1. Treatment patterns and patient characteristics among early initiators of PCSK9 inhibitors
- Author
-
Pallavi Rane, Dionne M. Hines, Jeetvan Patel, David J. Harrison, and Rolin L Wade
- Subjects
Male ,Time Factors ,Databases, Factual ,Endocrinology, Diabetes and Metabolism ,Patient characteristics ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Practice Patterns, Physicians' ,PCSK9 Inhibitors ,HeFH ,Utilization management ,Original Research ,Anticholesteremic Agents ,Antibodies, Monoclonal ,atherosclerotic cardiovascular disease ,Hematology ,General Medicine ,Middle Aged ,Treatment Outcome ,Drug Therapy, Combination ,Female ,Proprotein Convertase 9 ,Cardiology and Cardiovascular Medicine ,medicine.drug ,Adult ,medicine.medical_specialty ,Serine Proteinase Inhibitors ,Adolescent ,Pharmacy ,Formularies as Topic ,Antibodies, Monoclonal, Humanized ,Medicare ,Drug Administration Schedule ,Hyperlipoproteinemia Type II ,03 medical and health sciences ,Young Adult ,Ezetimibe ,Internal medicine ,medicine ,Humans ,Medical prescription ,Formulary ,LDL-C ,Aged ,Retrospective Studies ,business.industry ,Public Health, Environmental and Occupational Health ,statin ,Retrospective cohort study ,Cholesterol, LDL ,Atherosclerosis ,United States ,Vascular Health and Risk Management ,lipid lowering ,heterozygous familial hypercholesterolemia ,business ,Administrative Claims, Healthcare ,ASCVD ,Biomarkers - Abstract
Dionne M Hines,1 Pallavi Rane,2 Jeetvan Patel,2 David J Harrison,2 Rolin L Wade1 1Health Economics and Outcomes Research, IQVIA, Plymouth Meeting, PA, USA; 2Global Health Economics, Amgen Inc., Thousand Oaks, CA, USA Purpose: To describe patient characteristics and treatment patterns among early initiators of proprotein convertase subtilisin/kexin type nine inhibitors (PCSK9is) who initiated treatment within the first 6 months of market availability.Patients and methods: This retrospective cohort study used IQVIA’s longitudinal open-source point-of-sale pharmacy claims database (LRx) and PharMetrics Plus (P+) health plan claims database to identify patients initiating a PCSK9i between January 1, 2016 and June 30, 2016. The index date was defined as the date of the first PCSK9i prescription (index claim) during the enrollment window; patients were followed for ≥6 months postindex. Patient characteristics including use of baseline lipid-lowering therapy (LLT) and measures such as persistence and adherence to PCSK9i therapy were evaluated with respect to health plan type (commercial vs Medicare).Results: Overall, patients initiating PCSK9i (n=13,151) had a mean age of 66 years, and 51% were male. Approximately 67.4% of patients used some form of LLT (statin and/or ezetimibe) in the 24 months prior to initiating PCSK9i therapy. The proportion of patients covered by a commercial health plan (51.2%) was similar to that covered by Medicare (48.8%). Persistence on PCSK9i was marginally longer for patients with commercial insurance than Medicare (mean days on therapy 202.2 vs 198.5). Overall, 42.6% of patients discontinued their PCSK9i during the 180 days of follow-up.Conclusion: This study demonstrates that a large proportion of patients discontinue PCSK9i therapy at 30 and 90 days, which are the time frames for which many health plans require recertification to continue access to PCSK9i. Future studies looking at treatment patterns among patients who initiate PCSK9i therapy after the first 180 days once health plan formularies and utilization management criteria were finalized are needed to understand more comprehensively real-world PCSK9i usage patterns. Keywords: LDL-C, statin, atherosclerotic cardiovascular disease, ASCVD, heterozygous familial hypercholesterolemia, HeFH, lipid lowering
- Published
- 2018