicare Pharmetical Formulary list. Then many Advantage Plans have pharmetical formulary boards that feel free to modify a doctor’s prescription-change it to something else. Then a pharmacy gets a script for a high priced self-pay, and the pharmacy tries to do you a favor by getting your plan to pay for it. Then the medicine is disapproved by the local advantage plan formulary board, and the script gets lost. Hey, I needed that med! meanwhile my doctor and I are trying other self pays that just don’t work too well, and even put you in the ER and referred to a specialist.
This is one of my favorites–GI clinic having meds scripts audited by the formulary board in an opiate witch hunt and reduce the NetWorks and Medicares costs. OK, I had a self-pay that was being prescribed by my GI. 6 weeks later, the GI nurses took it on their own to apprise this patient—I passed the phone to a student while I was on hold- I called GI 3 times a day, and my pharmacy twice. My PCP wasn’t supposed to take charge of this non-opiod script. I was in the ER, my classes left substitutes crying–My PCP wrote the scripts for me after that.
This is just the tip of the medicare iceberg