A cholesterol-cutting drug from Amgen succeeded in lowering patients’ risk of cardiovascular trouble in a huge clinical trial — but the results, announced Friday, may not be good enough to prompt insurers to cover the expensive drug for millions of patients.

Amgen’s treatment, called Repatha, met its goals in a two-year trial on more than 27,000 patients with heart disease who were already taking a maximum dose of statins like Lipitor and yet still had stubbornly high cholesterol. Those who got Amgen’s drug were 15 percent less likely to suffer a bad outcome, defined as heart attack, stroke, hospitalization for chest pain, placement of a stent, or death.

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  • “However, looking at death rates alone, there was no significant difference between the two groups.”
    No change to all cause mortality indicates this drug has serious side effects. Yet it will probably be marketed to any and all identified by the industry as having “high cholesterol.” Statins have been marketed for years to lower cholesterol and cardiac events and while it’s benefits have been attributed to lower cholesterol, objective sources insist statin benefits are due to anti inflammatory properties. I’d be interested in hearing more about the actual biochemical mechanisms of this class of drugs.

  • This article asks the exact wrong questions. Why would the insurance company want to cover something this ridiculously expensive? Even if it was a miracle life saver, which it’s not, this only ensures that we all pay more and more of our living just to stay alive. Drugs are far over priced, and getting worse, not better. Don’t tell me about research costs. Show me results and give me a fair price, or spend your life doing something useful.

  • I suggest insurance companies not cover it.

    First of all I’m not all that excited because cholesterol lowering drugs have so far generally turned out to be both not very effective and very bad for you.

    Second, when insurance companies refused to pay $500 a month to cover an entire class of drugs for the common health problem GERD, within months, said drugs were available over the counter for the amount most people with insurance would pay in copays.

  • It would be interesting to find out which type of LDL cholesterol that this drug reduced. Type A (large buoyant ) LDL cholesterol is generally benign while type B (small particle) LDL cholesterol is the type generally associated with heart attacks. If the researchers did not measure this information directly, then one can look at the effect on triglycerides to infer a result for LDL type. Type A LDL is more common in patients with high LDL and low triglycerides while type B LDL is more common in patients with high LDL and high triglycerides.

    Ronald Krauss, MD, who teaches pediatric endocrinology at UCal SF, has done a lot of work in this area.

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