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Top Doctors Say New Cholesterol Drugs Best for Limited Group

Panelists say that doctors shouldn’t prescribe these drugs to everyone

Top U.S. heart doctors said Thursday that newly developed cholesterol treatments costing more than $14,000 per year are best used for the small group of patients for whom they have been approved — at least for now.

The drugs are vastly more expensive than the statins currently used by tens of millions of people to help control high cholesterol. The new drugs have drawn scrutiny from health insurers who are concerned that they will be widely prescribed.

The physicians' views, detailed at a Rethinking Cholesterol panel presented by Harvard T.H. Chan School of Public Health in collaboration with Reuters, are not much different than those of some health insurers.

CVS Health, a pharmacy benefit manager, has set up a program that aims to limit the drugs’ use and has said that it would try to use competition to wring steep discounts out of Amgen Inc. and Regeneron Pharmaceuticals and Sanofi SA, who make the drugs. It is that competition that may help get drug prices down — an issue that featured prominently in the presidential campaign this week when Hillary Clinton unveiled a plan to cap drug costs.

"The price tag is exceptionally high. The good news is three different companies and potentially as many as five may have products in this arena soon, and hopefully competition will bring us there," Paul Ridker, a cardiovascular specialist at Brigham and Women's Hospital in Boston, said during the panel discussion. "This is the first time we are going to see the payers really exert their influence here as much as the physicians and the patients, and that's going to be an interesting twist for the story."

How much drugs should cost is a difficult question, the panelists said. An independent nonprofit organization that evaluates clinical and cost effectiveness of new medicines said earlier this month that these same cholesterol drugs would not be cost effective if used by the 3.5 million to 15 million Americans who could be eligible for treatment.

There are several trials under way aimed at determining how much these new drugs cut the risk of heart attacks and deaths.

Patrick O'Gara, former president of the American College of Cardiology, said he is concerned that people who think they are statin-intolerant will seek out this drug.

"Release of these medications in an unfiltered way to a large number of patients with statin intolerance is a very worrisome proposition at this point and time, looking ahead and thinking about cost," O'Gara said.

Source: Reuters; September 24, 2015.

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