Author + information
- Chakkarin Burudpakdeea,b,
- Joseph Elassala,b,
- Velichka Valchevaa,b,
- Katherine Gorcycaa,b,
- Serban Iorgaa,b and
- Eli Rotha,b
Background: Alirocumab (ALI), a PCSK9-inhibitor, was approved in 7/2015, as an adjunct to diet and maximally tolerated statins for adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease, requiring additional lowering of LDL-C. We described the characteristics of patients (pts) prescribed ALI in the first months after approval, comparing pts with and without an ALI pharmacy (Rx) claim.
Methods: We identified ALI prescriptions (index date) from July – December 2015 using data from electronic health records (EHR), linked to healthcare claims. Other inclusion criteria were ≥1 Rx and medical claim pre-index and ≥1 Rx claim post-index. Clinical and demographic characteristics among pts with and without an ALI Rx claim were compared.
Results: Of ∼11 million pts in these EHR data, we identified 403 pts with ALI prescriptions (104 [26%] with and 299 [74%] without an ALI Rx claim). Among most variables, the clinical and demographic characteristics were similar for pts with and without an ALI Rx claim; mean age, 65 vs 64 years; mean Charlson-Quan Comorbidity Index, 0.28 vs 0.27; mean pre-index LDL-C [when available], 134 vs 132 mg/dL; recent acute coronary syndrome [ACS], 11% vs 8%; current use of any statin within 30 days before index, 30% vs 27%, and concomitant use of statins plus ezetimibe (all p-values > 0.05).
Differences were observed for gender (43% vs 57% female; p=0.020), non-ACS coronary heart disease (61% vs 48%; p=0.029), and those in the South Region (34% vs 49%; p=0.006), for pts with vs without an ALI Rx claim, respectively. More pts with an ALI Rx claim were also currently treated with lipid lowering therapies compared to pts without (58% vs 45%; p=0.024) and more had ezetimibe Rx claims, 29% vs 18%; p=0.024.
Conclusions: In the first months after US approval, 74% of pts with an ALI prescription do not have an ALI Rx claim in these data, despite having similar clinical characteristics and demographics to pts with an ALI Rx claim. These findings suggest that pts who might benefit from ALI do not obtain the drug despite having prescriptions. Provider and payer diligence is needed to ensure that pts receive prescribed ALI. Further data updates are forthcoming.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-060
- 2017 American College of Cardiology Foundation