AMCP partnership forum: Driving new advances in dyslipidemia management

Abstract

Proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors are specialty medications approved for the treatment of dyslipidemia. Because dyslipidemia is a prevalent and chronic condition, the costs associated with PCSK9 inhibitors must be carefully weighed against the benefits that they provide. However, the long-term clinical benefits of these agents are not yet fully defined, creating a complex situation for third-party payers who must determine how to allocate limited resources. To engage national stakeholders in a discussion of how to wisely use PCSK9 inhibitors in health care, the Academy of Managed Care Pharmacy organized a forum in Washington, DC, on September 16, 2015. The forum began with presentations reviewing the current environment for dyslipidemia treatment. Following these presentations, participants engaged in discussions regarding how to best select patients for treatment based on current treatment guidelines, how managed care pharmacy can best manage high-cost specialty products that may be indicated for large numbers of patients, and how managed care organizations can use real-world evidence to assess the impact of evolving treatment guidelines and options. Participants called for the development of a national database to gather more meaningful data regarding the impact of PCSK9 inhibitors on clinical outcomes. Such a database would be invaluable for determining the real-world impact of specialty medications and would support the development of sensible third-party payer benefit structures, coverage decisions, medical policies, and risk-sharing contracts. In the meantime, participants recommended enhanced collaboration among stakeholders for improved information sharing, increased collection and evaluation of real-world evidence, use of available cost-effectiveness analyses, and the implementation of strategies that optimize the use of evidence-based therapies.