Observational studyCirculation2017
Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitor Therapy: Payer Approvals and Rejections, and Patient Characteristics for Successful Prescribing.
Observational study in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 56 citations in OpenAlex.
- Cardioprotective therapy in type 2 diabetes guided by a proteomic risk model: A randomized trial.American journal of preventive cardiology · 2026Article
- Use of PCSK9 Inhibitors Among Patients Receiving Immune Checkpoint Inhibitors for Cancer.JAMA network open · 2026Article
- Harnessing mRNA for heart health: a new era in cardiovascular treatment.Theranostics · 2025Review
- Impact of manufacturer-initiated list price reduction on patient out-of-pocket costs forJournal of managed care & specialty pharmacy · 2024Article
- The importance of LDL-C lowering in atherosclerotic cardiovascular disease prevention: Lower for longer is better.American journal of preventive cardiology · 2024Article
- Treatment intensification with bempedoic acid to achieve LDL-C goal in patients with ASCVD: A simulation model using a real-world patient cohort in the US.Atherosclerosis plus · 2024Article
- Is there a role for earlier use of combination therapy?American journal of preventive cardiology · 2024Article
- An improved method for estimating low LDL-C based on the enhanced Sampson-NIH equation.Lipids in health and disease · 2024Article
- Disparities in PCSK9 Initiation Among US Veterans with Peripheral Arterial Disease or Cerebrovascular Disease.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2023Article
- Disparities in adoption of new diabetic therapies with cardiovascular benefits.Diabetes research and clinical practice · 2023Article
- A strategy to identify event specific hospitalizations in large health claims databases.BMC health services research · 2022Article
- Precision Reimbursement for Precision Medicine: Using Real-World Evidence to Evolve From Trial-and-Project to Track-and-Pay to Learn-and-Predict.Clinical pharmacology and therapeutics · 2022Review
- PCSK9 Inhibitors in the Management of Cardiovascular Risk: A Practical Guidance.Vascular health and risk management · 2022Review
- Trends in PCSK9 Inhibitor Prescriptions before and after the Price Reduction in Patients with Atherosclerotic Cardiovascular Disease.Journal of clinical medicine · 2021Article
- Longitudinal management and outcomes of acute coronary syndrome in persons living with HIV infection.European heart journal. Quality of care & clinical outcomes · 2021Article
- Factors Associated With PCSK9 Inhibitor Initiation Among US Veterans.Journal of the American Heart Association · 2021Article
- Real-world utilization of pharmacotherapy with new evidence-based cardiovascular indications in an academic preventive cardiology practice.American journal of preventive cardiology · 2021Article
- Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.Circulation · 2021Article
- A regional analysis of payer and provider views on cholesterol management: PCSK9 inhibitors as an illustrative alignment model.Journal of managed care & specialty pharmacy · 2020Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundProprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are a novel class of medications for patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease requiring additional lipid lowering beyond dietary measures and statin use. Because of the drugs' high cost, rates of prescription approval by payers may be low. We aimed to identify payer approval and rejection rates for PCSK9i prescriptions and the potential factors influencing these rates.
methodsThis is a retrospective, descriptive cohort study using nationwide pharmacy claims linked to electronic medical records from a nationwide data warehouse. The data set includes >220 million patients from all 50 states and all payer types with 5140 distinct health plans. PCSK9i prescriptions were submitted for 51 466 patients in the pharmacy data set. The main outcome was approval or rejection of PCSK9i prescription claims. Factors associated with approval and rejection of these medications in the United States were assessed.
resultsAmong patients who were prescribed a PCSK9i, 47.0% were approved for coverage by the payer. Variables that were associated with PCSK9i approval included age >65 years (
conclusionsRates of approval for PCSK9i therapy are low, even for patients who appear to meet labeled indications. Although a combination of clinical characteristics increases the likelihood of approval, payer type is the most significant factor.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.